Remarks by Acting Deputy Chief of Mission, Joseph J. FitzGerald,
Handover of HIV/AID Self-Test Kits,
Tuesday, December 01, 2020
Ministry of Health
Good morning Honorable Terrence Deyalsingh, Minister of Health, Dr. Godson Eze, Director of the HIV/AIDS Coordinating Unit, Ministry of Health, Dr. Ayanna Sebro, Technical Director, National AIDS Coordinating Committee, Permanent Secretaries, members of civil society, other distinguished guests and colleagues.
I am pleased to be here today with our friends and partners at the Ministry of Health to represent Ambassador Mondello, the United States Government, and the PEPFAR Caribbean Regional HIV/AIDS Program at the official ceremony to hand over a donation of HIV self-testing kits from the United States of America. We are all very proud of our partnership with the Ministry of Health, which has spanned almost a decade under PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief. Today also marks the celebration of World AIDS Day 2020. The U.S. government’s theme for this year is “Ending the HIV/AIDS Epidemic: Resilience and Impact.”
This theme reflects our strong bipartisan commitment to ending the HIV/AIDS epidemic globally and in the United States. It also highlights PEPFAR’s ongoing efforts toward achieving inclusive, resilient, and sustainable control of the epidemic through a focus on: 1) delivering quality, people-centered HIV prevention and treatment services; 2) strengthening the capacity and resilience of communities and health systems to address the HIV epidemic and other health challenges; and 3) partnering for greater impact, burden sharing, and sustainability.
The United States has invested more than $85 billion dollars in the global HIV/AIDS response – the largest commitment made by any nation to address a single disease – through PEPFAR and U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria. That support has provided life-saving anti-retroviral treatment for more than 18 million women, men, and children worldwide and prevented millions of new HIV infections. In 2017 alone, over 85 million people received HIV testing and counselling services globally. Working together with our partners in 54 countries, we have moved the HIV/AIDS pandemic from crisis to control.
Seventeen years ago, in 2003, when PEPFAR began, HIV was a death sentence in many parts of the world. Globally, PEPFAR has replaced death and despair with vibrant life and hope. According to UNAIDS, AIDS-related deaths have been cut by 60 percent since their peak in 2004, and new HIV infections have been reduced by 40 percent since their peak in 1998.
Since its inception, PEPFAR has had a strong commitment to children. We work to ensure infants are born HIV-free, young people and their partners can stay HIV-free through their adolescence, and children and adolescents living with HIV have access to the life-saving treatment and care needed for them to be AIDS-free. PEPFAR supports HIV testing services for millions of infants, children, and adolescents and life-saving treatment for those who are living with HIV. However, despite substantial declines in new HIV infections globally, the HIV/AIDS epidemic continues to disproportionately impact adolescent girls and young women in many countries.
Additionally, data from many high-burden countries show that men, particularly those ages 24-35 years, access HIV testing and treatment at low rates. Therefore, many men living with HIV do not know they are HIV-positive. This endangers their own health and fuels the spread of HIV among adolescent girls and young women.
PEPFAR is also committed to reaching key populations with non-discriminatory access to HIV prevention, testing, and treatment services to address their rising rates of new HIV infection and save lives.
As a result of these difficulties in the fight against HIV, case-finding is a strategic intervention in the national response. PEPFAR recommends increasing HIV self-testing as an emerging approach to expand access to HIV testing services among men and underserved, disenfranchised populations to increase case-finding.
Evidence from research in multiple countries indicates potentially high accuracy of HIV self-testing, especially when combined with the offer of directed assistance. Additionally, self-testing enjoys high levels of acceptability, ranging from 74-96 percent among couples, young women, adolescents, key populations, and health care workers.
In response to the restrictions in place due to the COVID-19 pandemic, PEPFAR recommends that where feasible and effective, programs should consider distributing HIV self-testing kits to index clients so that partners can screen themselves prior to coming to the facility. This may help ensure that only partners who are most likely to have HIV will come to the facility for confirmatory HIV testing per the national testing algorithm. Overall, to alleviate congestion at the facility level and reduce the need for in-person testing services, PEPFAR-supported countries may consider accelerating their plans for scaling up HIV self-testing distribution for those with increased risk of HIV infection.
Therefore, we are pleased to make this very timely donation of 5,000 HIV self-test kits to the Government of Trinidad and Tobago. This aligns with the Ministry’s vision to scale up HIV case finding and accelerate early diagnosis of persons who can quickly access treatment. To achieve HIV/AIDS epidemic control, PEPFAR is committed to ensuring all ages, genders, and at-risk populations know their HIV status, receive life-saving HIV prevention and treatment services, and, for those living with HIV, achieve viral suppression. This means focusing on quality, inclusive, client-centered care – meeting patients where they are with what they need – to improve access, retention, and outcomes.
We are grateful for the Government of Trinidad and Tobago’s commitment to building and sustaining partnership with the United States to end the AIDS epidemic. Thank you.