CHALLENGES and OPPORTUNITIES PANCAP at FIVE

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CHALLENGES and OPPORTUNITIESPANCAP at FIVE

• Edward Greene
• Assistant Secretary General
• CARICOM Community Secretariat

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Remembering Barry Wint

• Chief Medical Officer, Ministry of Health Jamaica
• Programme Manager Health Sector Development,
  CARICOM Secretariat
• Chair Interim Committee for the Inauguration of
  PANCAP 1998-2001

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ContentWhat is the
contextWhy this type of partnershipHow can a
regional network function effectively which
factors spur changeswho are the change agents
Where is the partnership heading after five
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1.What is the Context?

• Demographic/Epidemiological
• Trends
• Geography Small size/vulnerability
• Economic impact on GDP
• Social equity and social protection
• Political Advocacy and public policy

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AIDS cases CAREC Member Countries
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(No Transcript)
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• The economic impact of HIV/AIDS
• Direct and indirect costs of the illness in those
  persons already affected US300M
• Direct and indirect costs of increasing numbers
  to the treatment pool unless epidemic rate is
  slowed US500M.
• Aggressive prevention required.

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Principal causes of mortality( of total
mortality)
CAUSE OF DEATH AGE ROUPS 15-24 25-44
HIV/AIDS 13.6 28.5
HOMICIDE 19.8 10.2
MVAS 9.2 4.7
SUICIDE 4.5 2.7

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General population
30 000 BD
2500
Monthly income Per capita
2000
1500
Monthly consumption Per capita
1000
500
Savings/ Disavings
0
500
Source based on preliminary analysis of the
HASSUS, Barbados 2003 (Courtesy of S. Adamakoh)
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Responding to the Context?

• Challenge
• Increasing spread a so- economic and political
  issue
• Development not possible when our productive work
  force is dying

• Opportunities
• Making the case on the basis of empirical
  information
• Dramatizing the effects for the political leaders
  to see clearly that action NOW was essential

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2. Why a Partnership of this Nature?

• Previous experience with functional cooperation
• Expediency
• Leadership
• Goodwill

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NGO PLWA
REGIONAL AGENCIES
NGO PLWA
DONOR PARTNER
PANCAP
UN AGENCY
CIVIL SOCIETY
REGIONAL AGENCY
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Major challenge 2001No scriptNo
modelNo facsmile
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Creating the partnership

• Challenge
• Identifying a focal point
• Deciding on the first principles
• Grapple with a workable structure
• Persuading partners
• Overcoming skepticism

• Opportunities
• Building on the work of the Interim Committee
  based on research
• Drawing on CARICOMs experience in functional
  cooperation
• Finding willing partners
• Visionary political Leaders (will)
• Pledges from development partners

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How is a regional network to function
with maximum efficiency?3-ones (UNAIDS
2002)PLAN CRSF 2001COORDINATION RCMME
Resource Mobilization Utilization
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CRSF
PREVENTION
ADVOCACY
RESOURCE MOBILISATION
INSTITUTIONAL STRENGTHENING
CARE TREATMENT
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Stigma Discrimination
STIGMA
STIGMA
PREVENTION
ADVOCACY
PCU
PANCAP
PCU PANCAP
PCU
PCU
INSTITUTIONAL STRENGTHENING
CARE TREATMENT
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IMPLEMENTATION

COORDINATION
PCU
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PCU Staff distribution core and CCS counterparts
Staff Core 2002-4 Core 2003-5 Core 2006-7 CCS Counterpart 2002-4 CCS Counterpart 2004-2006
Professional 2 4(7) 12 4 5
Support - - 3 3 2
Total 2 4(7) 15 7 7
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CARICOM SecretariatCounterpart Staff
Contribution

• 2001 24.26
• 2002 12.88
• 2003 5.04
• 2004 4.79
• 2005 5.41
• 2006 7.35
• Average 6.82

• Other counterpart Services
• Maintenance
• Rental of space
• Procurement
• Fiduciary
• ICT
• New Fiduciary status wirh EU an Asset in Donor
  Harmonization

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CARICOM Secretariat
Mainstreaming HIV/AIDS Education Port of Spain
DeclarationHealth Caribbean Commission on
Health and DevelopmentYouth Mini grants
programmeSport CWC 2007/Mello and SDCulture
EdutainmentARE FACTORS SPURRING
CHANGE?CSMEAccelerated Project
ImplementationHarmonization National/Regional
Harmonizationprogrammes and resource
mobilization
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Effective regional network

• Opportunities
• The process leading to the CRSF
• Acceptance of the CRSF
• The requirement of a Plan by the Multilateral
  Agencies
• Building on the work of key partners
• Investing in key regional partners
• CCS a logical/willing coordinating agent

• Challenge
• Plan establishing set of common goals and
  targets
• Governance agreeing on roles
• Overcoming the issue of turf
• Building a spirit of complementarity

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3.WHAT ARE FACTORS SPURRING
CHANGE?CSMEAccelerated Project
ImplementationHarmonization National/Regional
Harmonizationprogrammes and resource
mobilization
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Free movement of skilled persons
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SHARING REGIONAL FRAMEWORKS
MAXIMIZING EFFICENCIES
Education / Training Subsystem
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CARIBBEAN REGIONAL STRATEGIC FRAMEWORK CRSF
2007-10
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Factors spurring Change

• Challenge
• Changing philosophies on HIV/AIDS response
• Changes in the regional configuration
• Changing in grant conditions especially GFATM
• Making provision for OECS/OCTS
• Demands for greater national impact

• Opportunities
• More partners accessing grants
• Increasing international recognition of the role
  of multinational entities like PANCAP
• New level of regional integration
• Highlighting the benefits of regional public good
  

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3.CHANGE AGENTS?Accelerated
ImplementationPIPS Management tool Enhanced
RD capabilities HIV/AIDS A public Health
Issue HIV/AIDS reduction of S D
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Change Agents

• Challenge
• Institutionalizing governance and accountability
  structures
• Small staff at PCU
• Implementation of projects
• Technical responses
• synergies between regional and national
  programmes
• Duplication of roles among core partners

• Opportunities
• New role for RCM
• Expanding PCU staff
• Establishing an indigenous planning tool (PIPS)
• Agreement on gaps in CRSF
• Focus on revision of CRSF
• IS THE UNIVERSAL ACCESS PROCESS A USEFUL
  INDICATOR ?

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4.SUSTAINABILITY? Securing long term
and predicable financingInstitutionalizing
Champions for ChangePriortorizing strategic
communicationsImplementing the GIPA principle
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INTERNATIONAL COOPERATION IN THE
CARIBBEAN(Multi-year programme estimates)in mil
USMarch 2005
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UNAIDS Cosponsors Secretariat PEPFAR Haiti
62.3 m. Guyana 27.6 m.

TOTAL 518.2 mil.
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GFATM ELIGIBILITY LIST (LAC) ROUND 5(based on
information contained in Annex 1 to GFATM
Guidelines for 5th call dated Jan. 2005)
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Low Income countries Lower-Middle Income countries Upper-Middle Income countries NOT ELIGIBLE
FULLY ELIGIBLE ELIGIBLE BUT MUST MEET ADDITIONAL REQUIREMENTS/ Upper-Middle Income countries NOT ELIGIBLE
Haiti Belize CUBA Dominican Republic Guyana Jamaica Suriname Bahamas Barbados Dominica Grenada St.Kitts /Nevis St. Lucia St Vincent Trinidad and Tobago

 
 
 
 
 
 
 
  countries except
  for those listed
  Proposals approved in 1st R.
  Proposals approved in 1st R.
  Proposal approved in 2nd R
      Proposal approved in 3rd R.
   
   
P.S. P.S. P.S. P.S.
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STATUS OF AGREEMENTS/DISBURSEMENTS
CARIBBEANMarch 2005
4
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GFATM approved funds for Caribbean at risk of
being lost
250 250 200 125 100 50 0
Total 223.1 million
Commited through agreements
At risk
Millions
138.7 million
84.4 million
35.6 mil (Haiti Phase 2)
1 2 3 4 5
Years
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GFATM Eligibility Criteria Areas for
PANCAP AdvocacyLow Middle Income Countries Co
financing, focusing on poor or vulnerable
populations and moving over time towards greater
reliance on domestic resources..Middle-income
countries financing from domestic
resources.Upper middle Income countries
Portfolio Committee to review its current
restrictions
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UNIVERSAL ACCESS TO PREVENTION CARE AND
TREATMENT REGIONAL ROADMAP
Sustainable Funding Human Capacity Prevention Str
engthen Health Systems Research and
Development Political Leadership
GIPA
Stigma and Discrimination and Gender Equity
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FRAMEWORK FOR CHECK LIST

• First 5 Years
• Transforming idea into reality
• Setting short term
• Settling partnership roles
• Identifying Targets
• Strengthening of core partners

• Next 5 years
• Investing in Sustainable
• Growth
• Revising priorities for medium/ long term
• Redefining partnership roles
• Pursuing medium/long term targets
• Emphasizing Harmonization
• Universal Access to prevention care and treatment
  

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Check list of Integrated Results
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Learning Agenda Regional/National Imp
lementation roles Involvement of Civil
Society CTC/CBC/CVC Effective Intra Network
Communications ENEWS/ PANCAP Website Strategic
Communication Level of Resource
Mobilization
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Continuous Assessment Regional/National
Demographic/Epidemiological TrendsAnalysis of
economic implications of HIV/AIDSBasic Research
and RDME Targets and GoalsHIV/AIDS and
MDGsCARICOM SOCIAL Statistics Programme
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• RIGHTS
• Benefit from PRG
• Access to information
• Participate in Governance
• PANCAP Branding

• OBLIGATIONS
• Contribute to CRSF
• Report to RCM on HIV/AIDS Response
• Share best practice
• Contribute technical
• assistance
• Commit to Targets set
• Commit to Universal Access by 2010

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• The Future
• Universal Access to HIV/AIDS prevention, care and
  treatment