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Source: Corresponsales Clave (Key Correspondents)

When the COVID-19 pandemic hit the Caribbean, most countries ordered some sort of lockdown measures to prevent the spread of the virus. The closure of government entities, the transit of people, among other measures, forced PANCAP/CARICOM and its sub-recipients to devise innovative responses to keep the Global Fund’s regional grant on course.

The grant is aimed at the sustainability of services for key populations–including  men who have sex with men, female sex workers and trans women–in ten Caribbean countries, will be implemented until September 2022 and has as its Principal Recipient the Secretariat of the Caribbean Community (CARICOM).

We spoke with Rosmond Adams, Director of the Pan Caribbean Partnership Against HIV and AIDS (PANCAP), about the impact of the pandemic on the course of the grant. In this regard, Adams points out that “the pandemic has been very disruptive with the grant, since, as you know, it is a multi-country grant, throughout the Caribbean. Countries are being affected in different ways by the pandemic, which makes it very difficult to coordinate activities.”

When the pandemic began, as in many other regions, most of the activities had to be changed to a virtual modality. “Some of the health ministries we worked with closed completely, while others worked alternately, so it was very difficult at first. (…)”, says the director.

They had to face many challenges in purchasing supplies. “We were doing a self-test pilot and we had to buy the kits. With the disruption of the pandemic, it took us a long time,” he says. They also had to redefine the monitoring of the implementation of the activities to guarantee they were being carried out as planned. Due to travel restrictions, all validations had to be done virtually.

Finally, because HIV programs are quite small in Caribbean countries, the COVID pandemic also affected the availability of human resources, since, in most cases, HIV staff, including those in laboratories, had to respond to COVID follow-up, testing and treatment. “When we tried to engage programs in gender-based violence, social contracting or sustainability of the HIV response, they said they were very busy with the pandemic,” Adams says.

An Adapting Civil Society

We also spoke with one of the proposal’s sub-recipients. Vanessa Rosario Brito and Mélissa Jaar Guérin, deputy director and co-project coordinator, respectively, of the Center for Orientation and Comprehensive Research (COIN), shared the response experience in the context of the pandemic in the countries where this organization implements activities: Haiti, Dominican Republic and Cuba.

“The COIN never closed its doors,” says Rosario Brito, “and kept on implementing strategies so that services for key populations could continue.” These strategies were aimed at being automated, so that activities were implemented without exposing users, suppliers or key actors.

“We had meetings with organizations to change implementation models. We set in place online strategies. It took a lot of work not only because we needed to get organizations and populations to have access to the Internet, to connectivity, but also due to the reallocation of funds that this implied,” says Rosario Brito.

It is noteworthy that both governments and civil society organizations quickly adapted to work in the context of the pandemic. “Civil society organizations have adapted to the context of the pandemic and are resuming contact actions with communities,” says Adams.

Clinical care activities quickly adapted to the context of the pandemic, says Rosario Brito. Virtual appointments were scheduled and, for example, in Cuba, medicines were provided for three months.

One aspect highlighted by COIN officials was that in Cuba, for the first time, community networks received resources from the Global Fund through mini-grants. In that country, as well as in the rest of them, the organizations determine their own projects and their priorities, and they are given a budget that the same organizations decide how to spend, although, in some cases, it may be granted to umbrella organizations. This is an achievement in the way organizations in the Caribbean work, according to the interviewees.

Beyond HIV, Beyond Covid

Both Rosario Brito and Jaar Guérin highlighted the challenges of regular work in the three countries where they implement actions. In addition to the pandemic, the health response challenges and natural disasters, Cuba, Haiti and the Dominican Republic have to deal with a different political and social context in each territory.

In the case of Cuba, state regulations represent an additional challenge that needs to be overcome to ensure the success of the grant, as all the activities and the entire funding must be authorized by the government.

In the case of the Dominican Republic, in addition to the usual challenges and the crisis caused by the pandemic, 2020 was also shaded by a political polarization due to the general elections in the country, as afterwards, the change of authorities forced the reinforcement of some work strategies. “That put everything uphill. It took us a little more work, but we were able to carry out the trainings and meetings with congressmen to introduce some strategies (such as the anti-discrimination law),” says Vanessa.

In the case of Haiti, it is immersed in other priorities due to its socio-political situation.

Sustainability, Social Contracting and International Cooperation

The sustainability of the response is an issue the regional grant had also set its sight on. In this regard, one of the objectives was aimed at consolidating a favorable environment for social contracting. However, two aspects must be taken into consideration in the case of the Caribbean: its dependence on external resources and the impact of the pandemic on the regional economy.

Rosmond recognizes that the Caribbean is a region heavily dependent on external resources. “We had been pushing governments to invest more, but, with the pandemic, and tourism being the main income of the islands, that is going to be very difficult,” he acknowledges.

In the case of Haiti in particular, government agencies tend to compete with civil society organizations (CSOs) for funding. This requires different strategies because there is greater dependence on cooperation funds. “Most of the response to HIV is funded by international cooperation,” Melissa tells us. “We are working on strengthening the capacities of CSOs and on mobilizing resources so that they can obtain financing.”

As for the Dominican Republic, Vanessa tells us that, despite the challenges, progress was made regarding resource mobilization strategies and agreements with private entities for product sales, as well as to develop a business plan and grow and trade products with supermarkets. In Haiti, an audiovisual production company has been launched that will hire people from the community.

It is expected that, little by little, the usual pace of grants will be reestablished and the goals set will be achieved.