1. 1 Coordinating Line Ministry Response To HIV/AIDS Sierra Leone’s Experience African Region Consultation on HIV/AIDS 14 – 18 February 2005, Addis Ababa, Ethiopia

2. 2 Presentation Outline  Background  Challenges/Issues of Line Ministries responding to HIV/AIDS in their sectors  Strategic Response to address those issues  Challenges of Line Ministry Response  Lessons Learned

3. 3 Background  Population is estimated at 5 million (Over 60% Muslims, 35% Christians and 5 % Others)  1986 Establishment National AIDS Committee (NAC)  1987 first HIV+ case registered  1987 NAC was transformed into National AIDS Control Programme within the Ministry of Health and Sanitation. HIV/AIDS the business of Ministry of Health. Result -Lack of consistent commitment from the political leadership -Absence of strong advocates to champion the cause -Lack of appreciation of the developmental implication of the epidemic

4. 4 Background Cont.  2001 institution of Cabinet Sub-Committee on HIV/AIDS and Start of collaboration to with IDA with other partners to design a multi-sectoral HIV/AIDS Programme for Sierra Leone (SHARP)  2002 Policy on HIV/AIDS enacted (1 st in the History of SL)  2002 NAC and NAS constituted to Coordinate National Response  2002 CDC estimates HIV Prevalence at 0.9% (1 st in the History of SL)  October 2002 SHARP effective & First time involvement of Non-Health Line Ministries in HIV/AIDS Control in Sierra Leone  2004 Preliminary results of the first antenatal study reported an overall national prevalence of 3.4%

5. 5 Issues/Challenges  Issues/Challenges foreseen on Multi-Sectorality of HIV/AIDS Programmes - Three Key Issues to Respond To: -How do we ensure that these new comers actively participate in the drive to contain the epidemic? (Capacity Building) -How do we ensure that the activities of these players are not duplicated and to ensure that we derive value for money? (Coordination) -How do we ensure that partner support towards HIV/AIDS in ministries are coordinated? (Coordination and Openness)

6. 6 Strategic Response to Issue of Capacity  How do we ensure that these new comers actively participate in the drive to contain the epidemic? -Establishment of HIV/AIDS Focal Point Offices and Constitution of Management Teams within Ministries -15 Focal point Offices and Management Teams have been Established -Development of a Template Work Plan on HIV/AIDS focussing on awareness and partnership collaboration/creation -14 Public Sector Institutions are getting support from NAS to implement Work Plans

7. 7 Strategic Response to Issue of Capacity cont. -Training of Management Teams on basic facts on HIV/AIDS, modes of transmission, STls, Condoms and VCT, PMTCT, Stigma and Care for Persons infected, Financial Management etc. This has resulted to: -HIV/AIDS understood as a Development Issue -Commitment and active support of decision makers -Mobilisation of Resources (Counterpart and from Donors) to scale- up activities -Sensitisation of staff to recognize their personal risks to HIV infection and to be motivated to change -Knowledgeable, compassionate and skilled staff etc. -Increased involvement of staff in HIV/AIDS activities

8. 8 Strategic Response to Issue of Coordination Inter-Departmental Coordination Mechanisms -Establishment of HIV/AIDS Focal Point Offices and Management Teams within Ministries for mainstreaming HIV/AIDS -Monthly meetings to review the activities of the Focal Point Person in the implementation of HIV/AIDS Work Plan Inter-Ministerial Coordination Mechanisms -Establishment of a Network of Permanent Secretaries that meets on a quarterly basis to review the performance of Line Ministries -Programme meetings of Focal Points convened by the Establishment Secretary’s Office (Department Responsible for Public Service) Result -Willingness to Learn, reflect and share experiences

9. 9 Strategic Response to Issue of Coordination cont. Partner Collaboration -Programme meetings of partners operating in the Ministries -Sharing of information and joint programme implementation -Involvement of partners in programme design and resource mobilization Result -Provision of additional resources from partners to scale-up and to compliment activities in Ministries e.g. UNFPA, UNICEF, ADB, US DoD and most recently ILO -Technical and logistical support to the Ministries

10. 10 Challenges of Line Ministry Response zProviding services for untargeted group zSynchronizing programmes (NAS and Partners) zMinistries raising the 10% counterpart funding zContinuous technical backstopping and monitoring of activities zScaling-up and its Coordination

11. 11 Lessons Learned zTemplate Work Plan for Line Ministries focussing on awareness creation and partnership collaboration contributes to the success of mainstreaming HIV/AIDS into the Ministry’s Delivery mechanism. zCommunity involvement in implementation of certain activities creates ownership and commitment from community members zContinuous Technical Backstopping to be provided by the Coordinator of the Public Sector Response to the HIV/AIDS Focal Point/Management Team to address problems as they arise z Advocacy of Top Leadership of the Ministry (Minister/Permanent Secretary) is required for commitment.

12. 12 I Thank You.