A few years ago Panama became the first Caribbean basin country to join the ranks of high income countries. This also meant it was the first country in the sub-region that PEPFAR pulled out of. The Panamanian government pledged to put US$600,000 towards social contracting for HIV prevention. Then COVID arrived, and Panama experienced the highest number of COVID-19 cases per 100,000 inhabitants in Latin America with significant consequences on its GDP for 2020. The government ended up delivering on only US$100,000 of the US$ 600,000 promised. Fast forward to August 2021. The CVC team is in Panama for its community-led monitoring project. It meets in the offices of the LGBTQ+ group “Asociación de Hombres y Mujeres Nuevas de Panamá”. The offices are dark and very hot because the electricity company disconnected the power on account of July’s energy bill being unpaid. Despite its high income status, the reality is that most of the income in the country is concentrated among the wealthy few, and this distorts the real picture.
An estimate of about 31,000 adults aged 15 and over are living with HIV in Panama. Of these only about 59% know their HIV status, and of those that know their status only 51% are virally suppressed. So clearly there is much to do to reach 95% virally suppressed by 2030. In Panama all the HIV care and treatment services are provided by the state. CVC’s community-led monitoring initiative is also being carried out in the Dominican Republic and in Guatemala. It uses a score card methodology to identify strengths and weakness of HIV treatment sites, make recommendations and devise an action plan to implement improvements. To achieve this in Panama we held a 2-day workshop with health care providers from 11 health care facilities, followed by a second workshop with the users of these services. Some of users belonged to Key Population NGOs including networks of PLWHIV. The rich data coming out of these workshops from a provider and a user perspective, will subsequently be presented at a third interphase workshop to be held in October, that brings together users, providers, and other key stakeholders and duty bearers to agree on an action plan to be conducted at the treatment sites. Both the providers and users will have a chance to monitor progress towards the goals set in these action plans over time, and rank the quality of the services offered/received.