Martinique. May 12, 2006.

Workshop on the Implementation of a Regional Surveillance System of ARV's Resistance.

The partnership between Martinique with CAREC/PAHO is recognized as co-conveners, in line with the objective of the workshop to build a comprehensive Caribbean Strategy to deal with HIV Drug Resistance from the public health perspective.

"… This event is a starting point for a true Pan Caribbean partnership; a model that needs to be used more and more…"

Dr. Roses explained how CAREC, PAHO and WHO have been working together as one entity, CAREC as a regional health institution and as part of PAHO, can serve as a convener, a bridge builder, and a technical resource. She acknowledged the technical leadership of WHO in this area.

"…The expected outcome of this workshop is a regional strategy for HIV drug resistance. The approach we have chosen is to have countries develop their country specific plans, which will help to determine which regional action needs to be taken to support countries…"

Dr. Roses addressed some of the next steps to work on:

- Regional and country HIV drug resistance working groups;
- HIV drug resistance prevention (attention to adherence, good clinical management, good drug supply management);
- Set up HIVDR early warning;
- Complete first HIVDR monitoring and surveillance studies;
- Develop HIVDR lab network for short- term testing plans and for future development.

Dr. Roses talked about the importance of the broader context: how the 3 by 5 initiative was successful in the Region and the importance to build on these achievements towards universal access to prevention, treatment, and care. Even though some countries have scaled up, others are still lagging behind in providing access to treatment (overall in the Caribbean, only 40% are on treatment); and the difficulty in providing equal access to certain population groups who are traditionally stigmatized, such as commercial sex workers, the poor, and the deprived.

Dr. Roses emphasized the PAHO/WHO focus on key health sector activities such as testing and counseling, expanding prevention, increasing access to care and treatment, and health system strengthening, referring at the same time to PAHO's Regional HIV/AIDS Strategy, which is very much in line with the UA target and attempts to operationalize the target.

We will have to work together to overcome some of the key challenges for scaling up towards UA: - Scaling up testing and counseling;
- Invest in getting strategic information, through surveillance and other means;
- Ensure high quality drugs at affordable prices;
- Address human resource gaps.