LOCAL non-governmental organisations (NGOs) at the forefront of the fight against HIV/AIDS are now battling for their own survival as funding from international donors decrease.

In 2023, US$19.8 billion was available for HIV programmes in low- and middle-income countries from international donors — nearly US$10 billion shy of the HIV funding target for 2025 — a 7.9 per cent decline since 2020.

The NGOs, which receive little or no support from the Jamaican Government, are seemingly victims of their own success as international donors look elsewhere while the Caribbean, and in particular Jamaica, wage a partially successful battle against HIV/AIDS even though the threat remains.

According to UNAIDS, the number of new HIV infections in the Caribbean decreased by 15 per cent between 2010 and 2022, with declines stronger among men (18 per cent) than women (10 per cent). Similarly, AIDS-related deaths dropped by 53 per cent during this period, with a higher rate of decline among women (56 per cent) compared to men (51 per cent).

The Planning Institute of Jamaica’s 2023 Economic and Social Survey reports the country’s HIV treatment cascade (90-90-90) showed that 91.0 per cent of people with HIV were aware of their status; 53.0 per cent of people with HIV who knew their status were retained on HIV treatment; and 79.0 per cent of individuals with HIV who were on treatment were reported as being virally suppressed.

This represents a sharp improvement over the past decade during which Jamaica also eliminated the mother-to-child transmission of HIV.

For Kandasi Walton-Levermore, executive director of Jamaica AIDS Support for Life (JASL), there is no doubt that the country is paying for its success.

“Right now I am in the fight of my life to get some funding to continue my treatment services at JASL. One of the things about JASL treatment programmes is that they are of a comprehensive nature, and this has allowed us to see results — and I say without apology — way better than you would experience in public health facilities,” Walton-Levermore told Jamaica Observer editors and reporters recently.

“A lot of the work we do at JASL we do through funding from international donors. However, we are improving; the country is a middle-income country and so international funding is not necessarily being poured into Jamaica right now, plus the Government does have a narrative that we have the resources here, and there are things that we can do, we are building our own programme and there are resources that are available,” Walton-Levermore said.

She pointed out that without the support from international donors JASL will struggle to pay doctors, nurses, and physiologists “who have made such a huge impact on the programme”.

Walton-Levermore told the Observer that an international donor, which has been providing financial support to JASL for some time, has now said its funding is limited and that JASL will have to see how it can consolidate its services.

“Now consolidating means I would have to leave off pieces of the programme, and that would make the work less effective,” declared Walton-Levermore.

While underscoring that local NGOs in the fight against HIV/AIDS are seeing a reduction in international donor funding, Jumoke Patrick, executive director for the Jamaica Network of Seropositives (JN+), said this could have the most impact on people in marginalised groups in the island.

“The good thing is that we in the Caribbean, and more so Jamaica, have been doing very well when it comes to getting persons on treatment and getting them virally suppressed. It still doesn’t mean that donors should decrease funding because we still have a lot of work to do to get those additional persons treatment,” said Patrick.

“Donor funding has been decreasing, particularly for the NGOs, and it is impacting mostly those which depend on this more and which work with marginalised populations as we know that within our country the Government is unable to work with some people because of positions on issues like homosexuals and sex workers.

“And so it is left to NGOs to do significant work with those communities, so it is important for donors to continue to support us, especially because that is what we depend on to ensure that we are reaching the Jamaicans who the public health care system is unable to reach at this time,” added Patrick as he pointed out that JN+ gets no financial support from the Government.

He argued that the Government must see NGOs as partners in the fight against HIV/AIDS as it will take a collaborative approach to achieve the goals of ending the epidemic.

“The Ministry of Health knows that JN+ is doing excellent work with people living with HIV, our record speaks for itself… so I think it is time for them to put cash to the table as well, because when donor funding is gone and no longer in the country, the Government has to realise that we are still going to be a critical and important partner, and it takes cash to care.

“So if they see us as a critical important partner, I think that cash support should be considered by the Government of the day,” said Patrick.

That call was echoed by Walton-Levermore, who noted that JASL gets a monthly subvention of $60,000 from the Government, “which we are grateful for, because it pays the water bill”.

“One of the things that we have been saying a lot to the Government is, ‘Look at your civil society partners, we have been with you from the beginning,’ and for an organisation such as JASL ,which is 33 years old this year, we would have been at the front of the HIV response. We would have walked this path with the Government as partners and helped with the country’s results, but still the Government doesn’t have a framework or a system of how it supports entities like JASL to ensure we continue the work that we are doing,” said Walton-Levermore.