Global AIDS Progress Report 2016 Republic of the Marshall Islands Submission date: 31 March 2017 1 | P a g e FOREWORD 2 | P a g e Table of Contents FOREWORD ....................................................................................................................................................................... 2 ACKNOWLEDGEMENT......................................................................................................... Error! Bookmark not defined. 1. STATUS AT A GLANCE ............................................................................................................................................... 6 1.1 The Report Writing Process and the Inclusiveness of the Stakeholders in this Process ................................... 6 1.2 The Status of the Epidemic .............................................................................................................................. 6 HIV Prevalence Rate for 15-49 years old................................................................................................................... 6 Summary of STI/HIV Cases ........................................................................................................................................ 9 STI/HIV Cases ............................................................................................................................................................ 9 1.3 The Policy and Programmatic Response ......................................................................................................... 9 1.4 Global Reporting Republic of the Marshall Islands Indicator Summary Data ............................................... 12 2. OVERVIEW OF THE EPIDEMIC ..................................................................................................................................... 15 2.1 The National Context ............................................................................................................................................ 15 2.2 The Organization of Health Care Services ............................................................................................................. 17 2.3 The National Health Portfolio Plan 2016 .............................................................................................................. 18 2.4 National HIV Coordination Mechanism ................................................................................................................ 18 2.5 The National HIV & STI Strategy2013-2017 .......................................................................................................... 19 2.6 Monitoring and Evaluation of the National Response .......................................................................................... 20 2.7 Funding the National Response ............................................................................................................................ 21 Annual allocations by Year – US$ ........................................................................................................................... 22 Estimated expenditure by GARP categories by year US$ ........................................................................................ 22 2.8 HIV Epidemiology .................................................................................................................................................. 23 Status of Cumulative HIV Diagnoses, RMI, 1984-2015 ........................................................................................... 23 Active Cases by Age Group RMI 2015 ..................................................................................................................... 23 HIV Cumulative cases by Transmission RMI 1984-2015 ......................................................................................... 24 3. NATIONAL RESPONSE TO THE AIDS EPIDEMIC ............................................................................................................ 24 Target 1: Reduce sexual transmission of HIV by 50% by 2015 .................................................................................... 24 Target 2: Reduce transmission of HIV among people who inject drugs by 50% by 2015 ........................................... 29 Target 3: Eliminate mother to child transmission of HIV by 2015 and substantially reduce AIDS-related neonatal deaths ......................................................................................................................................................................... 29 Target 4: Have 15million people living with HIV on antiretroviral treatment by 2015 ............................................... 30 Target 5: Reduce tuberculosis deaths in people living with HIV by 50% by 2015 ....................................................... 31 3 | P a g e Target 6: Reach a significant level of annual global expenditure (US22-23billion) in low and middle income countries ..................................................................................................................................................................... 31 Target 7: Critical Enablers and Synergies with Development Sectors ......................................................................... 31 Target 8: Eliminating Stigma & Discrimination .......................................................................................................... 33 4. Best Practices .............................................................................................................................................................. 33 4.1 Governance and Program Management .............................................................................................................. 33 4.2 A Supportive Policy Environment .......................................................................................................................... 34 4.3 Scale-up of Prevention Programs .......................................................................................................................... 34 4.4 Scale-up of Care, Treatment and/or Support Programs ....................................................................................... 35 4.5 Monitoring and Evaluation ................................................................................................................................... 35 5. Major Challenges and Gaps ........................................................................................................................................ 36 5.1 Treatment Care and Support ................................................................................................................................ 36 5.2 Data Collection...................................................................................................................................................... 36 5.3 Resources .............................................................................................................................................................. 37 6. Recommendations ...................................................................................................................................................... 37 6.1 Program Management ......................................................................................................................................... 37 6.2 Policy & Coordination ........................................................................................................................................... 38 6.3 Prevention, knowledge and behavior change ....................................................................................................... 38 6.4 HIV Testing and Counseling .................................................................................................................................. 39 6.5 Care, Treatment and Support: .............................................................................................................................. 39 6.6 Financing ............................................................................................................................................................... 39 6.7 Human Resources ................................................................................................................................................. 40 6.8 Monitoring & Evaluation and Surveillance ........................................................................................................... 40 7. Support from the Country’s Development Partners (if applicable) ............................................................................. 41 8. Monitoring and evaluation environment .................................................................................................................... 41 ANNEXES ......................................................................................................................................................................... 42 ANNEX 1: Consultation/preparation process for the country report on monitoring the progress towards the implementation of the 2011 Declaration of Commitment on HIV/AIDS ..................................................................... 42 ANNEX 2: National Funding Matrix ............................................................................................................................ 43 4 | P a g e Acronyms AIDS Acquired Immune Deficiency Syndrome ARV/ART Anti-Retro-Viral