1. ASAP support to the National HIV programme in Latvia Signe Rotberga Regional Coordinator for the Baltic States
In Latvia, HIV and AIDS epidemics are disproportionately located among injecting drug users (IDUs). HIV prevalence in this group is around 22-26%. Prisoners is another particularly vulnerable and marginalized population that is increasingly affected by HIV and AIDS. The HIV prevalence rate in the prison population has increased from 2.2% in 2000 to 6.1% in 2006, and it is 43 times higher than in the general population. As the National HIV/AIDS Program for the previous five year period expires in December 2007, the Ministry of Health started development of a new National Program for Drafting of the new National Program was completed by the time when a new United Nations Office on Drugs and Crime (UNODC) project “HIV/AIDS prevention and care among injecting drug users and in prison settings in Estonia, Latvia and Lithuania” was started.

2. ASAP/UNODC support in development of National HIV Strategy
No additional costs for the governments
Simple application procedure ( )
Quick response (telephone conference with key stakeholders)
Competent consultants with broad expertise: strategic planning, M&E, costing, interventions for IDUs and prisoners
My presentation will foucus on the techninal and financial support that ASAP provided to Latvia as well as the ASAP peer review process. As UNODC, one of the UNAIDS Cosponsors, let me give some initial reactions on ASAP and the process for requesting technical support and how this support is provided:
The ASAP Secretariat is a small group that depends on the UNAIDS secretariat and Cosponsors
Because of the nature of the epidemic which is concentrated on vulnerable groups, ASAP allowed us to take the lead in providing support to government so we felt empowered.
We in UNAIDS have a division of labor where one Cosponsor will take the lead without establishing a monopoly, allowing other Cosponsors to support according to their comparative advantages.
ASAP finances the technical support provided, including peer reviews and consultants, so there is no additional costs for the governments
There is a very simple application procedure – an is sent to the ASAP manager with a request, briefly describing the needs
ASAP responds quickly by scheduling a telephone conference with key stakeholders a few days after receiving the request
ASAP and partners such as the UNAIDS Technical Support Facilities share rosters of competent consultants with broad expertise in strategic planning, M&E, costing, interventions for IDUs and prisoners who provide technical support

3. Process of development of National HIV Strategy
Beginning of 2007: drafting by national experts
August 2007: ASAP peer review
October–December 2007: technical support for revision by national and international experts supported by ASAP, WHO, and UNODC; discussion with all major stakeholders
February 2008: Second ASAP peer review
Autumn 2008 (planned): approval by Government
In late-2007, UNODC informed the Ministry of Health about the possibility to submit the new HIV Program for ASAP peer review. The Ministry of Health decided to use this opportunity because the application procedure was very simple and the comments on the Program could be received very quickly and at no additional cost.
ASAP peer review comments acknowledged that Latvia had identified the main groups affected by its concentrated epidemic, however it was noted that the planned activities were not linked to the epidemiological data, targets and indicators should be revised and more details should be given on the planned activities, costs and financing sources, and assessing implementation capacity.
The Ministry of Health highly appreciated the constructive proposals and was interested to receive further support from ASAP and UNODC in revising the National HIV Program.
Country-based partners decided to revisit their plan and request technical support to strengthen the evidence base, design programmatic strategies in line with the epidemic, sharpen indicators and strengthen institutional arrangements.
It was decided to invite a team of four international consultants comprising an expert on costing, HIV prevention in prisons, interventions towards injecting drug users and a lead consultant with expertise in strategic planning and monitoring and evaluation.
WHO agreed to support a team of national experts who took part in the revision of the Program.
International experts had two missions to Latvia to collect and analyze additional data on the epidemic and to meet will all major stakeholders representing state and municipal institutions as well as non-governmental sector. A workshop was organized to present and discuss the revised Program.

4. Overall… As a result of ASAP support, the revised strategy:
Is driven by data on the epidemic
Includes greater detail on planned activities, costs and identification of financing sources in line with the data
Incorporates realistic and achievable assessment indicators and targets
Describes more clearly the institutional arrangements to implement the new strategy