First Annual Workshop and Conference

A Program of CIFAL Atlanta
Hosted by Emory Rollins School of Public Health
Atlanta, GA, June 19-23, 2005
• Workshop Home

Session 1: Discussion about Self Assessment Process in Cities

Delegations: Kingston, Port of Spain, Denver, Washington D.C

Discussion Points

Participants in Cities’ Self-Assessments:

Port of Spain, Trinidad: For this delegation, they were able to combine the assessment with a previously established community meeting

• CARE
• Friends for Life
• TNT Alliance
• DOMA: Downtown Owners and Merchants Associations
• Politicians (2 Counselors)
• Representatives from UN AIDS and UNITAR
• Urban Management Program of Latin America & The Caribbean
• Teacher organizations
• NGOs & CBOs
• Police
• Senior officials from HIV and social organizations
• HIV positive members of the community

Kingston, Jamaica:

• Representatives of minister’s office
• Politicians
• Poor Relief: governmental org
• University of the West Indies
• Public and private medical practitioners
• Employer groups representing the private sector
• Jamaica AIDS Support- NGO
• Jamaica AIDS Committee

Denver, Colorado USA:

• Three participants from local Denver government (due to time constraints)

• The urban population of Trinidad does not just include the 45,000 people that reside in the city but also the 300,000 people that work in the city. So “transient” populations and particularly in containing the spread of HIV/AIDS, we must acknowledge those that work in the city access.
• The assessments are so subjective that the entire group felt that some direction from UNITAR would have been helpful as to who should be included in the assessment.
The time pressure under which the assessment had to be completed was taxing to get together a very diverse group together.
• There was some question as to what perspective these assessment questions were being asked from. For example, some questions seemed to be directed at the HIV-infected community but then others seem to be directed at those in public health.
• When multiple people from the same organization were involved in the assessment, this actually provoked even more discussion as they didn’t all agree on their collective view on the topic. This in turn made a given organization question/discuss where their organization stood in the whole process.
• The fact that the assessment went to the mayor’s office arose as a point of discussion in understanding how local governments worked. In Denver, the fact that the assessment went to the mayor’s office meant that it got caught up in bureaucracy and wasn’t secured by the appropriate people until a week before the conference. Thus, it wasn’t completed by a diverse group of people but instead by three participants who worked in similar capacities.
• The Denver site chose to complete the assessment from the “City of Denver” perspective; there was some question as to its effectiveness due ot the fact that only a few people were involved in the assessment and these people were part of a close circle that may not have a full view.
• This was in contrast to the Jamaica site where the assessment sent to the mayor was ideal because there is good communication within the local government.

• It is very important to not just have those involved “who know” (for example, NGOs and governmental organizations who deal with AIDS daily). It is just as or more important that people who are not “in the know” are included to get true perspective and evaluation on where a city stands in how it deals with HIV/AIDS. 
• The other challenge that was noted was that there needs to be consciousness about not rating yourself to avoid looking bad.
• Another important aspect in choosing assessment participants is: “Just because the present group knows about resources and knowledge in a country that does not mean that the general population knows.”
• It has been encouraging that so many people are willing and enthusiastic to be involved with the assessment and the AIDS agenda at large. Wherever there has been a captive audience, there has been a local HIV agency set up. Younger women are especially involved in setting these up because the incidence in this group is so high. We want people to get comfortable by speaking about it, speaking about it, speaking about it. Talking may be the only thing that a community that is resource-poor can do.
• There is disconnection between funding and associating prevention and care.
• The assessment reinforced in many ways what was already known. That Jamaica has good national programming and data collection that was difficult to get going locally.  
• Prevalence in Jamaica is still rising even with these national programs in place. HIV testing has risen from 65 to 80% (?) but there continues to be a gap in prevention and care. 

• AIDS is no longer under the Ministry of Health but rather is under the umbrella of the prime minister which has given it more validity and more of a spotlight which allows more discussion about HIV/AIDS which helps reduce the stigma of the disease.
• There is much difficulty in data keeping on a city level. The national government keeps statistics on the country-level, but in Trinidad, it is not broken out on city/region levels which make it difficult to track progress.
• There are registries of those who are HIV positive in Jamaica and Trinidad but the reliability of those records are very questionable as many people register under fake names or addresses. This is done because there is such stigma with even just getting tested.
• Myths about HIV/AIDS are still active in parts of Trinidad
• The national ministry has funds to allocate but there is a severe lack of support staff which causes nothing to be done with the money. For example, an estimated 17,000 people are HIV positive in Trinidad (2% of the population) but only 1,500 people are receiving the fully subsidized anti-retroviral because people do not know it is available.
• Marketing must be directed towards the general public and must be targeted towards the marginalized groups.
• HIV/AIDS is being discussed and advertised more freely in Jamaica and the delegates feel like the knowledge base in the country is good. Prevention, care and education are well advertised on buses and in newspapers. There is free condom distribution.
• Earmarking (or designating funds) has been a problem with designating funds. There is always plenty of money for conferences but there is a lack of money for necessary building and infrastructure. For example, an excess of money was allocated to a rather unnecessary technology project while there was no money in the funds to put an air-conditioner into the building.
• There is a major disconnect between local and central government (all participants). The lack of coordination is seen in the amount of HIV/AIDS funding accessible on the national level but how it never trickles down to the local level. Individual NGOs & churches are important on a local level.
• There is a lot of assumption of groups in Kingston (NGOs, public health ministry) that the public knows the facts of HIV and HAART availability but that most people don’t know what they are assumed to know.
• One issue with legitimizing AIDS organizations locally is that they are mostly run by volunteers who do it part-time or who do not get paid for their services. By making organizations official and mandated as a “real and not voluntary” organization, this would help its position in the community.

Areas of Focus for Delegations…

Kingston, Jamaica: Inclusion, Access to Treatment, Measuring Change

Port of Spain, Trinidad: Care & Prevention, Mobilizing Resources, Ways of Working

Denver, USA: Adapt Response, Care & Prevention, Acknowledgement and Recognition