The Global HIV/AIDS Program Of Action
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Transcript of The Global HIV/AIDS Program Of Action
The Global HIV/AIDS Program Of Action
David Wilson
World Bank
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Regional HIV/AIDS strategies and action plans AFR: Intensifying Action against HIV/AIDS in Africa:
Responding to a Development Crisis, 1999 EAP: Responding to HIV/AIDS in the East Asia and
Pacific Region, 2003 ECA: Averting AIDS Crises in Eastern Europe and
Central Asia, 2003 LAC: HIV/AIDS in the Caribbean: Issues and Options,
2001; HIV/AIDS in Latin America The Challenges Ahead, 2003
MNA: Preventing the Spread of HIV/AIDS in the Middle East and North Africa, 2005
SAR: South Asia HIV/AIDS Business Plan FY04-FY06
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The Actions …
Enhance & intensify Bank support to client countries for effective prevention, treatment, care and support
Contribute to and complement the work of our partners, consistent with GTT
Scope is Bank-wide, country, regional and global, big enough scale for impact
Activities must be firmly grounded in evidence.
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The Program of Action responds to: Need to strengthen country programs
Bank’s mandate and comparative advantages
Harmonization, “Three Ones” vision
Changed environment for HIV/AIDS support
Persistent and emerging challenges*
Recommendations of reviews of Bank HIV/AIDS work, lessons of experience*
* More details on ensuing slides
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World Bank HIV/AIDS projects: the global picture since 1988
1988-1998
Haiti
Rwanda
1999-2005
Both
Dominican RepublicSt Kitts & NevisSt Vincent & the Grenadines CapeTrinidad&Tobago VerGrenada Barbados Jamaica
Burundi
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Lessons learned The Bank can make a difference
Country ownership, capacity and leadership – crucial to success “Three Ones”
Programs need to be informed by evidence – M&E critical
AIDS - a development issue - integrate into broad development planning processes
Governments, private sector, civil society, PLWHA, communities all have important roles
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What are the challenges?
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Challenges – persistent and emerging
National HIV/AIDS planning not strategic, prioritized Prevention, care & treatment efforts are too small,
coverage is too low Management and implementation constraints Health systems weak, overwhelmed Expanding access to treatment raises issues:
equity, sustainability, adherence, health systems Prevention, prevention, prevention Stigma & discrimination, denial, silence persist Donors could do better
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AIDS stakeholders and donors in one African country
MOH MOEC
MOFPMO
PRIVATE SECTORCIVIL SOCIETYLOCALGVT
NACP
CTUCCAIDS
INT NGO
PEPFAR
Norad
CIDA
RNE
GTZ
Sida WBUNICEF
UNAIDSWHO
CF
GFATM
USAID
NCTPNCTP
HSSP
HSSP
GFCCP
GFCCP
DAC
CCM
T-MAP
3/5
SWAPSWAP
UNTG
PRSP PRSP
US$200M
US$290 M
US$ 50M
US$ 60M
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The WB Global HIV/AIDS Program of ActionWork closely with partners for stronger, harmonized AIDS responses
Key Action Areas
1. Sustained funding for HIV/AIDS programs & health sector
2. Support stronger strategic, prioritized national planning
3. Accelerate implementation
4. Build monitoring and evaluation systems & capacity
5. Impact evaluation and analytic work to improve HIV/AIDS knowledge and improve programs
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1. Sustained funding for effective HIV/AIDS programs & to strengthen health systems
Bank will remain a major funder, flexibly funding countries and activities others cannot fund
Long-term funding to strengthen health sectors crucial for HIV/AIDS response and other health goals
Supports stronger efforts in other key sectors
Strong commitment to harmonize efforts among donors for better impact
Ensure funding for CSOs and communities
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Mismatch between funding and infection patterns
0%
20%
40%
60%
80%
100%
Sex workers General population
HIV rate Share of infections involving Share of funding
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2. Help countries to strengthenstrategic, prioritized national planning Training and “hands-on” technical support
HIV/AIDS to be better integrated in national development planning processes (PRSP, CAS, MTEF)
Programs and planning to be evidence-informed Guidelines, good practice notes Support a network of country practitioners to share
expertise Synthesis papers on national HIV/AIDS epidemiology
and optimal responses to match
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3. Support to accelerate implementation
Financial and technical support
Adequate funding for supervision
Simplify processes, procedures as needed
Implementation Advisory Service
Joint Problem Solving and Implementation Support Team (GIST)
Ensure CSOs, PLWHA, communities, private sector all play a role as needed
Networks among countries to share solutions, experiences
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4. Build country monitoring and evaluation capacity and systems, so that evidence informs responses GAMET country support team continue to provide
intensive practical field support Develop/strengthen national M & E frameworks Guidelines, for national M&E systems Good practice examples Global, regional, and national M&E training – goal:
strong national M&E expertise More impact evaluation Support better use of data to improve programs
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5. Generate, share and use knowledge. Do more impact evaluation and analysis
Do more impact evaluations of Bank support With others, carry out new analysis in key cross-
cutting cross-country areas (e.g. poverty, finance) and country-specific AAA
New publication series (a) good practice notes, (b) HIV/AIDS analytic reports
Distribute reports, guidelines etc widely, target potential users
Improve WB AIDS website
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AIDS Strategy & Action Plan (ASAP) Service
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Existing Strategies and Annual Action Plans
Strengths Forging high level
commitment Broad range of actions Consultative process and
involvement of various stakeholders
Focus on stigma reduction and egalitarian responses
Limitations• Not always based on
evidence and transmission patterns
• Not prioritized• Limited monitoring and
evaluation• Limited costing• Not translated into
implementable action plans• Not fully inclusive
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Review of Existing Strategies
Bank review shows evidence base and prioritization weakest - management and costing also weak
Source: World Bank, 2005
86%
43%
29%
57% 57%
0
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Goals EvidenceBase
Prioritization Mgmnt Costing
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Origins of ASAP March 2005 Global Task Team (GTT) established to
harmonize donors and improve implementation June 2005 Statement of GTT Sub-Committee on
Programming and Financing: Well elaborated national AIDS strategies and
annual action plans are a prerequisite for successful implementation
Requests from countries for assistance on improving strategies and preparing annual action plans
UNAIDS Division of Labor: WB to lead, on behalf of UNAIDS (ILO, UNDP, UNESCO, UNICEF, WHO and the UNAIDS secretariat as the main partners), in supporting strategic, prioritized, costed national plans
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Origins of ASAP (cont’d)
GTT August 2005 Implementation Update call for Establishment within the World Bank of a global te
chnical assistance service (ASAP) Development of internationally recognized
standards and criteria/self-assessment tool Thailand Workshop in January 2006
Draft ASAP Business Plan: list of support activities ASAP might usefully offer
Outline for self-assessment tool
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ASAP Menu of Possible Activities
Support for enhancing national strategies and annual action plans Upgrading existing tools or developing new ones Providing easy access to information and
resources relevant to strategic planning Responding to country requests to review and
comment on strategic plans and annual action plans
Providing or helping countries to access sources of technical assistance
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ASAP Menu of Possible Activities (cont’d) Knowledge sharing and capacity building
Training in using various planning tools and model Sharing information through workshops, networks of practiti
oners, on-line communities etc Helping to coordinate, harmonize and align effor
ts of different stakeholders Consolidating different sources of advice and guidelines on
various aspects of strategic planning Developing and supporting a process to help ensure wide d
onor support and buy-in to the strategy and annual plan