The Caribbean has the highest incidence rate of reported AIDS cases in the Americas.  With between 350,000 and 590,000 Caribbean people living with HIV/AIDS, the region has an adult HIV prevalence rate between 1.9% and 3.1%, second only to Africa (7.5% and 8.5%).  As a whole, the Caribbean is facing a generalized epidemic.  HIV/AIDS is well entrenched here, with a national prevalence of at least 1% in 12 countries, all of them in the Caribbean Basin.  The most recent national estimates showed HIV prevalence among pregnant women reaching or exceeding 2% in eight countries:  the Bahamas, Belize,  The Dominican Republic, Haiti, St. Lucia, Suriname, and Trinidad and Tobago.

In the Caribbean, the HIV/AIDS Epidemic is fuelled by many underlying factors:

• Socio-cultural and religious taboos.

• Bio-medical deficiencies - lack of comprehensive management of PLWHA include ARV treatment

• Lifestyle issues - substance abuse, influences from external media, culture (tourism) with a growing brand name culture and modern information technology

• Lack of individual skills  - negotiation, creation and maintenance of healthy human relationships, sex education and protective behaviours

• Economic factors – disparities in income distribution within and between countries, economic hardship within a consumption market   ++

Source:  CAREC: Status and Trends of the Caribbean HIV/AIDS Epidemic 1982-2002

UNFPA CARIBBEAN’S RESPONSE TO HIV/AIDS

Prevention, the centrepiece of UNFPA's fight against the disease, is being integrated into reproductive health programming around the world including the Caribbean. Prevention includes promoting safer sexual behaviour among young people, making sure condoms are readily available and widely and correctly used, empowering women to protect themselves and their children, and encouraging men to make a difference.

• UNFPA Caribbean has implemented a UNFPA/OPEC initiative for HIV/AIDS Prevention for three countries in the Sub-region: Belize, Guyana and St. Lucia.  The projects have been designed to reduce vulnerability to HIV/AIDS among youth and mobile populations.

• UNFPA Caribbean provides support to Caribbean Governments for the development of HIV/AIDS National strategic plans and policies.  This technical assistance is backed by the Latin America and Caribbean Division (LACD) and the Technical Support Division at our NY headquarters.

Leadership as a Vital Tool Against HIV/AIDS

Recognising that UNFPA’s overarching strategic approach is to focus on sustainability through capacity-building and through the promotion of inter-sectoral and inter-institutional links, UNFPA Caribbean, in collaboration with international agencies, governments and NGOs,  organised a two-day sub regional meeting for Caribbean Parliamentarians on HIV/AIDS, entitled “Leadership as a Vital Tool Against HIV/AIDS” in June 2004.

Objective and Purpose of the meeting

To encourage continued political leadership, commitment and action among Caribbean Parliamentarians in the fight against HIV/AIDS in the sub region.

It was envisaged that the meeting would serve as an impetus to continued dialogue and raise greater awareness of the subject among Parliamentarians so that they are further enabled to mobilise the political will necessary to give top priority to advocating, proposing and reforming legislation to address the HIV/AIDS pandemic within their countries. 

Why Parliamentarians?

Most HIV/AIDS strategies have been focused on promoting actions at the health sector level and with high level policy makers, while this is critical, it is our belief that in addition to this focus, more attention should be placed on the role of Parliamentarians.  They are an important group of people who can be effective advocates and agents of social change in their countries.

At the country level, parliamentarians can mobilise the political will necessary to give top priority to and generate the commensurate budgetary allocations.  Additionally, parliamentarians can advance legislation incorporating a human rights and a gender perspective, and monitor the commitments agreed to by their governments on this particular issue.

Strategy

Thirty persons from eight countries in the Caribbean, participated in the meeting.  A bi-partisan approach was taken in that both Government and Opposition Parliamentarians were invited to attend along with representatives from HIV/AIDS Commissions and NGOs who formed a country team to work together on this common challenge. 

Team building began before participants left their countries.  They were informed as to the composition of their team, with the HIV/AIDS Commission/programme team members being asked to assist in providing their thoughts on the role of the Parliamentarians in the response to HIV/AIDS, as well as to make suggestions on how Parliamentarians could be instrumental in the implementation of activities in support of each country’s National Strategic plan.  This we thought would help all participants, particularly parliamentarians to be prepared in advance and thus contribute to the dialogue more effectively. 

Expected Outcome

The major expected outcome of the meeting was the creation by country teams led by the parliamentarians of concrete Plans of Action aimed at mobilizing support, using their position, clout and prestige as well as their networks across constituencies. 

Tactics Used

The development of individual country Action Plans was one of the key tactics used to avoid the usual broad recommendations that sometimes emanate from regional meetings and which are most times difficult to follow up and implement at a national level, thus impacting on sustainability.

Collaboration

It would have been uncomplicated and straightforward for UNFPA Caribbean to have gone ahead and organized this critical meeting on its own and simply invite others to participate.

Instead we sought an organizing partner in the Inter-American Parliamentary Group (IAPG) and lobbied the Government of Trinidad and Tobago to be the official host of the meeting.  Additionally we partnered with UNAIDS, the Resident Coordinator Systems in Jamaica, Trinidad and Tobago, Barbados and Guyana, CARICOM and CAREC/PAHO/WHO who provided technical and financial support in the implementation of the meeting. As a Country office with reporting responsibilities to the Latin America and Caribbean Division we also sought technical assistance and financial support from both the Technical Services Division and the Information, Executive Board and Resource Mobilisation Division (IERD). 

This approach established stronger liaisons with the partners and put the requisite mechanisms in place for continuity and follow-up.  Experience has dictated that one of the major weaknesses of sub-regional and regional meetings is the difficulty encountered, once participants returned to their countries, in translating the recommendations from the meeting into real action. 

MAJOR RESULTS

(1)  Clarification of the practical and hands on role that could be played by Caribbean Parliamentarians in the fight against HIV/AIDS.   ACTION – Development of Individual Country-specific action plans by country teams

(2)  Commitment of Parliamentarians to support and speed-up legislative action in their individual countries in the fight against HIV/AIDS   ACTION -  Adoption of Parliamentary Declaration.