Implementation of regional and international HIV prevention - SAfAIDS

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The national strategic plans for the two countries also set out clear policy objectives andpriorities based on a needs analysis and rational policy choices. The NSP in Swaziland addressesthe needs of different segments of the population through the various strategies that areclearly outlined in the NSP. The country has an implied prevention strategy which prioritisesbehavior change around sexual activity and partnerships, condom logistics, promotionand management, prevention of mother-to-child HIV transmission of HIV, prevention andmanagement (early diagnosis and treatment) of STIs, post exposure prophylaxis, prevention ofHIV and AIDS at the workplace, and HIV and AIDS counselling and testing. Prevention strategiestarget the population groups that have been identified as high risk groups. These groupsinclude in- and –out of school youths, commercial sex workers, seasonal and factory workers,long distance truck drivers, the armed forces and employees of the public transport sector.The NASF in Zambia is also informed by needs on the ground, and priority areas areidentified in the national HIV and AIDS policy by stakeholders. NASF operationalises the HIVand AIDS policy. The HIV and AIDS policy outlines sectoral responsibilities which are neithergoals, objectives nor strategies. It is simply a responsibility. For this reason, it needs to beoperationalised. This is done through the NASF. Priorities with the NASF were also set by way ofthe Three Point Criteria, which was used to qualify each issue into a strategic issue. This criterionassessed three aspects of an issue, i.e., is the issue fundamentally complex; is there anythingwhich NAC can do about this issue within the provisions of its mandates and if NAC does notdo anything about this issue, are there grave negative consequences which will ensue as aresult of this failure? Through this criterion, strategic issues were identified and included in theNASF. The NASF also identifies within its guiding principles that HIV and AIDS interventionsshould be pro-poor, with HIV and AIDS mainstreamed in the national development agenda,sector policies, plans and budgets of the country in order to ensure sustainability. HoweverNASF does not have a deliberate objective specifically developed for the poor. Nonetheless,this principle is invoked in a different theme group, other than prevention, where it shouldhave been prominent.36In theme group three of mitigating the socio-economic impact of HIV and AIDS, all the threestrategic (14, 15 and 16) objectives are pro-poor. All three strategies outlined in that sectionaim at protecting and providing support for OVC, PLHIV and promoting the programme offood security and income/livelihood generation for PLHIV and their caregivers/families. Indeed,stakeholders agree that the documentation of objectives and strategies for PLHIV in both thepolicy and the NASF are clearly provided for and straight forward. The problem has been lackof concrete operationalisation of what is provided for. Besides being informed by needs on theground and priority areas co-identified with partners, the Strategic Plans for both Governmentsalso serve as vehicles for translating the numerous regional and international declarations andconventions to which they are signatory into programmes of action, by aligning themselveswith most of them. There is a strong realisation that HIV and AIDS are very much inter-linkedwith poverty, social and economic inequities between men and women and long-standingcultural behaviours and beliefs, and that the epidemic seriously undermines, the countries’commitment to achieving set targets from the different international declarations andconventions which they signed.6.1.4 Mechanisms for co-ordination and co-operation in prevention of HIVThe Swazi and Zambian national strategic plans make provisions for the co-ordination of amulti-sectoral response to HIV and AIDS. Clause 8 of the Second National Multi-sectoral HIVand AIDS Strategic Plan 2006-2008 in Swaziland spells out that NERCHA is “mandated to
co-ordinate the national response and further provide support in the form of funding andlogistics to a wide variety of implementing partners which include government, private sectorand civil society organisations.” Clause 9 of the strategy details the mechanisms through whichNERCHA co-ordinates actors in the HIV and AIDS sector. It mandates NERCHA to disseminatethe policy to all implementing and supporting agencies. It is responsible for the formulationand implementation of sectoral and constituency plans. It also has budgetary oversight i.e.,translation of the national strategy plan into annual sectoral operational work programmes,resource mobilisation and funding aspects regarding implementation of the plan. However,the strategy falls short of detailing mechanisms to ensure co-operation of multiple actors inHIV and AIDS. It actually admits that linkages of NERCHA to existing partners and stakeholderswithin the broader co-ordination framework are not defined. This has led to it being viewedwith suspicion and perceived as competing with implementing agencies.In Zambia, the NASF make provisions for the NAC to co-ordinate the multi-sectoral responseto HIV and AIDS. Through the NASF, NAC should work to strengthen the institutional legalframework as part of co-ordination. NASF emphasises co-ordination through decentralisedstructures, including policy reform, joint planning and formation of synergies between andamong stakeholders. However, there are many opportunities and mechanisms that exist inZambia which foster co-ordination in ways that are not described in the NASF. For example,at district level, most DATFs hold stakeholder forums on a quarterly basis (SHARe, 2008). Thepurpose of the stakeholders’ forum at that level is to share experiences, and lessons learnt, andto create linkages and synergies and reinforce practical co-ordination. Civil society is composedof self-co-ordinating bodies including the civil society forum itself, and the OVC forum. FBOsare co-ordinated through the Zambia Interfaith Non-Governmental Organisation on HIV/AIDS,the youth are co-ordinated through the Forum for Youth Organisations in Zambia, traditionalleaders through the National Royal Foundation, PLHIV through NZP+ and Treatment Advocacyand Literacy Campaign, while the disabled are co-ordinated by the Zambia Alliance of Peoplewith Disabilities.NAC in Zambia is also working with the Department of Manpower Development (PSMD) tocome up with a public sector strategy aimed at enhancing co-ordination of a public sector HIVand AIDS response. Co-ordination of private sector response ideally should be done through theTripartite Advisory Council and Decent Country Workplace Programme agenda. With supportfrom ILO the tripartite arrangement did carry out a detailed study in 2007 which led to theestablishment or declaration of the three pillars which ILO Zambia is using as the basis to supportthe world of work. Of these three pillars, pillar two is all about HIV and AIDS in the world of work.Unfortunately, even the NASF supplement did not consider funding the Tripartite AdvisoryCouncil the main co-ordinating body of all activities in the world of work, yet the privatesector contributes 58.5% of funding to the NASF. Zambia Workplace AIDS Partnership whichcomprises four private sector NGOs, falls outside the jurisdiction of the tripartite arrangement.Strictly speaking, ZWAP members are civil society organisations or agencies working in theprivate sector. In their quest to facilitate co-ordination and raise awareness in the informalsector where some members may not even be unionised, ILO did conduct yet anotherstudy in 2007 which concluded that the Zambia Chamber of Small and Medium BusinessAssociations (ZCSMBA) is better placed to have units within its district offices through whichHIV and AIDS may be co-ordinated in the informal sector. The NASF should have highlightedthese factors, considering there was an opportunity during the mid-term review of the NASF,but it did not.37
Page 3 and 4: ACKNOWLEDGEMENTSThis research was c
Page 5 and 6: 6.0 HIV/AIDS STRATEGIC PLANNING, MO
Page 7 and 8: SAfAIDS Southern Africa HIV & AIDS
Page 9 and 10: Generally, survey findings show tha
Page 11 and 12: The national HIV prevention, treatm
Page 13 and 14: RecommendationsSwaziland-specific r
Page 15 and 16: Civil Society Organisationsa) Co-or
Page 17 and 18: 1.0 INTRODUCTION1.1 BackgroundHIV i
Page 19 and 20: 2.0 METHODOLOGYThis assessment prim
Page 21 and 22: Table 2 below shows HIV and AIDS es
Page 23 and 24: Having developed its first PMTCT gu
Page 25 and 26: Zambia is one of the Sub-Sahara Afr
Page 27 and 28: During the reporting period it was
Page 29 and 30: In Zambia the HIV and AIDS response
Page 31 and 32: Convention or Declaration Date Swaz
Page 33 and 34: However, serious gaps exist. The tw
Page 35 and 36: Generally, HIV and AIDS data in bot
Page 37: through focus group discussions inv
Page 41 and 42: All these positions are filled. UNA
Page 43 and 44: 7.0 FUNDING MECHANISMS FOR HIV AND
Page 45 and 46: 8.0 HUMAN RESOURCE MANAGEMENTHuman
Page 47 and 48: 9.0 EXTERNAL OVERSIGHT MECHANISMSTh
Page 49 and 50: Nevertheless, the media in Zambia s
Page 51 and 52: 10.1.2 Specific lessons from Zambia
Page 53 and 54: 11.0 MECHANISMS FOR CO-ORDINATION O
Page 55 and 56: 12.1.1 SwazilandA number of key sta
Page 57 and 58: e) Strengthen M&E systems of key de
Page 59 and 60: REFERENCES1. A Report on the Assess
Page 61: ACTION POINTS FOR FUTURE USE59
Page 65: ACTION POINTS I WILL SHARE63

Implementation of regional and international HIV prevention - SAfAIDS

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