Expected results| Making the difference  | Innovations

PENSIDA III 2008-2012 es HIV/AIDS in Latin America and the Caribbean HIV/AIDS in Central América es pdf 202kb

December 18, 2007, Tegucigalpa – One of the greatest challenges for countries’ HIV responses has been the lack of structured plans that are evidence-informed, results-focused and funded.  In 2006, the Honduran Minister of Finance, Rebeca P. Santos, and the Minister of Health, Jenny Meza, requested the assistance of the Global HIV/AIDS Program (GHAP) of the World Bank through LAC to support the process of formulating a new HIV/AIDS strategy (PENSIDA III, 2008-2012).  The Bank responded through ASAP -the new AIDS Strategy and Action Planning service which the GHAP hosts on behalf of UNAIDS.

Honduras is a low-middle income country that holds the unenviable first place among countries in Latin America most affected by the virus, with an HIV prevalence of 1.5%.  The request came at a moment when there is new evidence of greatly improved condom use and falling prevalence levels among the groups most at risk of infection, and a determination to continue these trends, which will also contribute to making Honduras’ free ARV treatment program sustainable. Adrian Fozzard, World Bank Country Manager says “the motivation is strong to build on recent successes, and develop a new strategic plan to guide an effective national response.” 

Within 12 months, the initial goal was achieved: Honduras has developed a strong national HIV/AIDS Strategy -presented to the people of Honduras by the Minister of Health in the presence of the First Lady- which is firmly grounded in evidence on transmission patterns (transmission during unsafe paid sex and unprotected sex between men predominates), and focuses on achieving and monitoring measurable results in reducing new infections. In the process, all involved gained significant experience in strategic planning, costing, spending analysis, results monitoring, and participatory analytical work.

The Minister of Health, Jenny Meza, has stated that “finding the right compromise between a 'one-size-fits-all' approach (which can be alienating), and a 'reinventing-the-wheel-each-time' approach, (which can be wasteful) is a challenge."  For the Minister of Health, the knowledge-transfer approach and the catalytic role of the advisors and technical support team resulted in multi-directional learning among all involved which will have lasting effects.  For Cesar Nuñez, Head of UNAIDS Latin America, “the new strategy helps realize the 3-Ones principles and improves the national response to meet universal access goals.” 

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What are the expected results?

To ensure successful implementation of PENSIDA III and achieve the results envisaged in the new strategy within the framework of the “three Ones” -- a consolidated, single national strategic plan to coordinate the work with all partners; a national coordinating authority with a sector wide mandate, and a single national monitoring and evaluation system-, four important steps are being taken: 

• improved monitoring and evaluation efforts, both of the pandemic and the response.
• prioritization of efforts to reach vulnerable populations.
• allocation of the resources required to reach vulnerable populations.
• preparation of annual action plans and budgets.

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What made the difference in Honduras?

• Decisive national leadership and strong national staff was the anchor of the entire effort, by promoting shared learning, collegiality and mutual accountability. 
• The national team was open to new ideas, contributed substantive experience to the overall work and was relentless in their desire to meet the high expectations of the authorities and civil society. 
• Purposeful and active engagement of key stakeholders and international partners.
• A strong advice and technical assistance team that used virtual communication channels in between country-missions to sustain open communication, identify potential bottle-necks, and provide just-in-time support when needed.
• Sound management by the World Bank and national Honduran teams, which ensured continuity and discipline in seeing the joint venture through to completion, keeping to the agreed timetable.

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Innovations
The strategic planning exercise in Honduras has revealed the importance of working within a clear and structured framework towards clear quality deliverables. By developing a consensus about the strategic planning “roadmap” and agreeing on roles and responsibilities, technical advisors and national staff assured that the agenda remained on track.  By designing a structure with Honduran stakeholders under the umbrella of the Honduran Multisectoral AIDS Program (CONASIDA), the planning process approach promoted high levels of participation and ownership, at critical times.

Rosalía Rodriguez-García (GHAP/HDN) and Marcelo Bortman (LAC) who directed this strategy support effort underscore that “ this work has been greatly facilitated by effective partnership with the GOH and UNAIDS and also by close collaboration between the Global HIV/AIDS Program and the Latin American and Caribbean Region with the World Bank country office in Honduras. Through this process we learned what made a difference:

• Capacity enhancement through knowledge transfer;
• Listening, not talking -to encourage participatory analysis and planning;
• A focus on sustained managed support and products;
• An effective and real partnership with UNAIDS around a common goal: to support the client –the Government of Honduras- in their efforts to better respond to HIV.”

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