Implementation of the Declaration of Commitment on HIV/AIDS and The Political Declaration on HIV/AIDS - Statement by Mr. Shiraz A. Mohamed

I have the honour  to speak on behalf of the fourteen member states of the Caribbean Community (CARICOM), at this plenary meeting to review the implementation of the Declaration of Commitment on HIV/AIDS and the Political Declarations on HIV/AIDS.

I would like to use this opportunity to express appreciation to the Secretary-General for his report contained in document A/69/856.

CARICOM takes note of the extraordinary gains since 2000 of the global AIDS response which has resulted in a decrease of the number of new infections and AIDS related deaths in 2015.

We concur with the findings in the report that the work required to end this epidemic is far from over and that intensified efforts are needed to build on the impressive gains of the past.

 Madam President,

It is important to recognise that the transition from the Millennium Development Goals (MDGS) to the Sustainable Development Goals is upon us and with this, the realisation that several of the MDGs, especially those related to health and HIV will not be achieved. We are pleased to note that target 3.3. regarding the commitment to end the AIDS epidemic by 2030 was included in the report of the Open Working Group on the sustainable development goals. It means also that the existing AIDS related commitments and goals identified in the 2011 Political Declaration on HIV/AIDS to which this component of the UN General Assembly is dedicated, must be reconfigured and redirected to Defeating AIDS and advancing Global Health which is the theme of the soon to be released Report of the UNAIDS Lancet Commission.

I am pleased to report the significant progress that has been made in the Caribbean towards achieving the goals of the Political Declaration of the UN High Level Meeting (2011). Indeed this achievement is associated with several factors including:

Trends toward becoming the first region in the world to eliminate mother-to-child transmission of HIV.

A 52 percent decline in HIV infections among children between 2001 and 2012, due to 90 percent of pregnant women living with HIV receiving services to prevent mother-to-child-transmission;

A 49 percent decline in HIV incidence over the past decade

Reduced HIV prevalence from 1.5 percent in 2002 to 1.0 percent in 2012;

Availability of antiretroviral treatment  to 70 percent of those eligible, resulting in a major reduction in deaths due to AIDS and improved quality of life for people living with HIV;

Decreased HIV prevalence among female sex workers in several Caribbean countries;

Strengthened health systems and scaled-up of prevention, treatment, care and support services;

Substantial returns on investments from internal and external sources; and

Provision of regional public goods and services creating more affordable access to medicines and shared capacity in key areas.

These achievements are due in no small measure to the fact that the Caribbean region has pursued functional cooperation – in health, education, culture, crime and security and foreign policy - as an essential ingredient of its integration process. The areas of functional cooperation, especially health and education have outperformed its trade and economic components. The AIDS response more particularly led by the Pan Caribbean Partnership against HIV and AIDS (PANCAP), inaugurated in 2001 continues to be a best practice in the governance arrangement that includes, governments, private sector, civil society and development partners within a structured network and a Caribbean Regional Strategic Framework umbrella. It epitomises the true elements of shared responsibility and solidarity, the underlying philosophy of the 2011 Political Declaration.

Madam President,

Despite the overall gains, considerable challenges remain. The Caribbean has a mixed HIV epidemic, consisting of a low-level, HIV prevalence generalised epidemic in the adult population, and an unacceptably hyper epidemic among vulnerable and marginalised populations, including and especially men who have sex with men (MSM). A disturbing trend more recently is a spike in prevalence among young women which may also be related to the relatively high reported levels of domestic violence and other forms of sexual abuse against Caribbean women

The Caribbean through its CARICOM Council for Human and Social Development and the PANCAP network which expands beyond the CARICOM region to include the Dominican Republic, Cuba as well as the Dutch, English and French-Speaking Caribbean, has recognised the broader development agenda and accountability framework for AIDS within the post 2015 development Agenda. To this end it has highlighted the interconnections and potential synergies that break down the silos across the different sectors, placing emphasis on rights based movements that aim at social justice and equity: leaving no one behind.    

One illustration of this type of synergy is a creative programme by PANCAP, not without controversy, initiated in Guyana in late 2013 under the theme Justice for All. Its consultations in 8 countries so far include parliamentarians, civil society, youth and private sector. The Programme emphasizes that the HIV epidemic will not be controlled without significant reductions in the stigma and discrimination associated with HIV and AIDS.  It aims at creating a roadmap around five elements with targets that can be achieved in short, medium and long term scenarios.  The novelty of this exercise is that it shifts the emphasis away from the divisive to the cohesive approach which asks each stakeholder group to identify what it contributes toward ending the AIDS epidemic.

Already the First Ladies of the Caribbean led by Belize and Haiti in collaboration with UNFPA and the CARICOM Secretariat have embraced the concept launched by the UN Secretary General, with its variation “Every Caribbean Woman and Child” aimed at enhancing the health and wellbeing of women and girls through eliminating gender-based violence and adolescent pregnancies and protecting children from abuse.

In addition the Ministers of Health of the Region have urged Heads of Government to urgently consider strategies for joint action to ensure that the region continues to maximise the use of TRIPS-related flexibilities, including the Doha Declaration, which provides opportunities for Caribbean countries to expand access to low-cost, quality-assured pharmaceutical products and to pass laws to prevent patent ‘ever-greening’ practices.

This is in keeping with the recommendation of the Global Commission on HIV and the Law and the recent call by UNDP and the UN Special Envoys for HIV of the UN Secretary General to support access to affordable medicine as a human right.

While I have highlighted only some of the more creative Caribbean initiatives, the region is fully aware that ending the AIDS epidemic requires biomedical and behavioural approaches as well as global solidarity. Hence we applaud the initiative of the UNAIDS Executive Director in bringing together the Health Ministers of Africa and the Caribbean to focus on a roadmap to achieve shared responsibility and to fast track the approaches  that change the way we do business.

Madam President,

Changing the way we do business requires our leaders to demonstrate political will; civil society to maintain its activism; development partners  to provide adequate and sustained financing the efforts of ending AIDS; and strengthened national health systems. These among other indicators impose recognition that the 2011 Political Declaration, though still relevant, must allow for a framework that embraces the good practices in the AIDS response to advance global health, social justice and development. The key elements include collective leadership and engagement of the affected communities in decision making, investment in innovation and implementation research, pursuing operational convergence, building multi stakeholder collaboration and sustainable financing of the convergence of AIDS and global health.

Madam President,

In conclusion CARICOM is of the view that linkages with the AIDS response should be promoted across the post-2015 development agenda, particularly in the areas of poverty eradication, employment creation and the empowerment of women and girls.

CARICOM Member States will continue to take the necessary steps to create synergies at the country and regional level to achieve our targets on HIV and AIDS. In addition to seeking to advance South/South cooperation, we look forward to continued collaboration with our development partners to this end.   I thank you.