People living with HIV represented in all key decision forums.
Cuba has broad spectrum of activities focusing on the promotion of human rights and the respect of sexual diversity.
At the end of April this year, the Office of the Inspector General (OIG) released a diagnostic review of the Global Fund grants to the Republic of Cuba. The purpose of the review was to identify and share good practices; and to identify key risks to grant programmes and make recommendations on how these risks can be reduced.
The fieldwork for the diagnostic review was conducted from 31 October to 16 November 2011. The review covered all three grants to Cuba totalling $76 million, of which $68 million had been disbursed. The United Nations Development Programme (UNDP) was the principal recipient (PR) for all three grants.
As reported in an article in GFO 182, the OIG found strong evidence of successful national responses to HIV and effective TB control in Cuba. The OIG identified many good practices during the course of the diagnostic review. Cuba is a low disease burden country and has been classified as a middle income country, which makes it ineligible to submit further proposals to the Global Fund under current eligibility rules. Despite this, however, the OIG said the good practices it spotted may serve as lessons for other countries receiving Global Fund support.
Some of the good practices the OIG identified in Cuba are as follows:
All Global Fund-supported programmes rely on existing government staff and volunteers; so the only additional salary costs that were included in the programme funded by the grants was salaries for the PR (UNDP).
Among the volunteers associated with the HIV and TB programmes, people living with HIV play an important role at the national, provincial and municipal level. They are represented in all important decision forums related to the country's response to the diseases.
The national programme for HIV testing and counselling is carefully designed to maximise reliability and quality. It also has wide coverage, with over two million people tested in the first 10 months of 2011.
Cuba has an HIV prevention programme supported by the Global Fund which focuses on sexual rights, gender equality, respect of sexual diversity and prevention of sexual violence. It is a programme of the National Centre for Sexual Education (CENESEX) and the Ministry of Education, targeting youth aged 12-19. The programme addresses the main social drivers of HIV vulnerability. The OIG said that this focus on social vulnerability is highly appropriate.
The country also has Global Fund-supported programmes for men who have sex with men (MSM). They include a broad spectrum of activities focusing on the promotion of human rights and the respect of sexual diversity. "The programme has significantly decreased the stigmatisation of homosexuality in Cuban society and has stimulated a social and political dialogue on sexual rights that is unprecedented in Latin America," the OIG report says.