OECS Secretariat, Castries, St. Lucia, Wednesday December 1^st 2010. Head of the OECS Secretariat’s HIV AIDS Project Unit (OECS HAPU), Dr. James St. Catherine, says the Unit’s service to OECS Member States in tackling HIV and AIDS has yielded successes in many areas.  However he adds that there is still significant room for improvement in aspects such as getting people to know their HIV status, treatment compliance, capacity to monitoring the safety and effectiveness of treatment, and the human resource and infrastructural support for dealing with cases of HIV and AIDS.

Dr. St. Catherine states that regarding quality treatment the region is doing far better than expected but it is based largely on the assumption that many more of those who are eligible for treatment are being found. To this end Dr. St. Catherine agrees that finding those who are eligible for treatment is difficult because global programs have fallen short of expectations He says finding persons who don’t know they are living with HIV could prove the biggest challenge. In this regard he recommends effective promotion and strategic upgrading of Health facilities infrastructure to provide privacy and most importantly client-sensitive staff to instill confidence in potential users to help attract those who are infected to seek treatment: “Before you do an HIV test you really need counseling and if you look at how our health centres are organized it’s difficult to have private consultation because one is being asked very intimate questions such as sexual pursuits and behaviours, so one needs to look at redefining the infrastructure. Once you get someone to come to you and they face stigma you lose them if you cannot give them an almost one-stop-shop arrangement where, in one session, you can do all you have to do. Once they have to return then the return rate of persons coming for their test results and follow-up can decrease. Despite all the positives strides we have made we have to look at our own capacity to deliver a more efficient service that can allow persons to have a one-stop-shop arrangement with us.”

He also suggested that the method of case finding be reviewed.

In terms of the quality of treatment, the OECS HAPU says they have accessed training from the University of the West Indies and the International Training and Education Centre on Health, for clinicians who deliver HIV care and treatment. However, more doctors need training: “If you are going to make sure that all who need treatment get treatment, then all those who provide treatment should be part of your machinery. Unfortunately at this point in time we have not had that success so when I talk about quality, it is with regard to those who have the capacity to deliver quality treatment. That is why we really need to satisfy the quantity of people who need treatment and ensure they get the quality of treatment needed. All who provide care should really be part of this mechanism for treatment or care.” Dr. St Catherine recommends the decentralization of services as a key strategy to help ensure the finding and treating of the majority of person’s living with HIV and AIDS: “The programme is now very centralized. Persons actually have to find where the services are available and sometimes this creates difficulty with accessing treatment and care.” He also commented on attitudes towards persons living with HIV and AIDS: “Perhaps there is need for retooling of the entire health care system on the approach to dealing with persons living with HIV and AIDS. There is need to make the provider atmosphere friendlier so it would be easier for those who are uncomfortable because of stigma and discrimination to come forward.”

Dr. St. Catherine’s comments are timely particularly in observance of  World AIDS Day. He was speaking to the OECS News Link  www.oecs.org about the successes of his Unit while acknowledging the support of the OECS Global Fund  Round 3 grant. Dr. St. Catherine says the Global fund Round 3 grant went beyond its normal arrangement to provide additional support for the OECS Member States. The Head of HAPU added that although the close-out activities under Round 3 of the Global Fund grant ended in November 2010, the care of people living with HIV and AIDS in the OECS will continue: “There are a few things which have helped us. The ethical issue of putting someone on treatment demands that you continue to treat that person for life, as is required by our public policy obligations. There is an expectation that funding will be available to the OECS to continue the treatment and care of people with HIV and AIDS under the PANCAP Global Fund Round 9 Grant. We shall soon be moving from Global Fund Round 3 to Global Fund Round 9 and I think the Global Fund is expecting that Governments will see the wisdom of maintaining the good things so that they become sustainable. Hence they expect more contributions from the governments.”

Looking ahead  Dr. St. Catherine says the PANCAP Round 9 support intends mainly to ensure that no one who is HIV Positive or at risk of becoming HIV Positive is denied treatment, prevention and care services. OECS Member States have submitted a proposal for a Global Fund Round 10 grant: “What we are looking at is to provide a more comprehensive package of services in the future, once Round 10 is approved.”

Dr. St. Catherine has also praised the OECS HAPU Staff for their quality of work. He said when the project started in 2005 less than 100 persons were receiving ARV treatment. He confirmed that now more than 600 people in OECS Member States are on ARV treatment at less cost than when the OECS Global Fund project started: “The price which was once 12 and 15 thousand dollars is now around 3 hundred dollars. There is also now a constant supply of the drugs which once did not obtain in every country. Through the OECS PPS there is an adequate forecasting system available, a good tendering system, proper distribution and an effective supply management network.”

Other improvements attributed to the Global Fund Round 3 grant include the implementation of minimum standards for care and treatment, the development of treatment and care protocols, expansion of screening and diagnostic testing, more and better outreach programmes that have strengthened prevention services and  infrastructural development.

Dr. St. Catherine says his team at OECS HAPU has demonstrated willingness to learn from and serve the OECS Member States: “I think one of the things I have admired about the team is the capacity to grasp and grasp quickly, and to take up the posture of service rather than attempting to persuade. It takes a lot of patience, listening and trying to find ways to make things happen. The countries have taught us a lot of lessons and I think the team was willing to learn and in the process there has been tremendous growth. My pains have to do with loosing people who I think have got to where they can begin to deliver at an even higher level what they can do very satisfactorily. We have grown as a result of learning and learning to serve. ”

The OECS Secretariat has been the Principal Recipient of funds from the Global Fund under Round 3 since 2005.

Subject concact; OECS HAPU 1-758- 458 1260 & (758) 453 7476

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