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Improving Stewardship of National HIV/AIDS ProgramsThe Context All countries of Central Asia have National AIDS Programs in place and recognize the importance at a national level to implement HIV/AIDS programs in a coordinated way. In addition, strategic planning and situation analysis took place at the turn of the century in all 5 countries. There are National AIDS Centers functioning as a vertical system with a concentration of expertise for AIDS prevention, treatment, and care. Most of the countries have developed monitoring and evaluation indicators for HIV/AIDS. Funding for HIV/AIDS in four countries has reached an all time high, including grants from the Global Fund, the World Bank, DFID, USAID, UNODC, and other international donors. For the Global Fund grants, all four countries have established mechanisms for administering, monitoring, managing, and implementing those grants. Global Fund Country Coordinating Mechanisms (CCM) exist to varying functional degrees in each of the countries. Decision-making in the CCMs is not always transparent and decisions are sometimes made in small selective groups and only sometimes disseminated. While some of the countries’ CCMs have Secretariats, their structures are different in each country and they are not fully operational. The CCMs do not always meet Global Fund requirements for representation (especially NGO, civil society, and PLHIV) and membership selection. Procedures are not always place to ensure that the roles and responsibilities of the different stakeholders involved in the implementation of the Global Fund programs, including CCMs, Primary Receipients (PR), and Sub-Recipients (SR), are implemented transparently and in accordance with the approved Global Fund proposals. Three of the countries of Central Asia (Uzbekistan, Kyrgyzstan, and Tajikistan) have restructured their national coordination mechanisms for HIV/AIDS, though they are in varying stages of transition. This is in part due to requests from the Global Fund, but also in response to the move toward having one national coordinating body supported by UNAIDS. While the Global Fund provides substantial amounts of funds to the National AIDS Programs, it is only a portion of the total HIV/AIDS budgets in each country. The countries recognize the need to coordinate and manage the complete effort against the AIDS epidemic and not only that of the Global Fund. More and more, donors are committing to work with and under the coordination of a single national coordinating body. This is contributing to improvements in the ability of the NACMs to establish comprehensive policies to support HIV/AIDS prevention, care, and support. In addition, NGOs are receiving increasing recognition for their work on HIV/AIDS programs, and their role is increasingly appreciated. NACMs are beginning to understand their potential and the need to increase their capacity and ability to participate in the national response against the epidemics, and the relationship between them and the government is improving, though admittedly needs more support. There continues to be limited involvement of the NGO sector in policy and strategy development. CAPACITY’s Approach CAPACITY’s approach will be in accordance with the Three Ones Principle, put forward by the United Nations with full support of the United States and other member nations, as well as the Global Fund. The principle states that each country should have one national AIDS strategy, one national AIDS coordinating mechanism (NACM) to oversee the strategy, and one national monitoring and evaluation system to measure the impact of the strategy. Most countries have accepted the principle, but few have managed to put the principle into practice. This may be in large part due to a lack of methodology. Through collaboration with all interested stakeholders (government, donor, multilateral organizations, NGOs), CAPACITY is implementing a methodology to assist with the implementation of the Three-Ones Principle. As mentioned above, most countries in the region have restructured their CCMs to broader NACMs, which will increasingly bear the responsibility of coordinating HIV/AIDS funds and programs in the countries. CAPACITY is supporting these attempts to restructure coordination bodies, which should incorporate the needs of international agencies and donors, NGOs and civil society, and multiple sectors of the government into the national AIDS program.
To enable countries to adhere to the Three Ones Principle in practice, CAPACITY interventions include such activities as: 1) Produce a technical paper to spell out the methodology for implementing the Three Ones Principle and improving national AIDS stewardship. 2) Using rationale developed in the technical paper, advocate at national level with governments and international agencies to accept the authority of the NACM. 3) Support country efforts to restructure and establish one NACM. Additionally, it will be important to facilitate and strengthen the functioning of the NACM to ensure effectiveness and efficiency of leading the national AIDS program efforts, including those supported by the Global Fund. To this aim, CAPACITY will work on the following intervention areas. Structure/Function of the NACM Representation & Advocacy Role of NGOs on NACM, especially the RAC Improve Information/Communication Systems Monitoring & Evaluation System Organizational Development/Management Strengthening of national-level granting mechanisms Anticipated Results • Key stakeholders in the region cooperate and share information between countries and agencies. |
BulletinPartnerswww.rcaids.kz www.ncc.tj www.afew.org www.caap.info www.cdc.gov www.ddrprogram.org www.theglobalfund.org www.projecthope.org www.soros.org www.undp.org www.unicef.org www.unodc.org www.usaid.gov www.euro.who.int www.zplus.kz |
© 2008 Capacity Project
