The support to UNAIDS Regional Programme was supplemented with support to the Joint UNAIDS/UNFPA programme on HIV/SRHR ("the Linkages Programme") in December 2015 as a specific component in the Agreement. Separate reports have been submitted for the two programmes supported. The most important achievements are;
- UNAIDS and partners have ensured that HIV remains high in the political and development agenda. UNAIDS have advocated for the adoption of Fast-Track approach by, firstly, fifteen high-burden countries, and eventually all ESA countries. Countries were supported to identify their AIDS response priorities and to take a multisectoral approach involving civil society and youth networks in their Fast-Track programme. The ESA ministerial commitment on CSE1 and the CSW Resolution2 were achieved through persistent advocacy with the Regional Economic Communities (RECs), and engagement with countries. UNAIDS convened civil society with the objective of strengthening their coordination platforms and reinforcing their role on monitoring progress for the implementation of HIV commitments at regional and country level.
- UNAIDS has promoted that countries’ planning, programming and decision-making is based on high quality strategic information. UNAIDS have provided support to ESA countries on the Global AIDS Monitoring (GAM) reporting. Capacity building initiatives on new models of HIV estimates, key population size estimation, sub-population estimates and age & gender disaggregated data were conducted. The Situation Room, a platform which enhances routine and real-time data collection, analysis and dissemination, has been implemented in Kenya. UNAIDS is supporting six other countries, Lesotho, Namibia, Tanzania, Uganda, Zambia, and Zimbabwe to set-up their Situation Rooms. The Situation Room will be expanded to include SRHR indicators. In response to programmatic needs, UNAIDS has set up a Regional Data Hub for analyses, packaging and publishing of key HIV data and messages.
- UNAIDS has contributed to people left behind having equitable access to comprehensive HIV services. UNAIDS established and coordinated the African Think Tank on HIV, Health and Social Justice. The Think Tank engaged in dialogues to prevent and respond to human right crises in the ESA countries e.g. in Malawi and Mauritius. Technical support and advocacy resulted in recognition of HIV as a key element of the humanitarian agenda, and subsequently, HIV indicators were included in the humanitarian assessment tools. UNAIDS has supported community HIV service delivery models – the CATCH programme in Botswana and Rock Leadership ‘90’ project in Zimbabwe. These programmes have expanded HIV services to communities and were recognized as good practices for scale-up in respective countries. Commitments were achieved for Cities Fast-Track initiative across the ESA region. Male engagement agenda has gained momentum, particularly in Uganda, with the involvement of traditional leaders. UNAIDS RST ESA advocated for the adoption of ‘Test and Treat’ and HTS guidelines. Civil society have significant role in the AIDS response, but the space is shrinking, especially for those working with LGBTI, MS and sex workers. - On sustainable resources for HIV, UNAIDS supported SADC and EAC to develop Sustainable Financing Analysis frameworks, and countries to develop investment cases. Investment cases have shaped NSPs and Global Fund Concept Notes in countries. Global Fund Concept Notes were developed through the support provided by the Technical Support Facility (TSF). UNAIDS coordinated and provided management oversight to the TSF. The TSF unlocked about two billion US dollars in 2015 and three billion US dollars in 2017 for the ESA countries through the Global Fund. The regional framework on sustainable financing is yet to be translated into country actions. The constrained fiscal space limit growth of domestic financing of the AIDS response.
- The Linkages Projgramme have contributed towards the incorporation of the linkages between SRHR and HIV into 66 policies and strategies across all 10 participating countries and supported SADC and the EAC as regional entities to provide guidance to their member states on integration. A total of 49 guidelines were either revised or developed to include SRHR/HIV integration in Botswana (10), Kenya (7), Lesotho (4), Malawi (5), Namibia (4), South Africa (5), Swaziland (3), Uganda (1), Zambia (5), Zimbabwe (15). Seven of the participating countries in the Linkages Programme (Botswana, Lesotho, Malawi, Namibia, Swaziland, Zambia and Zimbabwe) adopted or adapted promising service models from the Integration Initiative that were suitable to the different levels of health service delivery and country contexts. Evidence from SRHR/HIV integration shows that SRHR/HIV integration has benefits for both clients and services providers; however, evidence on cost efficiency is insufficient and inconclusive.
