strengthening hiv/aids programs through multisectoral approaches ishrat z. husain usaid/bureau for...
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Strengthening HIV/AIDS Programs Through Multisectoral
Approaches
Ishrat Z. Husain
USAID/Bureau for Africa
Office of Sustainable Development
PHN Officers’ State of the Art MeetingJune 10-15
Nairobi, Kenya
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Overview
Progress since last SOTA Looking ahead Addressing constraints
– Approaches– Funding– Organization
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Progress Since Last SOTA
Agency Commitment – June 1, 2001 cable from the Administrator :
“It is imperative that USAID staff in heavily affected countries consider HIV prevention programming in all sectors, not just as
part of the Mission’s health programs. The design of activities in all sectors should take into account the impact of the HIV/AIDS pandemic on human and institutional capacity in the sector. In countries where there virus is not yet well established, Missions need to be cognizant of risk factors and should take the steps to
prevent the spread of the disease.”
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Country-level Progress
15 USAID Missions have more than one sector involved in HIV/AIDS. Effective practices include: – South Africa - Economic Growth– Zambia - Organization and Coordination– Tanzania - Policy Dialogue and donor coordination– Guinea and Madagascar - Multisectoral Program
in Low Prevalence Settings– Zimbabwe – Economic issues
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Country-level Progress Cont.
All high prevalence countries have adopted multi-sectoral national HIV/AIDS programs
Even a few low prevalence countries are doing the same
World Bank Map Project provides $1billion with emphasis on multi-sectoral approach
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Sectoral Progress/AFR/SD
Education:– Addressing Systemic Issues; number of countries
growing each day.– Mobile Task Team approach
Democracy and Governance- Two excellent toolkits– Grassroot- leveraged considerable amount of money
including global fund– Implementing Policy Change- very useful
Economic Growth- AGOA Papers and follow-up
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Looking Ahead
Stimulate champions in each sector to:– Mitigate impact on the sector– Adopt policies and programs to reduce risk– Contribute to care and support
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Central Role Sectoral Mitigation
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Inequalities in Income Distribution and HIV
45
50
55
Gini Index
Adult HIV prevalence end 1999
South Africa
Central African Republic
LesothoZimbabwe
NigeriaZambia
10
60
The Gini index measures the extent to which the distribution of income among individuals or households within an economy deviates from perfect equal distribution. A Gini index of zero would represent perfect equality, 100 would imply perfect in equality. Source: World Development Report, 2000/2001
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Care and Support
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Care and SupportPrevention Economic Mitigation
Continuum of HIV/AIDS
Program Components•Economic Mitigation
•Care and Support
•Prevention
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Sectoral Strengthening
Requires:– Review of impact on core objectives– Review of policies for their impact on
HIV/AIDS– Address systemic problems
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Addressing Constraints Cost and funding.
– CSD Guidelines – more research on effectiveness – Each sector should spend their own resources – 3 categories of expenditures: no investment e.g. policy
dialogue and co-location of activities, small investments e.g. large investments
Establish a special multi-sectoral fund Coordination Mechanism – National, Mission and
Washington level Concerted and Rapid Response Actions
– DART Model and Rapid Response Teams