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The Multi-Country HIV/AIDS Program (MAP) for Africa Status and Findings

The Multi-Country HIV/AIDS Program (MAP) for Africa Status and Findings

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The Multi-Country HIV/AIDS Program (MAP) for Africa Status and Findings

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  1. The Multi-Country HIV/AIDS Program (MAP) for AfricaStatus and Findings Keith Hansen ACTafrica February 2005

  2. Approved and Pipeline HIV/AIDS Projects June 2000 Projects in the pipeline

  3. Approved and Pipeline HIV/AIDS Projects June 2004 Projects approved Projects in preparation

  4. Approved and Pipeline HIV/AIDS Projects December 2004 Subregional projects (approved & pipeline) Projects approved Projects in the pipeline Capacity building help

  5. MAP status • 28 countries + 3 subregional projects • $1.08 billion committed so far • Nearly $400 million disbursed • ~ 40% of money to civil society • Laying groundwork for others • Several countries preparing second phase

  6. Support to national programs • Strengthen national mechanisms • 38 countries have NACs / joint reviews spreading • Global Fund building on mechanisms in many cases • Stimulate action by public sector • Benin: 20 ministries have AIDS plans funded • Cameroon: treatment has achieved 80% adherence and immune restoration / Global Fund scaling up • Eritrea: sex by students down from 9% to 2% • Ghana: M & E focal pts reporting in all 110 districts

  7. Support to civil society • Roughly 40% of overall funds • Greater involvement in governance • Over 30,000 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

  8. MAP Interim Review 2004 • Joint effort of World Bank, UNAIDS, bilateral donor, NGO • 6 country visits • Document review of other countries • Hundreds of interviews • Available on World Bank website

  9. 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

  10. 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?)

  11. Review: 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 • Accelerate attention to treatment • More explicit gender dimension • And … step up health sector support

  12. Unfocused funding

  13. Unfocused funding

  14. MAP eligibility criteria:Where do things stand? • 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

  15. Component performance • Capacity building • Need to improve, esp. in civil society • Public sector • Limited, cookie-cutter, MOH disengaged • Civil society • Strong but need to gauge impact better • Program coordination and M&E • M&E in urgent need almost everywhere

  16. Africa’s tomorrow depends on what we, together, do about HIV/AIDS today.