Caribbean

Under the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) Caribbean Regional Operational Plan, Barbados and Suriname will join Guyana in supporting the World Health Organization’s “Test and Start” recommendation through a coordinated effort to build national capacity and identify critical actions for improvement. Test and Start recommends beginning patients on antiretroviral (ARV) therapy immediately after an HIV-positive diagnosis, regardless of their viral load or CD4 cell count, in an effort to improve health outcomes. As an incentive for this initiative, the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project will procure and deliver the ARVs needed to support “Test and Start” roll-out in each country.

A key barrier to rapid transition to Test and Start is a sub-optimal supply chain logistics system that needs to support more precise forecasting, warehousing, procurement, and distribution systems for rapid test kits, viral load reagents, ARVs, and other HIV consumables. GHSC-PSM will provide targeted short-term technical assistance for improving supply chain management and logistics in Suriname and Barbados.

• antiretrovirals (ARVs)
• male condoms
• viral load reagents

Note: HIV rapid test kits are also procured through the GHSC-Rapid Test Kits project.

Key activities in the Caribbean include:

• Conduct a joint costing and performance study with the USAID Health Finance & Governance (HFG) project and Barbados and Suriname Ministries of Health to develop recommendations for specific actions that Ministries of Health can take to reduce waste and improve efficiencies in the supply chain for HIV commodities and other essential medicines
• Assist the Suriname Ministry of Health to conduct a quantification exercise to determine which products are needed for their Test & Start incentive procurement, from ARVs to rapid test kits, and CD4/viral load products
• Collaborate with the Pan American Health Organization (PAHO) and HFG project to assist the Barbados Ministry of Health in analyze prices they currently pay for ARVs and provide information on requirements to access the PAHO strategic fund for their decision-making

To support global partnerships, GHSC-PSM will seek to increase collaboration with PAHO/World Health Organization; the Pan Caribbean Partnership against HIV & AIDS; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and UNAIDS. To increase leverage for cost-effective pricing of key commodities, GHSC-PSM will promote the use of global/pooled procurement mechanisms, such as the PAHO Strategic Fund, when appropriate.