From Nevis Pages

I express my gratitude to the Clinton Global Initiative for affording me and the other panelists an opportunity to address you on the challenges and prospects for the health and well-being of women, girls and adolescents in the Caribbean. I do so on behalf of my colleague Heads of Government and in my capacity as the CARICOM Lead Head for Human Resources, Health and HIV. It is important to note that resulting from its deliberations, the 37th Annual Conference of Caribbean Community Heads of Government July 4-6, 2016 issued a communique endorsing the Every Caribbean Woman Every Caribbean Child Initiative, the umbrella under which the specific elements of this Commitment falls. This is indeed recognition of the importance that our region places on the role of women, girls and adolescents in the development process. It is also a commitment to the 2030 Sustainable Development Goals approved by 192 States at the UN General Assembly in September 2015 that highlight empowering of women and girls and the new focus on women, adolescent girls, young people and gender equality in UN High Level Political Declaration on ending the AIDS epidemic adopted by consensus in June 2016.

It is important to point out that the CARICOM region, which comprises 15 Member States and 5 Associate States, has operated as a Community for over 40 years. Although economic integration, foreign policy and security arrangements have been important pillars of its association, the major successes to date have been in the areas of functional cooperation, especially in health, education, gender and youth, all of which are pivotal to the Every Caribbean Woman Every Caribbean Child Initiative. These successes are due in no small measure to the role that our regional institutions play and the priorities that are placed on human development and cooperation with international partners. The Clinton Foundation for example, played a significant role in accelerating the AIDS response in the Caribbean, by becoming a member of the Pan Caribbean Partnership Against HIV in the Caribbean in 2002, by joining in advocating for a reduction of prices for antiretroviral drugs in 2004 and by pioneering access to generic drugs which by 2006 led to significant reductions from USD 10,000 in 2002 to USD 300.00 and now, under USD 100 per person per year. This led to a significant increase in the number of people with access to affordable medicines from less than 10 percent of persons living with AIDS in 2000 to approximately 50% in 2015. It also led to substantial reduction in deaths from AIDS and the aspiration, that inspired by this Commitment, the Caribbean will be the first region in the World to eliminate mother to child transmission of HIV.

I take this opportunity on behalf of the Caribbean to say thanks to President Bill Clinton and the Clinton

Foundation for its visionary advocacy and global reach and to the Clinton Global Initiative through its corporate sponsors and community partners for their support for valuable lifesaving interventions, innovative technology, investments in human development and creative leadership throughout the developing world. We hope that a formula will be found to sustain these efforts and a legacy well worth celebrating.

The Commitment that is being presented in this session is part of a worldwide concern for reducing the gender gap and for ensuring that our adolescents are not left behind. It is conceptualized to be initiated through a pilot phase in Jamaica to be followed by a second phase that rolls out to other Caribbean Countries. Consequently sustainable financing is required in order to achieve the overall outcomes. The Jamaica pilot will be presented by Senator Kamina Johnson Smith and I would like to take the opportunity for congratulating Jamaica for being able to provide a template based on the highly acclaimed continuous data series that capture information of Jamaica’s most critical social and economic indicators coordinated by the Planning Institute of Jamaica and Jamaica Statistics.

In the remaining period, I will identify the overarching and compounding context of this Commitment. They include:

o A legal gap analysis of adolescent sexual and reproductive health and rights illustrating that the minimum age for marriage varies greatly among countries and that while the legal age of consent ranges from 12-16 years, parental consent is required for accessing reproductive health services and commodities for those less than 18 years.

o Sexual abuse is widespread throughout the Caribbean and affects many adolescent girls and boys. While not all sexual intercourse is forced, the Caribbean region has a high rate of forced sexual debut affecting 38% of adolescents (32% male and 48% female), with those younger than 12 years old at higher risk of forced sexual debut (43%) than those between 13-15 (38%) and 16-18 years old (37%) . Children and adolescents could be victims of different forms of sexual abuse. Most perpetrators are known to victims; they are frequently trusted caregivers (e.g. fathers, stepfathers, relatives, friend, and neighbours) who take advantage of their position . Regional evidence highlights the high levels of incest and intra-familiar sexual abuse in Caribbean countries.

o In these circumstances the major point of concern in many Caribbean countries is that 20-25% of households are female headed and where a father figure is absent.

o CARICOM has established Health and Family Life Education (HFLE) as a vehicle through which comprehensive sexual education is delivered in the Caribbean. The aim of HFLE is to empower adolescents both in and out of school with knowledge and skills to make more informed choices about their health and wellness, inclusive of their sexual well-being. Yet there is resistance even to age appropriate sexual education and ambivalence and lack of aptitude by teachers and guidance counselors.

o Many of the policies for the reduction of teenage pregnancy have focused on changing the behaviour of the girl and not addressing the underlying determinants – child marriage, gender inequality, poverty, sexual violence and coercion, lack of education and lack of access to reproductive health services.

o Adolescent pregnancies in the poorest 20% of Caribbean populations are likely to be 4.8 times more births than the richest 20%.

o The high level of cervical cancer is partly related to lack of information, lack of early detection and treatment.

o It is also important to point out that WHO and UNICEF studies 2000-2011 show that that the involvement of older men with younger girls was considered to be widespread and even acceptable. They also show that 32% of adolescent boys 10-15 years were forced or coerced into their first sexual experience by older females and have been categorized as the “silent emergency.”

o Both forms of abuse could be detrimental to the total development of the adolescent which includes social, academic, spiritual and by extension implications for the region’s economic growth.

Some of the outcomes that this Commitment will hopefully achieve may be guided by the recommendations of a 2014 CARICOM-UNFPA consultation on teenage pregnancy and related issues. They provide a useful template for shaping the expected results of Every Caribbean Girl Every Caribbean Woman that by 2019 the region will:

o Reduce the number of adolescent pregnancies in each country by at least 20 %

o Achieve universal access of adolescents to age appropriate accurate information as well as access to quality sexual and reproductive health services and commodities

o Implement age appropriate gender and culturally sensitive comprehensive sexuality education at all levels of the education system including early childhood through the national Health and Family Life Education (HFLE) curriculum and the informal education modalities for those adolescents not in school.

o Adapt Legal and Social protection mechanisms for the prevention of all forms of violence against adolescent girls.

o Demonstrate that solutions to women’s health, especially with respect to cervical cancer, rest on an effective integrated health system with emphasis on early detection, “test and treat.”

o Apply legal standards that comply with international obligations including the Convention on the Rights of the Child (CRC) and the Convention on the Discrimination against Women (CEDAW).

Conclusion :Ladies and Gentlemen with your collaboration and support we feel assured that we are heading in the right direction

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