With the participation of representatives of UNAIDS, PAHO / WHO, members of the Coalition Plus, Frontline AIDS, Key Correspondents and other colleagues, both national and from the Americas and Caribbean region, and the previous words of welcome by Dr. Amira Herdoiza, who expressed that the results achieved were the product of assuming the responsibilities of the response in an articulated way, especially in the current times that one should not go back, but identify the impact and move forward, Kimirina, presented the report of the results of two consultancies, the first, on the evaluation of the Global Fund grant ECU-H-1129 of the “Project to support the National Goals in the elimination of HIV through community work in key populations”, and the second, the results of the systematization of the intervention methodology used for the work and reach of the key populations (gay men and men who have sex with men, Women Trans, Sex Workers and PLHIV) beneficiaries of the project, for the period 2017-2019.

The Global Fund approved the grant to the proposal presented by the Ecuador Country Coordination Mechanism -MCP- who, in turn, by public call, selected Kimirina as the Principal Recipient, for the civil society prevention component, a function that ended this June 2020, once the project closure has been completed.


The grant was focused on the development of the community HIV diagnosis system, in order to reach key seronegative populations, help them maintain their serological status over time, promoting behavioral change based on the acceptance of HIV testing as part of your healthcare routine, conducting HIV screening and diagnosis, and linking people with reactive / positive HIV diagnosis to the national health system.

Some results of the intervention:

In the session, via ZOOM, the results of the evaluation shown, by the representatives of the two external teams of consultants, showed that on average 90.28% of the people who participated in the evaluation considered that the execution of the project, it was in accordance with the priorities and needs of both key populations and those of public utility, related to the institutional needs for outreach support to these populations, since “it is considered that the care, accessibility and availability of antiretroviral treatment have improved” .

Another important aspect highlighted was that 91% considered intervention in key populations as relevant. Also, in the perception analysis of the attention and services provided to these populations, they considered that they responded to the expectations of the project beneficiaries (89%). The contribution of the intervention in the fulfillment of the national objectives related to 90-90-90 was recognized, as well as the adequate and understandable treatment of the impact of the HIV prevention messages delivered, the behavior change of key populations towards acceptance of HIV screening and diagnosis tests and other STI prevention and treatment methods.

The Global Fund assigns a rating to the performance of the Principal Recipient based on the fulfillment of expectations in relation to the goals to be achieved by the project, both in the process and at the end of it, ending Kimirina with a rating of A1 (see table below).


The results of the systematization highlighted that the constructions of the interventions themselves arose from a systematic process in which piloting constituted a fundamental element of lifelong learning in which the evidence from national and international studies was equally valued, as well as the contributions premises provided by community personnel and beneficiaries of actions, considered individually or through their grassroots organizations.

Kimirina's sense of "community" was expressed in all its spheres, from the collective construction of knowledge from national experts; Kimirina, the Ministry of Health and its operating units, as well as international contributions, aimed at specializing local work and interventions, providing the applied community model with technical foundation and excellent resolution capacity.

After the presentation of the results, Dr. Mónica Alonso from PAHO, expressed that the project had an advanced vision because it also focused on HIV negative people and not only on people living with HIV. She also highlighted the good evaluation methodology, on the high number of people reached and on the approach that the project achieved in bringing people closer to HIV prevention services. He considered it key to analyze in depth the information provided by the project, especially in the subject of "cost-opportunity" of the intervention, to demonstrate that this model allows the approach of key populations to services, including the use of new technologies, concluding among other comments, that the intervention paved the way for working together with the MSP and other state institutions linked to the response to HIV.

Dr. César Núñez, Regional Director of the Joint United Nations Program on AIDS - UNAIDS - emphasized, among other aspects, the importance that operational research played for the design and execution of the project, touching on the issue of relevance evaluation, since in the region we are used to passing anecdotal information without systematizing the information. Faced with the results achieved by the project in terms of linking people living with HIV to treatment, the challenge is posed by ensuring the supply chain to avoid affecting the second 90, of the objectives to be achieved by the country .

Javier Hourcade of Key Correspondents, shared his reflection on the situation in Ecuador and other countries in the region, in which it has not been possible to reduce the new number of HIV infections, but that efforts, such as those made through the The project, of working so that people have access to HIV tests and consequently enter treatment as soon as possible, substantially contributes to the reduction of new HIV infections, in addition to the cascades of prevention and care. He emphasized the current situation with COVID-19, and the impact on his access to prevention services. With particular reference to the role that Kimirina has played as an intermediary organization and currently as an implementer, she expressed her appreciation for the importance of national intermediary organizations, based in her own country, since, as in the case of Kimirina, they contribute not only to the generation of movements, but also the generation of social capital, among other things.

The issue of sustainability and domestic resources are the great challenges for universal health coverage. He indicated that when talking about social capital, it is when organizations can demonstrate "relevance", an example of this, such as when they have the capacity to test on a large scale, in addition, the ability to influence decision-makers, and developed their capacities to testing and dealing in their countries, so we must ask ourselves, what would be the impact for a country, if an organization like Kimirina disappeared, however, its proven relevance? The Global Fund should think about that cost, he said.

Regarding the importance of coordination and articulation among the various actors in the response to HIV, Dr. Aida Soto of PAHO-Ecuador reiterated that the project constitutes a key example of shared effort and the importance working together in the community system and the MSP as a successful key HIV response strategy.

Vincent Pelletier, Executive Director of the Coalition Plus, appealed to the importance that cooperation should look objectively if the strategies and interventions of the organizations are achieving the proposed objectives, working on the basis of innovative ideas and their results are visible and impactful Like Javier Hourcade, he questioned why the CCM did not let Kimirina continue to be the Principal Recipient ?, although he stated, "They are, of course, decisions of each country" expressing their respect for that decision.



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