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Elizabeth Lule Manager ACTafrica The World Bank’s Support to HIV/AIDS Programs in Africa

Elizabeth Lule Manager ACTafrica

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The World Bank’s Support to HIV/AIDS Programs in Africa. Elizabeth Lule Manager ACTafrica. A global view of HIV infection. 2. HIV/AIDS and DISABILITY. 60 million people live with disability in Africa People with disabilities face high risks of HIV infection - PowerPoint PPT Presentation

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Page 1: Elizabeth Lule Manager ACTafrica

Elizabeth LuleManager

ACTafrica

The World Bank’s Support to HIV/AIDS Programs in Africa

Page 2: Elizabeth Lule Manager ACTafrica

2

A global view of HIV infection

2

Page 3: Elizabeth Lule Manager ACTafrica

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HIV/AIDS and DISABILITY• 60 million people live with disability in Africa

• People with disabilities face high risks of HIV infection

– high exposure to sexual violence, coercion and rape because of physical dependence, life in institutions, lack of legal rights, low education status250M in ’05 alone

• Poor access to HIV information and services

– Low education status, low literacy rates, social and economic obstacles limit access, lack of physical access to HIV testing and treatment, misperceptions that disabled people are not sexually active

• Double stigma

• Lack of inclusion and participation in HIV and AIDS policy formulation and programming

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Africa Strategy 1999 and the WB 2005 Global Program of Action (GHAP)

1999 Africa Strategy

• Advocacy to intensify action

• Resource mobilization – internal and external

• Knowledge management

• Mainstreaming

• Capacity building

• Partnerships

2005 GHAP Program of Action• Assist countries to

– prioritize and cost national strategies and annual action plans

– integrate HIV/AIDS into the broader development framework (PRSP, MTEF)

– mainstream HIV/AIDS in other sectors

• Fund HIV/AIDS programs, groups, activities not funded by others and health systems

• Accelerate implementation• Results focused (M&E)• Analysis and knowledge sharing• Partnerships

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MAP eligibility criteria:

• Strategic approach to HIV/AIDS– Strategies, but not enough strategic action

• High-level coordinating body– Too closed, too much command-&-control

• Exceptional implementation measures– Flow of funds still slower than necessary

• Funding multiple agencies/actors

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MAP Status29 countries + 4* sub-regional projects

$1.12 billion committed so far

$744 million disbursed

> 50,000 civil society subprojects funded

Laid the groundwork for other donors

2nd phase MAPs prepared in 5 countries – 4 approved and 3 under preparation

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Projects approved

Approved and PipelineApproved and PipelineHIV/AIDS ProjectsHIV/AIDS ProjectsMay 2006May 2006

Projects in the pipeline

IDF grants

Subregional projects (approved)

THE MAP

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MAP structural achievements• Strengthen national mechanisms

– All countries have national authorities & programs

– Financial, procurement, M&E systems improving

– Harmonization—joint program reviews spreading

– Global Fund building on mechanisms in many cases

• Strengthen civil society involvement– Financial architecture in place; 40% of money to CS– Proven viability of decentralized flow– “Revolutionized” community dialogue on HIV/AIDS

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Support to civil society• Roughly 40% of overall funds• Greater involvement in governance• Over 50,000 subprojects funded

– Large share at community level– Proven viability of decentralized flow– Building mechanisms all partners can use

• Combine $ with capacity support– Kenya: training in financial and project

management, proposal writing, M&E

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Review: What’s working?• Laying foundations for national action• Promotes “The Three Ones”

– National leadership, strategy, and M & E– Joint reviews in Ethiopia, Kenya, Rwanda– Multi-donor pooled support in Malawi

• Substantial, flexible, streamlined resources• Engaging civil society (unprecedented)• Stimulating multisectoral involvement• New MAPs learning from older MAPs

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Review: What needs work?

• Accelerate implementation (variable)• Strengthen NACs and clarify role• Deepen political commitment• Strengthen public sector response

– Better sector programs; greater MOH engagement

• Simplify civil society procedures• Use full scope of MAP flexibility (outsource)• Substantially strengthen M&E (condition?)

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What to add?• More strategic national frameworks

– Design the program for the local situation

• Link disbursements to performance

• Technical guidance on good practices

• Enlarge civil society involvement to reach vulnerable groups including disabled

• Accelerate attention to treatment

• More explicit gender dimension

• Focus on vulnerable groups

• And … step up health sector support

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What needs to work for people living with disabilities

• More analytical work to generate the evidence base for effective policy dialogue

• Deepen political commitment• Capacity building for effective advocacy and

participation• Disseminate tools and good practices of what is

working• Forge strategic alliances and build coalitions

– www.africacampaign.org

References– Global Survey on HIV/AIDS and Disability, by Nora Groce, Yale University and World Bank (April 2004)– The Forgotten Tribe" Persons with Disabilities and HIV/AIDS by Ambrose Murangira, National Union of Disabled Persons,

Uganda (July 2005)– The Africa Campaign on Disability and HIV & AIDS

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Need to redefine the role of the World Bank for 2007-2011

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005*

World Bank MAP

GFATM

3 by 5PEPFAR

G8

Avg Price of ARVs

$7,944-20,224/Person per year

Avg Price of ARVs

$50-200/Person per year

* Projected fundingSource: UNAIDS, 2004.

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MUCH MORE NEEDS TO BE DONE