27-28 and 29 may pole was held the regional consultation to know the state of situation of national responses to HIV in Latin America and the Caribbean, with emphasis on the response of social security systems, and the system community during the COVID-19 pandemic .
The virtual consultation was organized by the Coalition PLUS Platform of the Americas and the Caribbean under the coordination of the Kimirina Corporation , a regional network made up of community associations from the Americas and the Caribbean region, involved in the fight against HIV and viral hepatitis and for the respect of the rights of the most affected populations, in coordination with the International Coalition for the Preparation for Treatment Latin America and the Caribbean (ITPC-LATCA) , global network of people living with HIV and people or entities that support them dedicated to ensuring access to quality treatment, care and services to all people living with HIV and marginalized communities.
The consultation had the broad participation of several key actors representing regional networks such as: REDLA +, REDCA +, RED DE JOVENES, ALEP / ITPC-LATCA, REDNAJ E CER, LACCASO, DVVIMSS , CORRESPONSALE S CLAVE, COQSIDA, AIDES, and others PFAC partners from different countries in the region working in the community response to HIV who shared information on the current situation and response in HIV prevention and care at the country and regional level , during the health crisis caused by COVID-19. Representatives of regional and international organizations such as the Pan American Health Organization (PAHO) and the Joint United Nations Program on HIV / AIDS (UNAIDS) were also present at the meeting, giving their feedback on the challenges and opportunities that we lived in the region in times of COVID-19.
The pandemic of COVID-19 came to make visible the inequality and inequity that exists in the region. A common denominator that made visible , was the precaried ad of the systems of health, which have been overwhelmed following the outbreak of the COVID-19. This has had a huge impact on people's lives, especially the most vulnerable groups such as people living with HIV, Transfeminine people, women sex workers, LGBTI communities, people deprived of liberty and people in human mobility, those who have been left out of the policies and response plans of governments.
This consultation allowed us to highlight some common challenges that the countries of the region have in relation to the response to HIV in times of COVID-19:
L os systems health issued protocols attention to what s PLWA in times of emergency , m uchos of care services for p eople living with HIV are suspended , including community systems given the restrictive measures imposed by countries . Barriers to access to testing for HIV, viral load, CD4 persist .
Prevention services for HIV is many countries have been suspended and l os health systems are focused on responding to the health crisis caused by COVID-19, leaving aside many diseases including HIV , in addition to l as measures The restrictions that have been adopted in many countries in the region to face the health crisis caused by COVID-19 did not take into account the specific needs of some populations and the effect that this would have on their lives, their health, and their socio-economic situation:
In the majority of countries, the governments in order to curb contagions, established specific days for the free movement of people, differentiating between women and men, which was discriminatory against trans and gender diverse people. Another aggravating aspect was also that compulsory social isolation measures and curfews have had a great impact on trans sex workers and women sex workers, who have been limited to exercising their work. The key populations have been strongly impacted by unemployment, poverty (the majority work in the informal sector) and face severe difficulties in terms of housing and food, among other causes.
The countries still do not have clear figures regarding the impact of COVID-19 in their communities and particularly in relation to people living with HIV (number of infected and deceased) , and the statistics show significant inconsistencies that do not allow evidence the true dimension of the impact of the epidemic.
COVID-19 has established a scenario that aggravates the socio-economic situation of the countries, due to social isolation measures, has promoted not only the loss of employment and the increase in informal work, which affects PLWHA potentially having than abandon your treatment.
With regard to Social Security, ome Institutes of Social Security in the region except Costa Rica and Mexico, they are not aligned or meet national standards as to the antiretroviral therapy ( ART ) , manage their own schemes outside the guidelines National technicians and have their own suppliers that do not guarantee the required stocks and their acquisitions are high cost, compared to national purchases, which has resulted in the countries being evidenced (even before the COVID pandemic- 19) Systematic interruptions of ART affecting a significant percentage of affiliated PLWHA
Despite the challenges in the region, community organizations have played an important role in guaranteeing the continuity of HIV care and prevention services , and above all , in supporting and accompanying the most vulnerable populations that have been seen. severely affected by the pandemic, maintaining its services in: Continuing care of services through telemedicine , delivery of ARVS medications at home , continuation of diagnosis and prevention programs , advice through social networks, virtual mental health support and the management and delivery of humanitarian aid, food and hygiene kits for the most vulnerable groups including people on human mobility.
The consultation concluded with a series of recommendations, the same that will serve organized civil society in the response to HIV the development of actions of political incidence, among others :
- Make a call to attention to the Social Security Institutes so that they align with national policies such as the Clinical Practice Guidelines for the prevention, care and treatment of HIV, as well as the unified purchasing system to avoid ruptures. of stock and the payment of over prices for the cost of ARVs.
- The urgency that all HIV prevention, HIV care and treatment services be reactivated and ensure access to these services for key populations facing HIV.
- It is imperative that screening for HIV, STIs, Viral Hepatitis, and the initiation of antiretroviral therapy for HIV continue.
- It is essential that social protection policies are created for the most vulnerable populations, particularly PLHIV, LGBTI people, women sex workers, among others, and that they be taken as priority populations for attention in the event of emergencies.
- Do not leave behind street populations and people in human mobility, considering all humanitarian aid measures deemed necessary.
- Promote processes of cohesion and articulation between the various actors in the response to HIV for the development of actions aimed at achieving policies and programs, for the work of combined HIV prevention and the achievement of the objectives committed by the countries and the UNAIDS region 90-90-90 and adopted by the SDGs to achieve zero AIDS deaths by 2030 and to reduce new HIV infections.
- E xycting that the commitments made by international development cooperation, and particularly South-South cooperation, between developed countries and those of low or middle income are reviewed, and activated to respond effectively to the current scenario of generalized crisis in the region, without abandoning the 2030 Agenda Objectives and supporting the participation of civil society .
César Bonifaz - Platform Coordinator of the Americas and the Caribbean of Coalition Plus
Paola Sánchez - Human Rights Corporación Kimirina