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The HIV/AIDS Strategy Process

The HIV/AIDS Strategy Process. Glenn Post, MD, MPH Office of HIV/AIDS. Context. Great increase in resources from minor component to dominating More scrutiny, reporting & interest 12 reports to congress in FY 03 (draft leg) about half on HIV/AIDS audits administrator

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The HIV/AIDS Strategy Process

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  1. The HIV/AIDS Strategy Process Glenn Post, MD, MPH Office of HIV/AIDS

  2. Context • Great increase in resources • from minor component to dominating • More scrutiny, reporting & interest • 12 reports to congress in FY 03 (draft leg) • about half on HIV/AIDS • audits • administrator • Operational plan -- missions prepare HIV/AIDS strategy for tech approval (GH with regional bureau and PPC)

  3. Targets, directives & strategic directions • Expanded Response targets • prevalence • PMTCT • community support for OVC • care & support for PLWHA • Scale/national-level impact • Prevention-to-care continuum

  4. Why you need a strategy • Not enough resources • Tough strategic choices • no blueprint • epidemic status • other-partner activities • direct impact/optimal use of funds • Roadmap when resources change • funding increase/decrease • Global Fund or other-donor program

  5. At stake

  6. Who needs an HIV/AIDS strategy? • Missions proposing/receiving $1 million or more per year for HIV/AIDS • Rapid scale-up countries • Intensive-focus countries • Regional offices • Basic countries

  7. What is a USAID HIV/AIDS strategy? • Stand-alone document • what is the situation? • what is the mission’s approach or strategy? • what will be the result? • what are the resources? <Tell your story> Note: Current approach may well be valid.

  8. What is the situation? • Background & problem analysis • status of the epidemic • critical populations & location • supports/constraints • prior USAID assistance/lessons learned • national strategy • other donors/Global Fund ‹What is going on?›

  9. Experience: Situation • Target populations -- specify • prevalence, size & location • Assess epidemic potential • comparative data • Context • USAID activities, results & lessons learned • private sector • national plan • other donors

  10. What is the mission’s strategy? • Objective • Rationale/targeting • Results framework • Interventions • Special concerns to consider -- stigma, youth, PLWHA, gender, etc. • Other programs & partners

  11. Experience: Strategy • Critical populations not targeted or targeted too broadly • Resources spread too thin • Results framework • not causally hierarchical • key program components missing

  12. Experience: Strategy (cont’d) • How USAID complements partners • strategic • geographic • Interventions • details, e.g., how plan to develop & where • defining behavior change

  13. What will be the result? • Nature & magnitude of expected change • critical group can have national impact • Key indicators and targets • Contribution to global E. R. targets • prevalence, PMTCT, OVC, PLWHA • Surveillance, behavior surveys, other M&E • Agency reporting

  14. Experience: Results & Reporting • Nature & magnitude of expected change unclear • need to put results -- prevalence, coverage -- in national context • Weak surveillance systems • Indicators don’t match results • USAID standard indicators not used (when should be) • Behavior change indicators limited to condom use

  15. What are the resources? • Actual or planned program funding <Where are the funds going?> • Staffing • OE -- constraints

  16. Experience: Resources • Present the current or straight-line budget first • Resource discussion too vague -- as appropriate, give a rough breakdown • directed to at-risk groups vs. general population • prevention vs. care/treatment

  17. When to submit ….Submit with new country strategic plan (CSP) -- ifby March 04 Otherwise: due by the end of FY 03: • Rapid scale-up Jan 03 • Intensive-focus June 03 • Regional office Sept 03 • Basic ($1m/yr or more) Sept 03

  18. USAID/W review • OHA sets up review meeting with regional bureau and PPC. • solicit comments • prepare discussion paper • inform mission of progress • share discussion paper • Mission participation welcome • discussion paper comments/corrections • at the meeting

  19. What can be the result of the technical review? • Draft strategy or concept paper (not subject to approval): • issues identified • comments and recommendations sent to mission • Final strategy: • approved/no significant issues • approved pending mission response • unresolved issues/mission to revise and resubmit

  20. How long will it take? • First major submission – preliminary draft or final • allow 4-5 weeks • Subsequent submission • allow about 3 weeks

  21. How USAID/W can help • Provide in-country TA -- OHA or CA -- for strategy development & -- as appropriate -- M&E, PMTCT, OVC, care, treatment, support, behavior change, youth, etc. <Priority countries have . . . priority> • Identify mechanisms for CA support • Provide virtual support/answer technical questions

  22. How USAID/W can help (cont’d) • Provide relevant materials/examples • Practical Field Guide • Carry out technical review of a concept paper or draft strategy --> recommendations for strategy development <The earlier the better>

  23. We’re prepared to go to some lengths . . . .

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