Latest Completion and Performance Reports
The East Asia and the Pacific region has tackled the spread of HIV/AIDS with a set of pioneering projects and innovative practices. As the nature and size of the epidemics is more thoroughly analyzed, more specifically targeted projects are being implemented, to address each country’s needs and emergencies. Here is a brief sample of closed and ongoing projects financed by the World Bank, which are designed to address the spread of HIV/AIDS in the region, together with a brief description of the results accomplished.
Cambodia—Disease Control and Health Development Project (Closed)
The Disease Control and Health Development Project's most significant contribution was to assist Cambodia to control the three most important infectious diseases - HIV/AIDS, malaria and tuberculosis. Data suggest that Cambodia significantly reduced the incidence of each of the three diseases during the project period. The project made very substantial contributions, especially in assisting the Government institution building efforts.
Cambodia has experienced among the highest HIV prevalence in Asia, with rapid increases in transmission since the first case was identified in 1991. The project played a key role in assisting Cambodia in institutional development as well as in program intervention activities through policy dialogue, substantial training and technical assistance.
First, the project was instrumental in helping the Ministry of Health prepare and implement HIV control programs as part of the Health Sector Strategic Plan and to scale up. It helped to move Cambodia’s HIV/AIDS prevention and control program from a collection of small and scattered donor-supported pilot-type schemes to a cohesive national program within the health sector.
Second, the project helped move the program from mostly donor-driven activities towards complete national ownership. Third, the project helped develop and establish high-quality program implementation and operating procedures for both Central level policy guidance and decentralized implementation in provinces with potentially long-lasting impact.
Finally, the project helped improve non-government organizations’ capacity to implement high priority HIV-related programs by supporting the programs carried by the umbrella NGO agency KHANA. The project also assisted in developing and extending a home-based care model for people living with HIV, aided in the achievement of 100 percent condom use in brothels, and participated in the intensification of targeted STI care for high risk populations, integration of syndromic case management in the services of health centers for the general population, the training of health workers, and the implementation of blood safety programs.
Read the Project Performance Assessment Report
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China – Disease Prevention (Closed)
The Disease Prevention Project aimed to prevent and control vaccine-preventable diseases to reduce morbidity, disability and mortality, especially in the poorest provinces of China; and to improve the capacity of the health sector to design and implement health promotion programs to prevent and control the rising prevalence of non-communicable diseases, sexually transmitted diseases/human immunodeficiency virus (HIV) and injury. The second objective was achieved through policy and institutional improvements and by implementing pilot programs, including surveillance, staff training, health education and other health promotion interventions, at selected locations.
The project performed quite successfully, delivering important results. A-state-of-art surveillance system was successfully established. Some innovative community-based interventions were successfully implemented. More importantly, health promotion has now become a regular activity in all project jurisdictions including China's three largest cities.
Read the Implementation Completion Report
China - Ninth Health Project (Ongoing)
The Ninth Health Project has a broader scope and aims at improving health services quality by targeting the poorest areas of the country. A crucial portion of its implementation activities, though, is dedicated to the prevention and control of the HIV/AIDS as well as safe blood practices. More specifically, the project aims at improving and expanding the policy environment, in order to prevent and control STDs, by leveraging interventions targeted at changing behavior and educating the general public, improving the disease surveillance system, and improving the management of blood transfusion services.
As far as the HIV/AIDS component is concerned, the results have been, up to now, satisfactory. During the initial phase, the provinces have introduced pilot projects and demonstrated that it is possible to implement difficult prevention programs such as condom provision and counseling to sexworkers, needle and syringe exchange among injecting drug users.
The Blood Management component was particularly successful. The project, in fact, has built a voluntary blood donation system in a short period of time. The percentage of voluntary donations has increased from 1997 to 2003, in Fujian from 10.7 percent to 86 percent; in Guangxi from 8.2 to 84 percent; and in Xinjiang from 14 to 71 percent, but they are reporting 100 percent voluntary donations. In all provinces, the rate of repeat donors has increased. Fujian is reporting 16 percent overall, but some of the project prefectures have reported much higher rates such as 30 percent for Longyan prefecture, Fuijian.
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Vietnam - Regional Blood Transfusion Centers (Ongoing)
The Regional Blood Transfusion Centers Project aims at securing the health benefits of safe blood transfusions in Vietnam. Its implementation strategy includes various subcomponents. First, the projects instituted a voluntary donation recruitment program, based on public education campaigns, and organizing blood collection sessions, focused on retaining donors that meet screening standards.
Second, a blood bank operations program was created, as to promote transporting, testing, processing, and storing collected blood, to later cross-match and dispose the necessary blood to be used at area hospitals. To date, there have been significant improvements in moving from paid donors to unpaid organized donors and to voluntary donors in the past few months. Thanks to the Ministry of Health circular on February 2004, blood donations have stopped to include payments to voluntary blood donors. The policy change marked a clear shift to voluntary blood donations in the country and the initial results from the change were encouraging.
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