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The Joint UN Regional Team on AIDS (JURTA) for West and Central Africa (WCA) : . « DELIVERING AS ONE » IN SUPPORT OF UNIVERSAL ACCESS FOR YOUNG PEOPLE IN WCA. Fatima Maiga Program Specialist- Young People and HIV- UNFPA SRO- WCA IATT/ YP & HIV- Annual Meeting- April 2009, Geneva.

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The Joint UN Regional Team on AIDS (JURTA) for West and Central Africa (WCA) :

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The joint un regional team on aids jurta for west and central africa wca l.jpg

The Joint UN Regional Team on AIDS (JURTA) for West and Central Africa(WCA) :

« DELIVERING AS ONE »

IN SUPPORT OF UNIVERSAL ACCESS FOR YOUNG PEOPLE IN WCA.

Fatima Maiga

Program Specialist- Young People and HIV-

UNFPA SRO- WCA

IATT/ YP & HIV- Annual Meeting- April 2009, Geneva


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Outline of the Presentation

  • Brief overview of the epidemic in the WCA region and analysis of the response (Where, among whom and why are HIV infections happening now? How are countries responding to the epidemic and how is the Jurta supporting them ?)

  • The Jurta for WCA: Vision; Membership; « Clients »; Contribution to the IATT strategic objectives; Next steps.


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The WCA Region : Background

  • WCA covers 25 countries with a population size of 346,9 millions. Out of these 25 countries, 21 are among the poorest countries of the world, in terms of Human Development

  • 10 out of these 25 countries are either in conflict or post conflict situation


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HIV prevalence from population-based surveys

in countries in West and Central Africa, 2003–2006.

Mali

Niger

Chad

Senegal

Burkina

Faso

Gambia

Guinea-Bissau

Guinea

Nigeria

Benin

Central African

Republic

Ghana

Sierra Leone

Cote

d’Ivoire

Adult HIV

prevalence %

Liberia

Cameroon

Togo

Equatorial Guinea

Congo

Democratic

Republic of

Congo

6.0 – 8.0%

Gabon

4.0 – <6.0%

2.0 – <4.0%

0 – <2.0%

No available data

Sources: Various surveys and reports.

7

.


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HIV epidemic in WCA: Situation and Trends

HIV prevalence among adults 15-49 varies from 0.5% (Mauritania) to 6.2% (RCA).

Overall adult national HIV prevalence has remained stable (Nigeria and CAR have the largest epidemic in the sub-region)

Signs of decline in HIV prevalence: Cote d’Ivoire, Mali and Urban Burkina Faso.

AIDS-related deaths have started to show a relative decline

HOWEVER…


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HIV EPIDEMIC IN WCA: TRENDS

  • Existence of significant intra-country disparities: e.g. in DRC, prevalence varies from 2.7% to 7.8% and in Togo, from 1.8 to 8.3%

  • Feminization of the epidemic: About 9 324 000 adults and children (3 871 700 women) are living with HIV, confirming the feminisation of the epidemic in this region (UNAIDS 2006 Report).


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HIV & Young People IN WCA: Current situation and Trends

  • .


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Sex- disaggregated VIH Prevalance (%) among young people (15–24 years ) in various countries 2005–2007

Swaziland

South Africa

Zimbabwe

*Central African Republic

Uganda

females

*Chad

*Côte d'Ivoire

male

Sierra Leone

Rwanda

Haiti

Guinea

Ethiopia

Benin

Mali

DR Congo

Niger

Dominican Republic

Senegal

Cambodia

India

0

5

10

15

20

25

VIH Prevalance (in %)


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Sex- disaggregated VIH Prevalance (%) among young people (15–24 years ) in various countries in West Africa

  • Traoré Y.,

  • WAHO 2006


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Sex before 15 among young people (15-24 years) by country


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.

A Study shows that on average, there is 3 condoms per person per year in Africa.


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.


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IN SUMMARY, the epidemic in the region is driven by:

  • Unprotected heterosexual intercourse ( remains the epidemic’s main driving force in WCA Africa)

  • Critical economic and social issues affecting gender relations , which increase women and girl’s vulnerability

  • High levels of migration and mobility.

    Overall trend of sexual behavior among YP is relatively positive.


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THE RESPONSE


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  • By late 2007, almost all the 25 countries of the subregion had embarked on the process of « scaling up their national responses » to make HIV prevention, treatment and care « universally accessible » to all by 2010

  • As of today, 13 countries are implementing nationally agreed roadmaps for scale-up over five years (2006-2010).

    Evidence suggests that those countries able to harmonize target setting with the strategic planning cycle, encountered far less difficulties in establishing targets than those who undertook a separate process .


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Challenges and opportunities

Despite efforts towards UA, challenges remain: In terms of access to prevention, care and treatment services, the situation in WCA is alarming.

An analysis of recently compiled UNGASS reports (2006) from 18 countries in the region shows that: (i) less than 6% of adults had access to Voluntary Counselling and Testing (VCT) services; and (ii) less than 50% of young people aged 15 to 24 reported the use of a condom during sexual intercourse with a non-regular sex partner.


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Constraining Factors

  • Countries are faced with difficulties to finance their national AIDS responses, including their UA scale up plans and programs ( Lack of knowledge and awareness about the existing or potential financial and technical resources)

  • Many countries also have capacity limitations for managing financial resources

  • Widespread misconceptions about HIV and AIDS as well as socio-cultural beliefs which undermine respect for gender rights and favor stigma and discrimination

  • Difficulties remain in coordinating financial and technical support to countries, despite mechanisms put in place ( JUNTAs, JURTA)


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Opportunities: the JURTA for WCA

BACKGROUND:

  • At a meeting in November 2005 in Dakar, the Regional Directors team for Africa approved the cosponsors’ regional HIV focal points proposal for joint action within the regional context of West and Central Africa and asked the group to focus its action on the intensification of country support.

  • In 2006, the group of Cosponsors’ Regional Focal Points on HIV prepared a proposal concerning the establishment of a Joint UN Regional team on AIDS (JURTA).

  • The JURTA started implementing its first joint plan of action by mid-2006. Second plan of action for 2008-2009 currently under implementation


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JURTA: Vision

  • The vision of the JURTA is to intensify the provision of coherent and efficient Joint UN Support at country and regional levels within the context of the MDGs and scaling up towards universal access and to assist countries to reduce the impact of HIV.


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MEMBERSHIP & FOCUS

Members: Staff from the 10 co-sponsoring agencies

Areas of focus: Based on the JURTA 2008-09 workplan, task teams were set-up to work on:

  • Technical Assistance:

  • Joint programmes of support at Country level

  • Making the money work

  • Strategic Information


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JURTA: “CLIENTS”

Within the 25 countries of the region, the primary clients of the JURTA are:

  • Joint UN Teams on AIDS at country level

  • UNCT (UN Country Team and Theme Group)

  • National AIDS Councils (NACs)

  • Technical Support Facilities

  • Regional Organisations and Commissions: African Union, ECOWAS, CEMAC, CEAC, ADB but also regional YSOs such as Afriyan.


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JURTA: CONTRIBUTION TO THE IATT/HIV & YP’S KEY OBJECTIVES AND ACTIVITIES

IATT/YP OBJECTIVE: “To build the capacity of Joint UN Teams on AIDS and/or Technical Working Groups on AIDS and partners at country level to scale up HIV prevention, among young people through:

- providing evidence-informed policy, operational, and technical guidance on country level planning, management and implementation of HIV interventions for young people; and

- producing strategic information and tools, including M&E tools, to track progress on implementation and inform further programming”.


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JURTA’S KEY ACHIEVEMENTS:1. Technical support to the National AIDS Council of Senegal.

  • Starting 2007, the JURTA ( mainly UNFPA, UNICEF and WHO ) provided substantive technical support to the Senegal NAC to assess the state of its national prevention efforts aimed specifically at the 10-24 years old in Senegal

  • A peer- review methodology was used to assess HIV prevention programs aimed at adolescents and young people in all the 11 regions of Senegal

  • The review allowed for stakeholders to identify gaps and opportunities to guide future planning and interventions.

  • As part of this process, the Jurta adapted a Joint review tool of prevention programs among adolescents and young people and documented the entire process in Senegal in view of replicating the experience in other countries in the subregion.


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Key Results

  • The review and dissemination workshop have enabled program planners and implementers (including YSOs) to pinpoint crucial gaps in their response, mostly in terms of coverage and coordination of activities. For instance, the review highlighted the lack of focus on most- at-risk young people, including girls; and has allowed for frank and open discussions among all stakeholders on challenges, solutions and way forward.


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2. Sub- regional workshop on  HIV programming for and with Youngpeople

- Held in Douala  from 22 to 26 September 2008 and facilitated by the JURTA (UNAIDS RST, UNICEF, UNFPA and  WHO) with support fromCESAG (key regional training institution). 

- Peer review Methodologyused

- Main Objective:Mobilize and assist countries with the highest prevalence in the region ( CAR, CI, DRC, Congo,Cameroun, Chad , Gabon) in reviewing their national  prevention  response andidentifying gaps and opportunities intheir national planning and implementation processes.

 - Participants: 70 representatives from nationalHIV & AIDS programmes, JUNTAs and JURTA, Civil Society Organizations, including youth leaders.


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KEY RESULTS

A Road map for each participating 

country was developed, with focus placed on:

- Prevention, with particular emphasis on most at risk and vulnerable adolescents and young people

  • Monitoring and evaluation

  • Procuring Technical assistance: identification of TA needs for 2009 in support of countries’ roadmaps.


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3. Empowering youth at the 2008 ICASA

In 2008, the JURTA worked with:

  • The Youthfront, a coalition of local, regional and international youth-led organizations

  • International YSOs: Save the Children, Plan International, Africaso

  • ICASA 2008 Secretariat

    In order to:


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  • Provide adequate technical and financial support to the Youthfront activities

  • Organize the ICASA youth preconference: more than 270 participants from over 41 countries

  • Ensure effective and quality participation of youth in the main conference: e.g, there were 24 youth led sessions.

  • Disseminate strategic information: launching of the Global Guidance Briefs on HIV Interventions for Young People


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Key Results:

" The best thing that happened to ICASA 2008 was youth participation. There was not a single session I was on that I did not see young people there".Peter Piot, at ICASA 2008.

« ICASA 2008 ends with call for stronger youth focus »ICASA 2008 closed on 7 December with a strong message: youth are essential in the response to AIDS in Africa, especially those living with HIV. The closing ceremony began with a statement delivered by Ms Souadou N'Doye, a young Senegalese. She spoke on behalf of all young Africans and urged those in attendance to ensure that young people are involved in the design of HIV – UNAIDS 2008;

Source: UNAIDS Website 07 December 2008


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NEXT STEPS

  • As a way forward for 2009 and beyond, the Jurta will continue to Support WCA countries in their UA scale up efforts.

    Particular emphasis will be placed on strengthening our collaboration with the JUNTAs : support them in the development, implementation and quality assurance of their workplans.


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The JURTA’s 2009 youth-related activities will address region specific challenges and priorities, particularly:

  • Insufficient funding or low absorption capacity of funding at country level:

    In June 2009, with funding from UNFPA, the JURTA will organize a subregional experts workshop to strengthen the « Youth and HIV » components in national documents (PRSPs, NSP, National youth action plans) and Global Fund proposals.


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  • Strengthening planning and programming processes at country level: the Jurta together with members of the GIATT will undertake joint missions in Cameroon and CAR to support the review of national HIV prevention programs in favor of adolescents and young people.

  • Ongoing activities to build the capacity of regional youth organizations and networks, including providing them with skills and opportunities to assist countries and stakeholders at country level


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WE HOPE TO DO ALL OF THIS IN CLOSER COLLABORATION WITH A STRENGHTENED AND EXPANDED IATT/HIV & YP.

THANK YOU FOR YOUR ATTENTION!


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