Building, improving and sustaining response to HIV: Learning from Cuba's Success



Building, improving and sustaining response to HIV: Learning from Cuba's Success

December 4, 2015

This report shows how the national response to HIV and AIDS in Cuba, supported by the partnership between the Global Fund and UNDP (UNDP serves as Principal Recipient of Global Fund HIV grants in Cuba since 2003), has effectively tackled the complex combination of political social, cultural and financial factors that have often rendered HIV and AIDS such an intractable challenge elsewhere, and points to some of the key actions which are likely to help sustain this success.

In particular, the report identifies the following success factors that, in spite of the specificity of the Cuban context, can help inform successful approaches in other countries:

-    Strong health and social welfare systems: Cuba’s HIV response has benefited from a strong, functional health system and human capacity in health and social welfare domains.
-    Focus and scale: The response to HIV in Cuba has, for the most part, strategically focused where it will make the biggest difference, and has been implemented to scale.
-    Combined, comprehensive programming: The use of combined, comprehensive programming approaches characterizes Cuba’s response (with services delivered by a mix of specialist and community health care and support providers, including social care and legal support, campaigns to reduce stigma, etc.).
-    Addressing the broader context and promoting social change: HIV prevention programming in Cuba identifies and addresses the many social and cultural factors influencing vulnerability to HIV.
-    Flexibility and adaptation: Cuba has shown the importance of adapting responses to adopt the most effective approaches, e.g. a move to a decentralized model which incorporates elements of community care self-help and human rights.
-    Aiming for sustainability: Many of the strategies adopted in Cuba’s response to HIV and AIDS are critical to ensuring its long term sustainability; This includes integration of interventions into the strong health sector, progressive decentralization of care and support toward community health facilities, use of primarily domestic resources, and documenting and learning from experience.