Managing Risk and Overcoming Health Systems Bottlenecks in Haiti Emerging Lessons Jessica Faieta - Senior Country-Director, UNDP/Haiti & Dr Joelle Deas – National HIV Program, Ministry of Health/Haiti

UNDP and The Global Fund To date UNDP is the Principal Recipient (PR) of 64 Global Fund Grants in 29 countries (1.4 billion, 13% of GF resources) UNDP, mandated with Capacity Development has the role of a Transient PR. To date UNDP handed-over 14 grants to National Entities. (Transition/handover underway in 8 countries) 2

Global Fund in Haiti UNDP is the Principal Recipient (PR) for the Global Fund HIV Grant (US$ 52 million) and TB Grant (US$ 10 million) PSI is PR for Malaria Round 8 Grant (US$ 31 million) Due to the 2009 OIG audit and 2010 earthquake, Haiti was placed under Additional Safeguards Policy (ASP) UNDP became PR of the HIV & TB grants amidst the 2010 post-earthquake context : January 12 th 2010 Earthquake Cholera Outbreak Difficult Hurricane Season Political Instability 3

PEPFAR in Haiti Launched in Haiti in 2004 with the relatively modest budget of $28 million PEPFAR Haiti’s budget has grown exponentially every two years to reach $56 million in 2006, $100 million in 2008, and $144 million in 2010 PEPFAR Haiti’s main activities include Prevention, Care and Support, Treatment, and Health Systems Strengthening 4

Haiti HIV Implementation Context In Haiti UNDP is managing the implementation of the HIV Grant through 14 Sub-recipients. US Government agencies are implementing PEPFAR activities in Haiti through about 31 partners.  Both implement their activities through the Ministry of Health and other partners – government, NGOs, private entities, and universities at the central and local levels. 5

Why This Collaboration? The Global Fund and PEPFAR/US Government are the 2 largest donors for HIV and TB in Haiti As of today: the Global Fund has committed a total of US$ 189 million for HIV and US$ 38 million for TB for Haiti PEPFAR invested approximately US$729 million in support of Haiti’s national HIV/AIDS response, between 2004 and

Main Services Targeted under this Collaboration for the HIV Component Antiretroviral Therapy (ART), Voluntary Counseling and Testing (VCT) and Prevention of Mother to Child Transmission (PMTCT) Services for Orphans and Vulnerable Children (OVCs) Services for Most at Risk Populations (MARPs) Health Systems Strengthening-Related Services Reporting, Monitoring and Evaluation 7

Main Steps Taken So Far / Achievements A mapping exercise on the co-funded Organizations /Services by the 2 donors Applying the Cost-Sharing Principles for co-funded organizations/specific services Conducted the first joint On-Sight Data Verification (OSDV) exercise for HIV services Leading partners in the National Exercise for Quantification of HIV drugs 8

Main Steps Taken So Far / Achievements CCM reform: Vital for the GF program oversight through “Grant Management Solutions” (GMS) funded by USAID Appointment of a GF/PEPFAR Liaison Officer (Focal Point) who is also a member of both the CCM Oversight and Project Development committees (writing new proposals to the GF) Harmonize the Supply Chain for HIV health products through one entity “Supply Management Systems” (SCMS) Reflections with the Ministry of Health on the unique consolidated supply chain and on the health information system 9

Why This Collaboration? For Better Planning: who does what, where, with whom Avoiding Duplications More Efficient Utilization of Resources Reaching wider coverage: services and geographically 10

How did this Collaboration Benefit the Response to HIV and TB in Haiti? Better coordinated efforts to support the National AIDS Program and the National TB program (no duplications) Better planning/clearer vision, particularly the procurement planning and availing of HIV-related health products for the Haitian people Sharing of implementation best-practices Better reporting through one integrated reporting system for HIV (On-going) Better Coverage (both geographical and provision of services) 11

The Way Ahead To continue the planning process, finalizing the planning data-base To conduct the planned “Portfolio Review” - October 2012 To outline a more structured collaboration strategy in light of the planned “Portfolio Review” To continue the joint OSDVs (HIV done in March and TB planned for September 2012) To continue working towards the envisioned unified procurement system for the country To continue working towards a unified health information system 12

Conclusion The Collaboration between the Global Fund and PEPFAR/US Government in Haiti led to: Improved efficiency in the fight against HIV and Tuberculosis in Haiti Improved performance of both programs This Partnership results in : Improvement in the outcomes in the fight against the 2 diseases in Haiti and benefiting the 2 programs. 13

Thank You 14