Canada Southeast Asia Regional HIV/AIDS Program - CSEARHAP

Introduction

Although the vulnerability of migrants and mobile populations has been highlighted as a priority for inclusion in the national HIV/AIDS strategies of many countries, they are a particularly difficult group to reach. As a result, significant reform is required in the way national governments deal with them.

Almost exclusively dependent upon donor funding for HIV programming, each country in this project (Cambodia, Lao PDR, Thailand, and Vietnam) recognises the need to more effectively address HIV vulnerability among mobile and migrant populations through comprehensive programming, rather than through traditionally fragmented interventions that have yielded only mixed results.

This project sought to build national and regional capacity to develop programmes that work across sectors to reduce the vulnerability of mobile and migrant populations to HIV/AIDS. It worked closely with the national governments in each of the countries.

Objectives

The specific objectives of this project were:

• To develop enabling national policies conducive to reducing risk among mobile populations and that are reflected in gender-sensitive national plans in the context of the Regional Strategy on Mobility.
• To strengthen national capacity to collaborate regionally on mobility-related HIV/AIDS programmes.
• To strengthen regional cooperation and coordination in addressing common issues on mobility-related HIV policies, plans, and programmes.

Results

CSEARHAP overcame a number of challenges in the initial stages/start up of the project to make substantial progress towards its planned results. In particular, the CSEARHAP team succeeded in reaching and sometimes exceeding goals in two of the four countries (Cambodia and Vietnam), while making significant strides in the other two countries, especially in light of the conservative political and cultural contexts in these countries.

Overall, as noted in the Final Evaluation Report, the project results have contributed to reducing MMP vulnerability to HIV/AIDS in the GMS through:

• the review and revision and development of national policies in several sectors that strengthen the prevention through education protocols of workers migrating through official channels;
• the initiation of operational protocols for these policies in several jurisdictions; and
• the demonstration and sharing of initial efforts to address HIV vulnerability in cross-border migrants.

 

Outcome 1: Enabling National Policies

Outcome 1 addressed the development of enabling national policies conducive to reducing HIV-related risk among MMP and the reflection of these policies in gender-sensitive national plans in the context of the Regional Strategy on Mobility. The design of this Outcome recognized that each of the four partner countries was at a very different stage with respect to its National AIDS policies and congruency with the Regional Strategy. Significant progress was evident for this Outcome: mechanisms for sustainable multi-sectoral policy dialogue around reducing HIV risk to MMP was initiated in all four CSEARHAP countries, leading to an enabling policy environment and, more importantly, the development, approval, and in some instances operationalisation of eighteen new national policies and plans. Some of these new policies and plans addressed the gender aspects of mobility-related HIV risk. New financial resources were identified, sourced, and allocated to mobility-related HIV prevention; despite the fact that some of the national ministries themselves failed to allocate funds to the specific national or provincial plans designed through CSEARHAP, other donors have contributed to the operationalisation of plans in three of four countries, thereby contributing to sustainability and donor harmonization.

Outcome 2: National Capacity Building

Outcome 2 focused on strengthening national capacities to plan and collaborate regionally on mobility-related HIV/AIDS programmes. While capacity building was also a cross cutting concern of the project (in that all project outputs contributed to enhanced capacities), Outcome 2’s targeted outputs focused specifically on capacity building around cross-sectoral and bilateral or regional programming management, mainstreaming gender, mobilizing appropriate resources related to HIV and mobility, and addressing cross-border and regional MMP issues. Significant achievements were also made in this Outcome area: that capacity was successfully being developed is evident in the policy and legislative and strategy changes accomplished or in process (as noted in Outcome 1 above). Examples of improved capacity gained through CSESARHAP interventions include:

• Improved knowledge and skills of the multi-sectoral teams at the national and provincial levels;
• Improved coordination and collaboration across sectors on issues of HIV and mobility both national-provincial and cross-border; and
• Increased capacity levels within institutions to address issues of HIV and mobility through policy review, development and enforcement, advocacy for HIV and MMP programming – as evidenced through the demonstration projects.

Multi-sectoral information sharing and coordination increased both within and across the partner countries, leading to the development (or planning) of more coherent programmatic responses to issues around HIV vulnerability of MMP – all reflective and in support of the Regional Strategy. The project’s partners also gained capacity to conceptualise and develop funding proposals to sustain the activities begun with CSEARHAP funding.

Outcome 3: Regional Coordination

Outcome 3 focused on strengthening regional coordination and collaboration to address common issues on mobility-related HIV policies, plans, and programmes to ensure that country work plans responded effectively and coherently to the Regional Strategy. Through the MAP-4 mechanism, a forum that brought together representatives from each country, the international donor community, executing agencies, and associations representing the private sector, civil society and people living with HIV/AIDS, CSEARHAP engaged country partner governments, international organisations, and civil society in information sharing, discussion of lessons learned, and successes, challenges, and opportunities related to programming and policy development to reduce MMP vulnerability to HIV. CSEARHAP engaged regional organisations, multilateral organisations, and donors in efforts to ensure that programming being developed or undertaken by each was synergistic with and complementary to, rather than duplicative of, CSEARHAP programming. This led to the development of several collaborative funding proposals, including one submitted to GFATM. CSEARHAP country teams participated in, and presented at, several regional and international conferences, thereby contributing to international lessons learned and global best practices. Several of CSEARHAP's best practices were up-taken by UNAIDS and published.

Lessons Learned and Recommendations

A number of key lessons were learned and recommendations made during the implementation of CSEARHAP that could be transferable to similar projects funded by CIDA or by other donors. The core recommendations address the need to use a more clearly defined "Design and Deliver approach" - which would be more suitable for the implementation of projects which require official Canadian government signoff or bilateral MOUs before activities can begin with local government partners - and the need to have standard operating procedures in place for regional programming. Other lessons and recommendations address seniority issues within partner organizations, utilizing migration cycles to ensure the appropriate integration of HIV prevention services, sufficiently identifying and targeting MMP, the importance of regional mechanisms to facilitate programming that crosses borders, the necessity to engage at all levels to effect policy change and implementation, and utilizing demonstration projects to showcase methods and approaches that can be scaled up.