The PANCAP Response to “Improving Access of HIV services to the Migrant Population”

The concept has been developed on basis of a fact-finding mission to the region conducted by EPOS and entails in-depth understanding of the situation in the Caribbean with regards to access to HIV-services not only for migrants but all citizens of the visited countries. The methodology thus builds on the interviews and discussions with representatives of implementing and advisory partners and stakeholders, including PANCAP. With over 80 members, the roles and responsibilities of PANCAP members require better definition and its managerial, structural and financial capacity for coordination needs to be improved. All its previous and current programs touched the topic of migration as a cross-cutting issue, but PANCAP now decided to approach this problem directly.

The main strategic objectives of the PANCAP HIV/AIDS Programme 2008-2012 are to improve universal access to HIV/AIDS prevention, treatment, care and support services, an improved inter-sectoral response to the epidemic, overall prevention of HIV transmissions, capacity development for HIV/AIDS services and monitoring, evaluation and research. Many countries in the region have underdeveloped social welfare systems that fail to protect vulnerable groups. The HIV/AIDS Program states that efforts in this regard have to be made to support the development of policies, programmes and legislations to promote human rights, specifically of undocumented migrants. In addition, the participation of these groups in the response to HIV/AIDS shall be improved and they should be included at all levels of decision making related to policy and implementation. Moreover, regional policies addressing HIV/AIDS related migrant issues will also be advocated.

The project will be embedded in and be part of the regional programme for HIV/AIDS, the Caribbean Regional Strategic Framework on HIV and AIDS 2008-2012. The project is planned for 2010-2013 and will, therefore, feed into the last phase of an already existing strategy. This situation will facilitate planning and implementation on the political level, as the general strategy is already agreed upon and signed by all national partners of the project, and it is used as basic guidance for planning of HIV/AIDS programmes on the national level.

PANCAP have explicitly expressed the need to provide regional guidance to national governments with a focus on migrants as a group which is highly vulnerable to HIV/AIDS. The project will cover areas that are currently under-financed, thus strengthening the overall programme outcomes. Moreover, the project will feed into the planning of the next period of PANCAP activities and will assist in shaping and defining the phase from 2012 onwards. The PANCAP strategy to fight HIV/AIDS in the Caribbean is organized around six priority areas:

1.    An enabling environment that fosters universal access to HIV prevention, treatment, care and support services.

2.    An expanded and coordinated multi-sectoral response to the HIV epidemic.

3.    Prevention of HIV transmission.

4.    Treatment, care and support.

5.     Capacity development for HIV/AIDS services

6.     Monitoring, evaluation and research.

The shared overarching objective is to decrease the transmission of HIV/AIDS by building capacity of Caribbean regional and national health systems to sustainably deliver highly effective, quality HIV/AIDS prevention, treatment, care and support services in the course of the project implementation. The envisaged direct benefit of the project is at the same time its module and phase objective, namely the creation of an enabling environment to improve access of migrants to HIV prevention, treatment and care in selected countries of the Caribbean.

Successful implementation of the module objective will contribute to the achievement
for the overarching shared objective, which is also in line with the Caribbean Regional Strategic Framework 2008-2010, and the National Strategic Plans for HIV/AIDs for each of the participating countries. Indicators and monitoring modalities at this level will make use of existing data and indicators, which is in line with the “Three Ones” Principle, of one national Monitoring and Evaluation System. This is also in compliance with the Paris Declaration,which emphasises harmonization of donor countries actions. At the level of direct benefit, specific project related indicators have been proposed for monitoring.The focus on “access” implies a strong role for the HIV service providers on the national level. Due to the relatively short timeframe of the project - two and a half years - it is unlikely that significant results on the level of the target group can be achieved on a broader scale by 2013, unless the current strong political will promotes the new approaches and ensures that legal provisions will be accepted in the first year of the project.

The four indicators will monitor the expected direct benefit of the project. The tight alignment of indicators and components will, without doubt, facilitate result-oriented project implementation and monitoring. The structure and indicators of the project directly are reflected in the “results-chain” of the project.