Jamaica’s HIV programme has benefited from an allocation of just over US$9 million from the Global Fund and the country’s removal from the list of nations to be transitioned out of the programme in the next review cycle.

Word of Jamaica’s status came from Ivan Cruickshank, chairman of the Country Coordinating Mechanism for the Global Fund, in an interview with the Jamaica Observer as part of the newspaper’s focus on HIV/AIDS 36 years after the virus was first discovered.

The decision was made by the Global Fund during its last review cycle which ended last year.

“They constantly review the situation, but as it is now, we are not scheduled for transitioning, even after 2021,” Cruickshank told the Observer.

His reference to 2021 was in relation to the end of the Global Fund’s current allocation cycle.

“There is a possibility that beyond 2021 we will be able to get additional funding, but that again we will know as we go through the implementation of this particular grant that we are now implementing,” Cruickshank said.

The Global Fund — which provides support to countries in response to AIDS, tuberculosis, and malaria — allocates funds to eligible countries for a three-year period based on the country’s disease burden and income level.

When Jamaica was upgraded to an upper middle-income country by the World Bank in 2009, concerns were raised that the island could lose the grant funding. However, in 2016, the Global Fund committed to continue supporting Jamaica’s HIV response beyond the previously decided 2018 transition deadline.

In October this year, at its Sixth Replenishment Conference held in France, the Global Fund raised US$14.02 billion — the highest amount ever for the partnership, which is working to end the three diseases.

Of that amount Jamaica has been allocated US$9.9 million but, according to Cruickshank, the country’s HIV programme now has a bit more than that at its disposal.

“It’s actually US$11.1 million. We have the country allocation of a little over $9 million and then we have $2 million from what they call the catalytic funding. So those will take us into 2021,” said Cruickshank, who is also executive director of Caribbean Vulnerable Communities, which states on its website that it is a coalition of community leaders and non-governmental agencies that provides services and advocates on behalf of Caribbean populations which are especially vulnerable to HIV infection or often forgotten in access to treatment and health care programmes.

Asked if there are any new strategies to utilise the funding, Cruickshank said: “We actually sat together and worked on a proposal with the Ministry of Health [and Wellness] around how we would invest that US$9 million. A portion of it will go towards our traditional treatment, prevention, intervention [programmes] and a part will be focused on human rights intervention… about how we ensure that we create a more enabling environment to address questions around stigma and discrimination. The other part is creating the environment and context for sustainability beyond the Global Fund grant.”

He said that had Jamaica not received the new funding, the country’s HIV programme would most likely have suffered some setback.

“As a country, I don’t think we are fully ready for a transition, especially if we want to ensure that it’s not just only focused on treatment, but [that] we’re addressing all of the other dimensions of what it takes to effectively respond to the epidemic. We would not have been in a position, as a country, to actually undertake all of the activities and interventions that are necessary if we had not gotten this pool of funding. So this continued funding is absolutely critical to positioning us in a way that eventually allows us to leave the Global Fund,” he said.

In an earlier interview ahead of the December 1 observance of World AIDS Day, the Joint United Nations Programme on HIV and AIDS Country Director Manoela Manova said while the new allocation, though greatly appreciated, may not be enough to implement all the programmes here, the greater issue is how we utilise the funds.

“I think it’s what we do with the funding that… is our problem. So yeah, it might not be enough, but if we use them in the best way… and if we use them also to really lobby for the Government to come in, not [just] with huge resources… the funding can, if used wisely, be enough,” Manova said.

As an example, she pointed to programmes designed to reach specific groups, such as transgender people and men who have sex with men (MSM).

“We were really putting a lot of resources into trying to reach these people, and we are not. So that, for me, is unwise. Obviously the issue was not the resources — it’s how, it’s a strategy, what would work to reach them,” Manova said, suggesting a coordinated approach among all the organisations and entities dedicated to HIV prevention and treatment.

Asked if she thought there were too many groups wanting to get funding to implement programmes, Manova said that may be true, but argued that marginalised communities can only be reached by those who represent them.

“We can never reach a sex worker or MSM with the institutions and the services in the health system; we need this to be done by organisations that represent them, that is the only way. The community organisations can reach them, so they are needed,” she said.

“We can’t do the response without these partnerships. It’s how we coordinate, how we manage the partnership. Do we need three organisations targeting MSM or it’s one, and then the others can target others?” she asked.

“But we need them. Without them we will not reach anything, so community organisations are critical for the response. And that’s what we are advocating — that there should be a mechanism, once the donors are gone, that the Government will have to find a way to fund these community organisations,” she said.

Meanwhile, Cruickshank acknowledged the concern raised by other health care experts about the fall-off in the HIV education campaign, which, they say, has negatively affected new infections and responsible sexual behaviour.

“We actually are looking at developing a new HIV strategy,” Cruickshank explained. “There is a recognition that we actually have to rethink prevention and re-strategise around prevention. So even though we put in the proposal around a particular set of issues, there is an opportunity for us to do what is called reprogramming throughout the life of the grant,” he said.