Opportunities for Resource Mobilization- PEPFAR perspective Anthonia Aina - HTC/Gender Coordinator US Centers for Disease Control and Prevention (CDC) Nigeria Sept 17, 2013 Dakar Senegal
PEPFAR • The President's Emergency Plan For AIDS Relief (the largest health initiative ever initiated by one country to address a disease) • a commitment of $15 billion over five years (2003–2008) from United States PresidentGeorge W. Bush to fight the global HIV/AIDSpandemic • 15 resource-limited countries with high HIV/AIDS prevalence were designated to receive • In July 2008, PEPFAR was re-authorized to $48 billion through 2013, including $39 billion for HIV and the global Fund, $4 billion for TB, and $5 billion for malaria • PEPFAR Gender Program supports and build the capacity of US Mission Agencies (CDC, USAID and DOD) Implementing partners to development effective plans that implement evidence-based strategies to address gender norms and inequities
Sources of Resources • Donor Agencies • Multilateral and Bi-lateral Organizations • Governments • NGOs • CBOs • FBOs • Corporate organizations(Banks) • Individuals Philanthropists
Opportunities Window for Resource Utilization Typical Resources -The 3 “Ms” Man – human, manpower, staff Money – funds, capital Materials – equipments, machines, instruments, stationeries, • Integration • Collaboration • Synergy Formation • Partnership • Alliance Creation • Be Receptive, open • Discussion forum • Be prepared, organized • Hopeful
How? • Advocacy-lobbying • Proposal writing • Awareness creation • Meetings • Conferences • Access to FOAs • Grants • Contracts
Integration • PEPFAR country teams and Implementing Partners (IP) develop country operational plans (COPs) and design programs that integrate gender throughout the HIV continuum of response • Over 150 IPs and subs present in the 36 states and the FCT in a country of 170m • Gender is integrated into each step of the program cycle by IPs
Whyis integrating gender into HIV programs important? • Gender norms, relations, and inequities affect health outcomes for everyone. • Understanding the unique needs of men and women, boys and girls, and other gender identities helps identify target populations and dedicate resources where they are most needed. • Ignoring gender-related barriers, such as norms and expectations and gender-based violence can negatively affect service utilization, treatment adherence, and health outcomes for everyone. • Responding to the unique needs of men and boys, women and girls, and other gender identities may improve program outcomes and enhance sustainability
Whatdoes it mean to integrate gender into HIV prevention, care, and treatment? Integrating gender into HIV programs means responding to the unique needs (?) of men and women, boys and girls, and other gender identities so they are equally able to: • access and utilize HIV prevention, care and treatment services initiate and practice healthy behaviors; and • improve their health outcomes • live lives free from violence, stigma and discrimination
Increase gender equitable access to income and productive resources including education • Providing economic opportunities empowers individuals to avoid high risk behaviors, seek and receive health care services, and provide better care for their families. • Illustrative examples: Programs to ensure that girls are given equal opportunity to attend school (e.g., support for tuition fees, uniforms & supplies) and/or vocational training (in marketable skills); • Working with governments to develop policies that increase women‘s access to economic resources, including credit, markets, land, savings, and social assistance; • Programs to provide alternative income generation activities for transgender sex workers.
Provide gender-equitable HIV prevention, care and treatment Strong PEPFAR-supported programs promote evidence-based and innovative strategies to ensure that men and women, girls and boys, have access to prevention, care and treatment services. This includes tailoring services to meet the unique needs of various groups, and decrease gender related barriers,taking into account the specific and often different reproductive health needs of women and girls • Illustrative examples: Programs that provide male-friendly HIV/AIDS and reproductive health services to encourage men‘s participation in health care (e.g. provide services where men live/gather, include evening and weekend hours if men request) • Design and implement targeted interventions to overcome barriers for MSM and transgender populations, such as training of health providers to reduce stigma and discrimination. • Programs that integrate HIV/AIDS services into family planning and reproductive health clinics in order to facilitate women‘s access to services at a single location.
Meaningful participation of women, girls and marginalized groups • Women, girls, and other populations who have been marginalized and discriminated against due to prevailing gender norms (e.g. MSM, SW, TG) need to participate in the design, management, monitoring and evaluation of HIV prevention, care and treatment to effectively address their health needs. • In order to become agents of their own health and overall empowerment, programs must move beyond viewing them only as end-users and beneficiaries and acknowledge and support their roles as principal actors and decision-makers.
Health system strengthening to ensure capacity building Multiple organizations including government (national, state and district levels), health institutions, and community based organizations can play a significant role in implementing the following recommendations: • Promote pre-service training, in-service training, and mentoring on gender issues for relevant professions (community-based workers, health care personnel including informal health workers) • Support development of civil society organizations through building advocacy, administrative and technical skills to deliver and monitor high quality health and social services. • Training of local law enforcement and members of the judiciary on laws that promote gender equality and protect the right of women and girls
Country Ownership & Multisectoral Approach It is imperative to support country ownership through close partnership with national and local governments, civil society, UNAIDS and the UN family, the GFATM, bi-lateral donors, the private sector, and other key stakeholders Recommendations: • Promote linkages to programs outside the health sector, including the legal system, education, and food security, etc. • Increase efforts to raise-awareness among families, communities and government decision-makers about the range of determinants influencing the health of men and women, girls and boys • Address and respond to harmful practices, including child marriage, forced marriage, FGM, violence against LGBT populations, and “honor” crimes.
Community Engagement A community-based approach allows community members to use their skills and resources to expand the reach of health messages and services through culturally accepted venues. This approach can help communities work locally to prevent and respond to social and health problems, including HIV Recommendations: • Engage community leaders, role models, and gatekeepers, including religious/tribal leaders, school teachers, mothers-in-law and grandmothers, etc. in PEPFAR gender activities as appropriate. • Work with local actors to identify cultural norms and practices that support HIV prevention, treatment and care, as well as gender equality, and to develop actions to reinforce them. • Employ community members in the provision of information and services, such as trained peer educators, community-based distributors, and community caregivers.