organisation of eastern caribbean states (oecs) report on the oecs gfatm hiv/aids project four...
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ORGANISATION OF EASTERN ORGANISATION OF EASTERN CARIBBEAN STATES (OECS)CARIBBEAN STATES (OECS)
Report on the OECS GFATM HIV/AIDS Project Report on the OECS GFATM HIV/AIDS Project
FourFourteenth Meeting teenth Meeting of the of the
PANCAP Regional Coordinating Mechanism PANCAP Regional Coordinating Mechanism
BarbadosBarbadosMarch 24 – 25, 2010March 24 – 25, 2010
Content:Content:
• Introduction
• Programmatic performance and
planned Actions
• Achievements
• Financial performance
• Future Options
IntroductionIntroduction
The OECS GFATM HIV/AIDS Project • Aim: To scale up ‘Treatment and Care’ for PLH
in six OECS countries
• Duration: 5-years: March 2005 to Feb. 2010
• Costs: Total for Project US$17.2m; GFATM Grant US$10.2m
• Principal Recipient: OECS Secretariat• Sub-Recipients: Ministries of Finance & Health• National Implementing Agents: Ministries of Health
Performance - Programmatic
(June 30th 2009)
IndicatorsPhase 2 Targets
Actual
1. Number of PLWHA receiving antiretroviral combination therapy in accordance with Caribbean Guidelines
459 561 122%
2.1 Number of people receiving HIV counseling and testing including the provision of the test results
69836 11874 17%
2.2. Number and percent of HIV-positive pregnant women receiving a complete course of antiretroviral prophylaxis to reduce the risk of mother-to-child transmission
108 44 40%
3.1 Number of facilities carrying out comprehensive clinical staging of PLWHA as per Caribbean Guidelines
6 7 120%
Programmatic performance
(to June 30th 2009):
IndicatorsPhase 2 Targets
Actual
5.1 Number of countries with a system in place to receive and respond to complaints of discrimination by people living with and affected by HIV/AIDS
5 4 80%
6.1 Number of countries using standardized monitoring and evaluation patient tracking system 6 5 83%
7.1 Number of PLWHA receiving care and support 654 574 88%
8.1 Percent (%) of people (15-49) who both correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions around HIV transmission
90 (%) NA
Planned actions - Planned actions - Indicator 2.1Indicator 2.1
• Revisit of the working definition for the indicator
• Collaborate with Partners to: – Increase uptake and institutionalize HIV rapid testing to
facilitate ‘same session’ results
– Secure access to • HIV confirmatory testing services, • CD4 proficiency testing and • QA/QC for related laboratory services
– Pursue the Certification of national Laboratories
• Promote behaviour change initiatives
Planned actions - Planned actions - Indicator 2.2: Indicator 2.2:
• Maintain– The over 90% coverage of ante-natal clients at MCH
clinics, – The provision of antiretroviral medications and – Access to polymerase chain reaction (PCR) testing
(Clinton HIV/AIDS Initiative);
• Promote the uptake (almost 100%) of these services by pregnant women;
• Request studies to more accurately determine the numbers of HIV positive pregnant women; and
• Advocate for improved HIV surveillance
Planned actions - Planned actions - IIndicator 5.1ndicator 5.1
The PR has moved to: (a) Identify some funding for the operations of the
Human rights desks/mechanisms in the OECS;
(b) Joined the PANCAP Technical Advisory Group (TAG) to address Stigma and Discrimination; and
(c) Initiate planning at country level and to negotiate technical Assistance to strengthen the Human rights mechanisms for tackling acts related to HIV/AIDS stigma and discrimination.
ACHIEVEMENTSACHIEVEMENTS
To respond to the capacity building needs to meet the agreed goals and targets through the development and establishment of:
Standardised Monitoring & Evaluation systems and Data collection tools
Standardised Financial Management systems for the project; and
Standardised Patient Monitoring and Tracking System (PMTS)
SYSTEMS STRENGTHENING
ACHIEVEMENTS ACHIEVEMENTS cont’d…cont’d…
In the areas of : Clinical staging, Treatment and care - Clinical
Mentorship programs through CHART for Doctors, Nurses and Pharmacists
HIV related Testing and Diagnosis – Support from CAREC, CDC and CCAS
Leadership – CHILI program Behavioral Change Communication – COMBI Data Management – Collaboration with PAHO Monitoring and Evaluation – Support from CHRC
HUMAN RESOURCE DEVELOPMENT
Major ChallengesMajor Challenges
• Knowledge of HIV status– Individual
– Country
• Behavior impact– Consumers/Individuals
– Providers
– Planners
– Policy makers
ConsiderationsConsiderations
• Institutionalization of PITC and rapid testing
• Surveillance systems strengthening• OECS Regional and national
information networks (including Information standards & QA/QC)
• An OECS PLH representative organization
• R&D to generate Strategic Information
• Effective and coordinated Behavior impact programs as per target group
Major ChallengesMajor Challenges
• Capacity – Local Human
resource
– Laboratory
– Information systems
• Funding & the attending conditions
ConsiderationsConsiderations
• Strengthening OECS Training institutions e.g. establish a designated OECS CHART center
• Strengthening Leadership in OECS• Research on strategies for retention of
personnel• Development of a tiered Laboratory
system
• Negotiations for more flexible terms and conditions
• An OECS regional HIV/AIDS Frame work based on the “Three Ones”
• Coordination of the partners contributions
Future IssuesFuture Issues
• Managing HIV/AIDS as a Chronic disease
• Managing HIV/AIDS as a Public Health issue
• Managing HIV/AIDS using a Human Rights approach
Future Directions**Future Directions**
• Mainstreaming HIV/AIDS in the health sector
• Strengthening Health and social sectors using ‘best practices’
• Adopting a Prevention/‘Disease aversion’ strategy
• Reduction of the vulnerabilities
• Comprehensive health sector planning and adequate resource allocation for HR
• Promoting a Human Rights culture• Empowerment of the MARPS• Establishment of Human Rights Commission• Reduction in Stigma and discrimination
** Influenced by strategic information, leadership, resources, sensitivities, absorptive capacities, etc
Financial performanceFinancial performance (to June 30, 2009):(to June 30, 2009):
-
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
9,000,000U
S$
Series1
Series2
Series1 7,844,805 6,359,435 5,505,294
Series2 81% 87%
Budget Disbursement Expenditure
Financial ExecutionFinancial Execution
Financial performance cont’dFinancial performance cont’d.:.:
-
100,000
200,000
300,000
400,000
500,000
600,000
700,000
Antigua Dominica Grenada St. Kitts &Nevis
St. Lucia St. Vincent
DisbursementsExpenditure
Disbursement versus Expenditure by Sub-Recipient from inceptionDisbursement versus Expenditure by Sub-Recipient from inception
Financial SituationFinancial Situation
Phase II Funding:
Approved Project Budget for Phase II (to February 2010)
Cash received to June 2009
Project Funds held by GFATM as at June 30, 2009
Disbursement requested for July 2009 to Feb 2010 (based on Work plan and cash-in-hand)
Grant Funds forecasted to be ‘Unrequested’ at end of February 2010
US Dollars:
$6,860,183
$4,320,844
$2,539,339
$555,677
$1,983,662
FUTURE OPTIONSFUTURE OPTIONS
• NO COST EXTENSION – 6 Month extension up to August 2010 plus 3 months ‘wrap-up’
• ‘CLOSE OUT’ PLAN – To bridge gap until Round 9 proposal (September 2010 to …)
• OECS TREATMENT OBJECTIVE within PANCAP Round 9 Proposal – 5 year funding for treatment (Originally September 2010 to August 2014)
• PEPFAR 2 US Caribbean Initiative
• OECS REGIONAL ROUND 10 PROPOSAL (OECS HIV/AIDS Strategic Plan)
THANK YOUTHANK YOU
Thank you!