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

Overview

Progress since last SOTA Looking ahead Addressing constraints

– Approaches– Funding– Organization

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.”

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

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

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

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

Central Role Sectoral Mitigation

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

Care and Support

Care and SupportPrevention Economic Mitigation

 Continuum of HIV/AIDS

Program Components•Economic Mitigation

•Care and Support

•Prevention

Sectoral Strengthening

Requires:– Review of impact on core objectives– Review of policies for their impact on

HIV/AIDS– Address systemic problems

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