Postal address: Plaza de la Salud. Edificio Escuela de Enfermería. Primer Nivel. Santo Domingo, Rep. Dom.

Transcripción

1 Custom analysis extract of: UNGASS - National Composite Policy Index (NCPI) 2007 Caribbean Dominican Republic COUNTRY: Dominican Republic Name of the National AIDS Committee Officer in charge: Leonardo Martínez Postal address: Plaza de la Salud. Edificio Escuela de Enfermería. Primer Nivel. Santo Domingo, Rep. Dom. Tel: lmartinez@copresida.gov.do Date of submission: 1/31/2008 : Organisation Direcció General de Control de las Infecciones de Transmisión Sexual y SIDA (DIGECITSS) : Name/Position Director General - Angel Almanzar : respondents to Part A : respondents to Part A A.I / A.II / A.III / A.IV / A.V : Organisation Consejo Presidencial del SIDA (COPRESIDA) : Name/Position Encargada de Programa de Laboratorio - Cleotilde Peña A.I / A.II / A.III / A.IV / A.V : Organisation Consejo Presidencial del SIDA (COPRESIDA) : Name/Position Encargada Programa Nacional de Transmisión Vertical VIH - Claudia Bautista Page 1

2 : respondents to Part A : Organisation Consejo Presidencial del SIDA (COPRESIDA) : Name/Position Encargado Componente GTH - Henry Mercedes : respondents to Part A : respondents to Part A : respondents to Part A A.I / A.II / A.III / A.IV / A.V : Organisation Superintendencia de Salud y Riesgos Laborales : Name/Position Superintendente - Fernando Caamaño : respondents to Part A A.I / A.II / A.III / A.IV / A.V A.I / A.II / A.III / A.IV / A.V : Organisation Secretaría de Estado de Salud Pública y Asistencia Social : Name/Position Sub Secretario de Estado de Salud Colectiva - Nelson Rodríguez : respondents to Part A : Organisation Secretaría de Estado de Salud Pública y Asistencia Social : Name/Position Sub Secretario de Estado Atención a las Personas - José Rodríguez : respondents to Part A A.I / A.II / A.III / A.IV / A.V : Organisation Secretaría de Estado de Trabajo : Name/Position Coord Programa Prevención Lugar del Trabajo - Ruddy Frias : respondents to Part A A.I / A.II / A.III / A.IV / A.V A.I / A.II / A.III / A.IV / A.V : Organisation Dirección General de Prisiones : Name/Position Coord Programa VIH A.I / A.II / A.III / A.IV / A.V : Organisation Consejo Nacional de Atención a la Niñéz : Name/Position Coord Programa VIH A.I / A.II / A.III / A.IV / A.V : Organisation Dirección General de Promoción y Educación para la Salud : Name/Position Director General - Maireni Gautreaux Page 2

3 : respondents to Part A : Organisation Centro de Promoción y Solidaridad Humana : Name/Position Director Ejecutivo - Bayardo Gómez : respondents to Part B : Organisation Niños del Camino : Name/Position Coord Prevención - David Ventura : respondents to Part B : respondents to Part B : Organisation UNFPA : respondents to Part B Page 3 B.I / B.II / B.III / B.IV : Organisation Amigos Siempre Amigos : Name/Position Coord Educación - Daniel Benítez B.I / B.II / B.III / B.IV : Name/Position Asesora VIH/SIDA - Betania Betances Position: A.I / A.II / A.III / A.IV / A.V : Organisation Centro de Orientación Integral : Name/Position Gerente de Educación - Francisca Ferreira : respondents to Part B B.I / B.II / B.III / B.IV B.I / B.II / B.III / B.IV : Name/Position Coord Programa Prevención - Dorka Rojas : respondents to Part B : Organisation USAID : Name/Position Gerente VIH y Tuberculósis - María Castillo : respondents to Part B : Organisation REVASA B.I / B.II / B.III / B.IV : Organisation Movimiento Sociocultural Trabajadores Haitianos : Name/Position Director Ejecutivo - Joseph Cherubín : respondents to Part B B.I / B.II / B.III / B.IV B.I / B.II / B.III / B.IV B.I / B.II / B.III / B.IV Oficial Unidad Monitoreo

4 Position: Full time/part time Full time Position: Since when? 2006 Position: Asistente Unidad Monitoreo Position: Full time/part time Full time Position: Since when? 2006 Position: Técnico Digitación Position: Full time/part time Full time Position: Since when? 2006 Position: Full time/part time Full time Position: Full time/part time Full time 1. Has the country developed a national multisectoral strategy/action framework to combat AIDS? IF YES, period covered: How long has the country had a multisectoral strategy/action framework? 1 Page 4

5 1.2 Which sectors are included in the multisectoral strategy/action framework with a specific HIV budget for their activities? Health: strategy/action framework Health: earmarked budget Education: strategy/action framework Education: earmarked budget Labour: strategy/action framework Labour: earmarked budget Transportation: strategy/action framework Transportation: earmarked budget Military/Police: strategy/action framework Military/Police: earmarked budget Women: strategy/action framework Women: earmarked budget Young people: strategy/action framework Young people: earmarked budget Agriculture: strategy/action framework Agriculture: earmarked budget Finance: strategy/action framework Finance: earmarked budget Human Resources: strategy/action framework Human Resources: earmarked budget Justice: strategy/action framework Justice: earmarked budget Minerals and Energy: strategy/action framework Minerals and Energy: earmarked budget Planning: strategy/action framework Planning: earmarked budget Public Works: strategy/action framework Public Works: earmarked budget Tourism: strategy/action framework Tourism: earmarked budget Trade and Industry: strategy/action framework Trade and Industry: earmarked budget Other*::Bateyes strategy/action framework Other*::Bateyes earmarked budget Page 5

6 1.3 Does the multisectoral strategy/action framework address the following target populations, settings and cross-cutting issues? a. Women and girls: b. Young women/young men: c. Specific vulnerable subpopulations[3]: d. Orphans and other vulnerable children: e. Workplace: f. Schools: g. Prisons: h. HIV, AIDS and poverty: i. Human rights protection: j. Involvement of people living with HIV: k. Addressing stigma and discrimination: l. Gender empowerment and/or gender equality: 1.4 Were target populations identified through a process of a needs assessment or needs analysis? IF YES, when was this needs assessment /analysis conducted? Year: What are the target populations in the country? Adolescentes, Niños y Niñas, Habitantes de Bateyes, TRSX, HSH, Migrantes, PVVS, Mujeres, Población General, PPL. 1.6 Does the multisectoral strategy/action framework include an operational plan? 1.7 Does the multisectoral strategy/action framework or operational plan include: a. Formal programme goals? : b. Clear targets and/or milestones? : c. Detailed budget of costs per programmatic area? : d. Indications of funding sources?: e. Monitoring and Evaluation framework? : 1.8 Has the country ensured full involvement and participation of civil society[4] in the development of the multisectoral strategy/action framework? Active involvement Page 6

7 IF active involvement, briefly explain how this was done: A través de alianzas estratégicas con los diferentes subsectores. A través de mesas de construcción colectiva a nivel nacional con participación multisectorial. Invitando a actores claros establecidos, permitiendo que los grupos afectados participen. Evaluación mediante una historia de trabajo conjunto desde los inicios de la epidemia. 1.9 Has the multisectoral strategy/action framework been endorsed by most external Development Partners (bi-laterals; multi-laterals)? 1.10 Have external Development Partners (bi-laterals; multi-laterals) aligned and harmonized their HIV and AIDS programmes to the national multisectoral strategy/action framework?, all partners 2. Has the country integrated HIV and AIDS into its general development plans such as: a) National Development Plans, b) Common Country Assessments/United Nations Development Assistance Framework, c) Poverty Reduction Strategy Papers, d) Sector Wide Approach? 2.1 IF YES, in which development plans is policy support for HIV and AIDS integrated? a) National Development Plans: b) Common Country Assessments/United Nations Development Assistance Framework: d) Sector Wide Approach: e) Other:: 2.2 IF YES, which policy areas below are included in these development plans? HIV Prevention: development Plans a) / b) / c) / d) Treatment for opportunistic infections: development Plans a) / d) Antiretroviral therapy: development Plans a) / b) / c) / d) Care and support (including social security or other schemes): AIDS impact alleviation: development Plans a) / b) / c) / d) Reduction of gender inequalities as they relate to HIV prevention/treatment, care and/or support: Reduction of income inequalities as they relate to HIV prevention/ treatment, care and /or support: 3. Has the country evaluated the impact of HIV and AIDS on its socio-economic development for planning purposes? development Plans b) / c) / d) development Plans b) / d) development Plans c) Reduction of stigma and discrimination: development Plans e) Page 7

8 3.1 IF YES, to what extent has it informed resource allocation decisions? 3 4. Does the country have a strategy/action framework for addressing HIV and AIDS issues among its national uniformed services such as military, police, peacekeepers, prison staff, etc? 4.1 IF YES, which of the following programmes have been implemented beyond the pilot stage to reach a significant proportion of one or more uniformed services? Behavioural change communication: Condom provision : HIV testing and counselling(*): STI services : Treatment: Care and support : (*)If HIV testing and counselling has been implemented for uniformed services beyond the pilot stage, what is the approach taken? Is it voluntary or mandatory (e.g. at enrolment)? Briefly explain: Para incluirse en el cuerpo uniformado es obligatorio. Para la Población Civil es voluntaria. 5. Has the country followed up on commitments towards universal access made during the High-Level AIDS Review in June 2006? 5.1 Has the National Strategic Plan/operational plan and national AIDS budget been revised accordingly? 5.2 Have the estimates of the size of the main target population sub-groups been updated? 5.3 Are there reliable estimates and projected future needs of the number of adults and children requiring antiretroviral therapy? Estimates and projected needs 5.4 Is HIV and AIDS programme coverage being monitored? (a) IF YES, is coverage monitored by sex (male, female)? (b) IF YES, is coverage monitored by population sub-groups? IF YES, which population sub-groups? NNA, Mujeres, Bateyes, PPL, TRSX, GTH, Embarazadas, Jóvenes, Usuarios de Drógas. Page 8

9 (c) IF YES, is coverage monitored by geographical area? IF YES, at which levels (provincial, district, other)? Provincial Distrito Nacional Zonas vulnerables 5.5 Has the country developed a plan to strengthen health systems, including infrastructure, human resources and capacities, and logistical systems to deliver drugs? Overall, how would you rate strategy planning efforts in the HIV and AIDS programmes in 2007 and in 2005? 2007: : 5 Comments on progress made in strategy planning efforts since 2005: Asignación de recursos Alianzas estratégicas con la Sociedad Civil y ONGs. Inclusión de la estratégia de las ITS/VIH/SIDA en los procesos de reforma. Plan Estratégico Nacional Evaluación de la respuesta de las ITS/VIH/SIDA. Incluimos en los acuerdos y procesos de acceso universal a Terapia Antiretroviral - Prevención. 1. Do high officials speak publicly and favourably about AIDS efforts in major domestic fora at least twice a year? President/Head of government : Other high officials : Other officials in regions and/or districts : 2. Does the country have an officially recognized national multisectoral AIDS management/coordination body? (National AIDS Council or equivalent)? 2.1 IF YES, when was it created? Year: IF YES, who is the Chair? Name: Title/Function: Dr. Bautista Rojas Gómez Secretario de Estado de Salud Pública y Asistencia Social Page 9

10 2.3 IF YES, does it: have terms of reference? : have active Government leadership and participation? : have a defined membership?: include civil society representatives? (*): include people living with HIV?: include the private sector?: have an action plan?: have a functional Secretariat? : meet at least quarterly?: review actions on policy decisions regularly?: actively promote policy decisions?: provide opportunity for civil society to influence decision-making?: strengthen donor coordination to avoid parallel funding and duplication of effort in programming and reporting?: (*) If it does include civil society representatives, what percentage? Consejo Empresa Privada, Coalición ONG - SIDA, Red Personas Viviendo con VIH, Alianza Solidaria, Iglésia Evangélica, Iglésia Católica. 3. Does the country have a national AIDS body or other mechanism that promotes interaction between government, people living with HIV, civil society and the private sector for implementing HIV and AIDS strategies/ programmes? 3.1 IF YES, does it include? Terms of reference : Defined membership : Action plan : Functional Secretariat : Regular meetings (*): (*)If it does include regular meetings, what is the frequency of the meetings: Anuales IF YES, What are the main achievements? Seguimiento a las políticas definidas. Mesas de reuniones con las agencias cooperantes para dar seguimiento a las intervenciones pautadas en los planes operativos. Page 10

11 IF YES, What are the main challenges for the work of this body? Recursos exclusivos de donaciones. Integración de PVVS a Sistema de Seguridad Social. sostenibilidad a largo plazo. 4. What percentage of the national HIV and AIDS budget was spent on activities implemented by civil society in the past year? 65% 5. What kind of support does the NAC (or equivalent) provide to implementing partners of the national programme, particularly to civil society organizations? Information on priority needs and services : Technical guidance/materials: Drugs/supplies procurement and distribution : Coordination with other implementing partners : Capacity-building : 6. Has the country reviewed national policies and legislation to determine which, if any, are inconsistent with the National AIDS Control policies? 6.1 IF YES, were policies and legislation amended to be consistent with the National AIDS Control policies? 6.2 IF YES, which policies and legislation were amended and when? : policy/law Ley o Ley de SIDA : year 1993 : policy/law Ley 87-01que crea el Sistema Dominicano de Seguridad Social : year 2001 : policy/law Ley o Ley General de Salud : year 2001 Overall, how would you rate the political support for the HIV and AIDS programmes in 2007 and in 2005? 2007: : 7 Page 11

12 Comments on progress made in political support since 2005: Evitar la interrupción de continuidad de ejecución de planes por cambios políticos. Inclusión de nuevos esquemas, fortalecimiento del PNRTV. Acceso universal población general, mayor cobertura en la atención, mayor empoderamiento. Adquisición de recursos, alianzas estratégicas con la sociedad civil y ONG. Aumento de la cobertura, adquisición de nuevos esquemas antiretrovirales, aumento de unidades de atención. El aumento de acceso universal a Tarv y a pruebas de CD 4 y CV.. Fue un plan de consenso donde los actores claves participaron, donde los actores "naturales participaron. Ha habido una cobertura de atención que ha sido ampliada. Formulación Plan Estratégico. Formulación Marco Conceptual Monitoreo y Evaluación 1. Does the country have a policy or strategy that promotes information, education and communication (IEC) on HIV to the general population? 1.1 IF YES, what key messages are explicitly promoted? Be sexually abstinent: Delay sexual debut: Be faithful: Reduce the number of sexual partners: Use condoms consistently: Engage in safe(r) sex: Avoid commercial sex: Abstain from injecting drugs: Use clean needles and syringes: Fight against violence against women: Greater acceptance and involvement of people living with HIV: Greater involvement of men in reproductive health programmes: Other::Respeto a la diversidad sexual y los derechos humanos Other::Empoderamiento y autoestima para la toma de decisiones respecto a la sexualidad 1.2 In the last year, did the country implement an activity or programme to promote accurate reporting on HIV by the media? 2. Does the country have a policy or strategy promoting HIV-related reproductive and sexual health education for young people? Page 12

13 2.1 Is HIV education part of the curriculum in primary schools? : secondary schools? : teacher training? : 2.2 Does the strategy/curriculum provide the same reproductive and sexual health education for young men and young women? 2.3 Does the country have an HIV education strategy for out-of-school young people? 3. Does the country have a policy or strategy to promote information, education and communication (IEC) and other preventive health interventions for vulnerable sub-populations? Page 13

14 3.1 IF YES, which sub-populations and what elements of HIV prevention do the policy/strategy address? Targeted information on risk reduction and HIV education: Targeted information on risk reduction and HIV education: Targeted information on risk reduction and HIV education: Targeted information on risk reduction and HIV education: Targeted information on risk reduction and HIV education: Targeted information on risk reduction and HIV education: Stigma & discrimination reduction: Stigma & discrimination reduction: Stigma & discrimination reduction: Stigma & discrimination reduction: Condom promotion: Condom promotion: Condom promotion: HIV testing & counselling: HIV testing & counselling: HIV testing & counselling: (*)If Other sub-populations, indicate which sub-populations Recursos Humanos en Salud. Bateyes. Personas con discapacidad. HSH. Clients of sex workers Prison inmates Condom promotion: Other sub-populations (*) HIV testing & counselling: HIV testing & counselling: Reproductive health, including STI prevention & treatment: Reproductive health, including STI prevention & treatment: Reproductive health, including STI prevention & treatment: Reproductive health, including STI prevention & treatment: IDU MSM Sex workers Clients of sex workers Prison inmates Other sub-populations (*) Prison inmates Stigma & discrimination reduction: Other sub-populations (*) Condom promotion: MSM Sex workers Clients of sex workers MSM Sex workers IDU MSM Sex workers Clients of sex workers Prison inmates MSM Sex workers Clients of sex workers Prison inmates Page 14

15 Overall, how would you rate policy efforts in support of HIV prevention in 2007 and in 2005? 2007: : 5 Comments on progress made in policy efforts in support of HIV prevention since 2005: A partir de 2005 se estructuró y se implementó una estrategia basada en grupos poblacionales La incorporación en el sistema de educación del tema VIH/SIDA. La mayor calidad de esfuerzos en VIH/SIDA estuvieron centrados en la atención clínica, el 80% de los recursos económicos 4. Has the country identified the districts (or equivalent geographical/ decentralized level) in need of HIV prevention programmes? IF YES, to what extent have the following HIV prevention programmes been implemented in identified districts* in need? Blood safety: the activity is available in all districts* in need Universal precautions in health care settings: Prevention of mother-to-child transmission of HIV: Risk reduction for men who have sex with men: Risk reduction for sex workers: the activity is available in all districts* in need Programmes for other vulnerable subpopulations: Reproductive health services including STI prevention & treatment: School-based AIDS education for young people: Programmes for out-of-school young people: the activity is available in the activity is available in Harm reduction for injecting drug users: the activity is available in the activity is available in the activity is available in the activity is available in the activity is available in the activity is available in Overall, how would you rate the efforts in the implementation of HIV prevention programmes in 2007 and in 2005? 2007: : : : 5 all districts* in need all districts* in need IEC on risk reduction: the activity is available in all districts* in need IEC on stigma and discrimination reduction: the activity is available in some districts* in need Condom promotion: the activity is available in all districts* in need HIV testing & counselling: the activity is available in all districts* in need all districts* in need all districts* in need all districts* in need all districts* in need all districts* in need all districts* in need HIV prevention in the workplace: the activity is available in all districts* in need Page 15

16 Comments on progress made in the implementation of HIV prevention programmes since 2005: Los aportes de la inclusión de la estrategia por base poblacional que permitió una mayor penetración y difusión de los programas. 1. Does the country have a policy or strategy to promote comprehensive HIV treatment, care and support? (Comprehensive care includes, but is not limited to, treatment, HIV testing and counselling, psychosocial care, and home and community-based care). 1.1 IF YES, does it give sufficient attention to barriers for women, children and most-at-risk populations? 2. Has the country identified the districts (or equivalent geographical/decentralized level) in need of HIV and AIDS treatment, care and support services? IF YES, to what extent have the following HIV and AIDS treatment, care and support services been implemented in the identified districts* in need? Antiretroviral therapy: some districts* in need Nutritional care: Paediatric AIDS treatment: all districts* in need Sexually transmitted infection management: Psychosocial support for people living with HIV and their families: Antiretroviral therapy: Nutritional care: some districts* in need Page 16 some districts* in need Home-based care: some districts* in need Palliative care and treatment of common HIV-related infections: HIV testing and counselling for TB patients: Post-exposure prophylaxis (e.g. occupational exposures to HIV, rape): HIV treatment services in the workplace or treatment referral systems through the workplace: HIV care and support in the workplace (including alternative working arrangements): TB screening for HIV-infected people: all districts* in need TB preventive therapy for HIV-infected people: TB infection control in HIV treatment and care facilities: Cotrimoxazole prophylaxis in HIVinfected people: all districts* in need all districts* in need some districts* in need some districts* in need

17 Paediatric AIDS treatment: some districts* in need Sexually transmitted infection management: Psychosocial support for people living with HIV and their families: TB preventive therapy for HIV-infected people: TB infection control in HIV treatment and care facilities: Cotrimoxazole prophylaxis in HIVinfected people: Post-exposure prophylaxis (e.g. occupational exposures to HIV, rape): HIV care and support in the workplace (including alternative working arrangements): 3. Does the country have a policy for developing/using generic drugs or parallel importing of drugs for HIV? HIV treatment services in the workplace or treatment referral systems through the workplace: Home-based care: some districts* in need Palliative care and treatment of common HIV-related infections: HIV testing and counselling for TB patients: TB screening for HIV-infected people: 4. Does the country have access to regional procurement and supply management mechanisms for critical commodities, such as antiretroviral drugs, condoms, and substitution drugs? 4.1 IF YES, for which commodities?: Antiretrovíricos, preservativos y drogas de sustitución. all districts* in need all districts* in need some districts* in need some districts* in need some districts* in need Overall, how would you rate the efforts in the implementation of HIV treatment, care and support services in 2007 and in 2005? 2007: : 5 Comments on progress made since 2005: se realizaron comentarios. 5. Does the country have a policy or strategy to address the additional HIV- or AIDS-related needs of orphans and other vulnerable children (OVC)? Page 17

18 5.1 IF YES, is there an operational definition for OVC in the country? 5.2 IF YES, does the country have a national action plan specifically for OVC? 5.3 IF YES, does the country have an estimate of OVC being reached by existing interventions? Overall, how would you rate the efforts to meet the needs of orphans and other vulnerable children? 2007: : 5 Comments on progress made in efforts to meet the needs of OVC since 2005: se realizaron comentarios. 1. Does the country have one national Monitoring and Evaluation (M&E) plan? IF YES, Years covered: IF YES, was the M&E plan endorsed by key partners in M&E? 1.2. IF YES, was the M&E plan developed in consultation with civil society, including people living with HIV? 1.3. IF YES, have key partners aligned and harmonized their M&E requirements (including indicators) with the national M&E plan?, all partners 2. Does the Monitoring and Evaluation plan include? a data collection and analysis strategy : behavioural surveillance : HIV surveillance : a well-defined standardized set of indicators : guidelines on tools for data collection : a strategy for assessing quality and accuracy of data : a data dissemination and use strategy : Page 18

19 3. Is there a budget for the M&E plan? 4. Is there a functional M&E Unit or Department? In Progress 4.1 IF YES, is the M&E Unit/Department based in the NAC (or equivalent)? : 4.2 IF YES, how many and what type of permanent and temporary professional staff are working in the M&E Unit/Department? Number of permanent staff: IF YES, are there mechanisms in place to ensure that all major implementing partners submit their M&E data/reports to the M&E Unit/Department for review and consideration in the country s national reports? 4.4 IF YES, to what degree do UN, bi-laterals, and other institutions share their M&E results? 4 5. Is there an M&E Committee or Working Group that meets regularly to coordinate M&E activities?, but meets irregularly 5.1 Does it include representation from civil society, including people living with HIV? IF YES, describe the role of civil society representatives and people living with HIV in the working group Asegurarse de que se este llevando a cabo de una manera metodológica. Complementa y retroalimenta. De promotores de información, vinculo con los sujetos de monitoreo, consejería, etc. Facilitar toma de decisiones, contribuir a la sistematización de la información, intercambio de información. Su papel es participativo, acompañar en el desarrollo del proceso, en el grupo de trabajo. 6. Does the M&E Unit/Department manage a central national database? 6.1 IF YES, what type is it? De cobertura nacional que se maneja de manera electrónica. 6.2 IF YES, does it include information about the content, target populations and geographical coverage of programmatic activities, as well as their implementing organizations? Page 19

20 6.3 Is there a functional Health Information System (HIS)? National level : Sub-national level (*): (*)If there is a functional sub-national HIS, at what level(s) does it function? A nivel Local y Nacional 6.4 Does the country publish at least once a year an M&E report on HIV, including HIV surveillance data? 7. To what extent are M&E data used in planning and implementation? 4 What are examples of data use? Casos VIH/SIDA, Datos de vigilancia de serología de infección VIH/Hepatitis B y pacientes con ITS, Datos de estimaciones nacionales.. PVVS,. PVVS medicados,. PVVS con tuberculosis y. De embarazadas con VIH. Planificación estratégica, Estrategias de CCC y Planes Operativos Prevalencia en embarazadas de VIH. Proyecciones de compra de insumos farmacológicos y no farmacológicos, La planificación de las intervenciones. What are the main challenges to data use? La cobertura no es general, solo mide hasta cierto nivel provincial. 8. In the last year, was training in M&E conducted At national level? : At sub-national level? : Including civil society? : Overall, how would you rate the M&E efforts of the AIDS programme in 2007 and in 2005? 2007: : 8 Comments on progress made in M&E since 2005: La inclusión en el 2007 de la Endesa y a la realización de manera periódica de vigilancia centinela y los estudios de comportamientos contratados y de los cuales se esperan informaciones para el primer trimestre el 2008 y cálculos de las Estimaciones Nacionales. 1. Does the country have laws and regulations that protect people living with HIV against discrimination? (such as general non-discrimination provisions or provisions that specifically mention HIV, focus on schooling, housing, employment, health care etc.) Page 20

21 1.1 IF YES, specify: Ley sobre SIDA La Ley General de Salud y el Plan Decenal de Salud de la Secretaría de Estado de Salud Pública (SESPAS) 2. Does the country have non-discrimination laws or regulations which specify protections for vulnerable sub-populations? 2.1 IF YES, for which sub-populations? Women: Young people : IDU: MSM: Sex Workers : Prison inmates : Migrants/mobile populations : IF YES, Briefly explain what mechanisms are in place to ensure these laws are implemented: La Política Nacional de Juventud, que se encuentra en una fase de revisión actualmente; el Plan Nacional para la Equidad de Género (PLANED) y el Plan Estratégico Nacional para el SIDA (PENSIDA). IF YES, Describe any systems of redress put in place to ensure the laws are having their desired effect: La Comisión Presidencial del SIDA (COPRESIDA), las campañas de educación y programas de la fiscalía acerca de la violencia contra la mujer, los programas de la Secretaría de Estado de la Juventud y su Política Nacional de Juventud, los Proyectos de trata de blanca y mujeres migrantes, así como algunos comités y comisiones de seguimiento, dentro de los que se destaca la Comisión Permanente para el Seguimiento a los Acuerdos de UNGASS. 3. Does the country have laws, regulations or policies that present obstacles to effective HIV prevention, treatment, care and support for vulnerable sub-populations? 4. Is the promotion and protection of human rights explicitly mentioned in any HIV policy or strategy? 5. Is there a mechanism to record, document and address cases of discrimination experienced by people living with HIV and/or most-at-risk populations? 6. Has the Government, through political and financial support, involved most-at-risk populations in governmental HIV-policy design and programme implementation? Page 21

22 IF YES, describe some examples Las Alianzas de Base Poblacional, las organizaciones y grupos de la sociedad civil. El Mecanismo Coordinador de País del Fondo Global. Las Redes de PVVS que tienen representatividad en todos los mecanismos establecidos. La Coalición de ONG del Área de SIDA, que agrupa a la mayoría de ONG, Organizaciones de Base Comunitarias y grupos con trabajo en SIDA en el país. Los Veedores Sociales, que representan a las dos redes de PVVS del País. El Plan Estratégico Nacional. 7. Does the country have a policy of free services for the following: HIV prevention services : Anti-retroviral treatment : HIV-related care and support interventions : IF YES, given resource constraints, briefly describe what steps are in place to implement these policies: Son aplicadas mediante el establecimiento y expansión de las Unidades de Atención Integral (UAI) con apoyo de la SESPAS en los hospitales del sistema público de salud y en algunas organizaciones no gubernamentales para ofrecer atención y tratamiento antirretroviral gratuito a las PVVS. Estas Unidades son coordinadas desde la Dirección General de Control de las ITS y SIDA de la SESPAS con el apoyo del COPRESIDA. Su crecimiento y expansión fue cubierta con fondos provistos por un préstamo otorgado al país por el Banco Mundial y tras una demanda por medidas cautelares sometida por las PVVS en la Corte Interamericana de Derechos Humanos. El financiamiento otorgado por el Banco Mundial terminó en el 2007 y la SESPAS ha asumido el costo del personal que ofrece servicios en estas unidades. Los servicios ofrecidos en estas unidades son gratuitos, así mismo los medicamentos Antiretrovirales a las PVVS que cumplan con los parámetros establecidos en el país. De acuerdo con estos parámetros para una PVVS calificar para recibir tratamiento antirretroviral gratuito debe mostrar menos de 200 células CD4, una Carga Viral alta y/o la presencia de alguna enfermedad oportunista que pueda poner en peligro la vida del paciente. La existencia de medicamentos Antiretrovirales está garantizada por el apoyo recibido por el programa de la Fundación Clinton, de USAID y el Fondo Global. 8. Does the country have a policy to ensure equal access for women and men, to prevention, treatment, care and support? In particular, to ensure access for women outside the context of pregnancy and childbirth? 9. Does the country have a policy to ensure equal access for most-at-risk populations to prevention, treatment, care and support? 9.1 Are there differences in approaches for different most-at-risk populations? 10. Does the country have a policy prohibiting HIV screening for general employment purposes (recruitment, assignment/relocation, appointment, promotion, termination)? Page 22

23 11. Does the country have a policy to ensure that AIDS research protocols involving human subjects are reviewed and approved by a national/local ethical review committee? 11.1 IF YES, does the ethical review committee include representatives of civil society and people living with HIV? 12. Does the country have the following human rights monitoring and enforcement mechanisms? - Existence of independent national institutions for the promotion and protection of human rights, including human rights commissions, law reform commissions, watchdogs, and ombudspersons which consider HIVrelated issues within their work: - Focal points within governmental health and other departments to monitor HIV-related human rights abuses and HIV-related discrimination in areas such as housing and employment: - Performance indicators or benchmarks for compliance with human rights standards in the context of HIV efforts: - Performance indicators or benchmarks for reduction of HIVrelated stigma and discrimination: IF YES, on any of the above questions, describe some examples: Los Veedores Sociales contratados por el COPRESIDA. 13. Have members of the judiciary (including labour courts/employment tribunals) been trained/sensitized to HIV and AIDS and human rights issues that may come up in the context of their work? 14. Are the following legal support services available in the country? Legal aid systems for HIV and AIDS casework: Private sector law firms or universitybased centres to provide free or reduced-cost legal services to people living with HIV: Programmes to educate, raise awareness among people living with HIV concerning their rights: Page 23

24 15. Are there programmes designed to change societal attitudes of stigmatization associated with HIV and AIDS to understanding and acceptance? IF YES, what types of programmes? Media : School education : Personalities regularly speaking out : Overall, how would you rate the policies, laws and regulations in place to promote and protect human rights in relation to HIV and AIDS in 2007 and in 2005? 2007: : 4 Comments on progress made in promoting and protecting human rights in relation to HIV and AIDS since 2005: Algunas personas calificaron de mínimos los cambios realizados del 2005 al 2007, estos destacaron que los cambios son debido a la implementación del proyecto del Fondo Global por parte de COPRESIDA y las organizaciones de la sociedad civil. Esto concuerda con los que mencionaron los compromisos con agencias de cooperación internacional por parte del Gobierno Dominicano. Algunos se refirieron a este tema como presión internacional destacando el papel del sistema de Naciones Unidas y los compromisos asumidos en UNGASS y las Metas del Milenio. La minoría se refirió al fortalecimiento de las redes y los grupos de la sociedad civil y a la participación en la toma de decisiones producto de este fortalecimiento. Sin embargo casi todos estuvieron de acuerdo en que si bien se ha sensibilizado a la población general en cuanto a los derechos humanos, todavía falta sensibilizar a la minoría que tiene el poder de incidir para un cambio realmente favorable en materia de promoción y respeto de los derechos humanos, en especial en lo relativo al VIH y a las poblaciones vulnerables así como a las más expuestas. Overall, how would you rate the effort to enforce the existing policies, laws and regulations in relation to human rights and HIV and AIDS in 2007 and in 2005? 2007: : 4 Comments on progress made in enforcing existing policies, laws and regulations in relation to human rights and HIV and AIDS since 2005: En cuanto a las reglamentaciones también estuvieron de acuerdo con que éstas no se aplican a todos por igual. Citaron como ejemplo el caso del SIDA en el Lugar de Trabajo, diciendo que aunque existe un departamento en la Secretaría de Estado de Trabajo, la aplicación de la ley es diferente cuando se trata de empleadores del Estado Dominicano y del Sector Privado. Mencionaron el temor de las personas que viven con VIH de reclamar sus derechos, pues esto les costaría la publicación de su condición serológica. Destacaron el hecho de los esfuerzos realizados por parte de las organizaciones del Estado Dominicano, en especial del COPRESIDA de que la sociedad civil asuma el protagonismo en materia de la promoción de los derechos humanos y el cumplimiento de las leyes. También se reconoció que este progreso no ha sido equitativo para todos los grupos vulnerables. Page 24

25 1. To what extent has civil society contributed to strengthening the political commitment of top leaders and national policy formulation? 4 2. To what extent have civil society representatives been involved in the planning and budgeting process for the National Strategic Plan on AIDS or for the current activity plan (e.g. attending planning meetings and reviewing drafts) 4 3. To what extent are the services provided by civil society in areas of HIV prevention, treatment, care and support included a. in both the National Strategic plans and national reports?: b. in the national budget?: 2 4. Has the country included civil society in a National Review of the National Strategic Plan? IF YES, when was the Review conducted? Year: To what extent is the civil society sector representation in HIV-related efforts inclusive of its diversity? 4 List the types of organizations representing civil society in HIV and AIDS efforts: ONG s: de Mujeres, Religiosas, De Jóvenes, De Poblaciones Vulnerables: VSV Trabajadoras Sexuales Migrantes Bateyes Personas con Discapacidad OBC s: De PVVS y de Juntas de Vecinos. Universidades 6. To what extent is civil society able to access a. adequate financial support to implement its HIV activities?: b. adequate technical support to implement its HIV activities?: 3 3 Overall, how would you rate the efforts to increase civil society participation in 2007 and in 2005? 2007: : 5 Page 25

26 Comments on progress made in increasing civil society participation since 2005: La mayoría de los participantes destacó los factores que influyeron en los cambios proyectados desde el 2005 hasta el Dentro de estos citaron: La inclusión de nuevos actores en la Respuesta Nacional al VIH. La creación de las Alianzas de Base Poblacional. El aumento en las fuentes de Financiamiento. Dentro de estos se destacó los recursos del Banco Mundial, y la implementación del proyecto del Fondo Global. Los esfuerzos realizados a través del COPRESIDA para facilitar el acceso de la sociedad civil al financiamiento. 1. Has the country identified the districts (or equivalent geographical/decentralized level) in need of HIV prevention programmes? IF YES, to what extent have the following HIV prevention programmes been implemented in identified districts in need? Blood safety: all districts* in need Universal precautions in health care settings: Prevention of mother-to-child transmission of HIV: Risk reduction for men who have sex with men: Programmes for other vulnerable subpopulations: Reproductive health services including STI prevention & treatment: 1. Has the country identified the districts (or equivalent geographical/decentralized level) in need of HIV and AIDS treatment, care and support services? some districts* in need Risk reduction for sex workers: all districts* in need School-based AIDS education for young people: Programmes for out-of-school young people: IEC on risk reduction: all districts* in need IEC on stigma and discrimination reduction: all districts* in need HIV testing & counselling: all districts* in need Harm reduction for injecting drug users: Condom promotion: all districts* in need some districts* in need some districts* in need HIV prevention in the workplace: some districts* in need Other programmes::ppl some districts* in need Page 26

27 Overall, how would you rate the efforts in the implementation of HIV treatment, care and support services in 2007 and in 2005? 2007: : 6 Comments on progress made in the implementation of HIV treatment, care and support services since 2005: hay comentarios. 2. What percentage of the following HIV programmes or services is estimated to be provided by civil society? Prevention for youth : >75% Prevention for IDU : >75% Prevention for MSM : >75% Prevention for sex workers : >75% Counselling and Testing : 25-50% Clinical services (OI/ART)* : <25% Home-based care : >75% Programmes for OVC** : 25-50% 3. Does the country have a policy or strategy to address the additional HIV and AIDS-related needs of orphans and other vulnerable children (OVC)? 3.1 IF YES, is there an operational definition for OVC in the country? 3.2 IF YES, does the country have a national action plan specifically for OVC? 3.3 IF YES, does the country have an estimate of OVC being reached by existing interventions? IF YES, what percentage of OVC is being reached? 40% Overall, how would you rate the efforts to meet the needs of orphans and other vulnerable children? 2007: : 6 Comments on progress made since 2005: Sin comentarios. Uniting the world against AIDS Page 27