Regional: HIV/AIDS Prevention and Capacity Development in the Pacific (ADF Grant)

Sovereign Project | 38599-022

Summary

The goal of the assistance is to halt and begin to reverse the spread of HIV/AIDS in the Pacific by 2015. The purpose is to have an effective response to HIV/AIDS in place in Pacific Developing Member Countries in regard to government and community capacity to address HIV/AIDS, through the implementation of the ADB Pacific region roadmap on HIV/AIDS.

The Project has four components: (i) Strengthening surveillance. This component focuses on developing national HIV/AIDS surveillance capacity, with a focus on developing methodologies and skills for conducting second-generation surveys to better understand the status of and risk factors governing HIV infection and prevention among high-risk subpopulations across the region. The activities will focus mainly on building capacity so that the countries and the region can mobilize and target resources to curb growing rates of

infection.

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Project Name HIV/AIDS Prevention and Capacity Development in the Pacific (ADF Grant)
Project Number 38599-022
Country Regional
Project Status Closed
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 0021-REG: HIV/AIDS Prevention and Capacity Development in the Pacific (ADF Grant)
Asian Development Fund US$ 8.00 million
Strategic Agendas Inclusive economic growth
Regional integration
Drivers of Change
Sector / Subsector

Health - Disease control of communicable disease

Gender Equity and Mainstreaming
Description

The goal of the assistance is to halt and begin to reverse the spread of HIV/AIDS in the Pacific by 2015. The purpose is to have an effective response to HIV/AIDS in place in Pacific Developing Member Countries in regard to government and community capacity to address HIV/AIDS, through the implementation of the ADB Pacific region roadmap on HIV/AIDS.

The Project has four components: (i) Strengthening surveillance. This component focuses on developing national HIV/AIDS surveillance capacity, with a focus on developing methodologies and skills for conducting second-generation surveys to better understand the status of and risk factors governing HIV infection and prevention among high-risk subpopulations across the region. The activities will focus mainly on building capacity so that the countries and the region can mobilize and target resources to curb growing rates of

infection.

(ii) Community-based interventions for HIV/AIDS prevention. This component will provide support for a regional condom social marketing program, including the design and delivery of mass media and targeted communication programs promoting condom use and the supply of male and female condoms; for behavior change communication (BCC) programs, including the development of tailored BCC materials and the design and delivery of BCC programs; and for sexually transmitted infection (STI) treatment and care programs, including the provision of training for local health care workers and of equipment and materials for STI treatment facilities.

(iii) Targeted interventions for vulnerable groups. This component focuses on supporting targeted interventions for vulnerable populations in the project Pacific developing member countries (PDMCs), including (a) establishing five drop-in centers for seafarers and their communities with information about HIV/AIDS, STIs, and safe sex and referrals to appropriate services; (b) developing and distributing information, education, and communication materials for vulnerable groups; (c) providing targeted training for nongovernment organizations working with vulnerable groups; (d) providing support for regional maritime schools in training on HIV/AIDS and STIs; (e) providing training in enhancing livelihood skills for HIVpositive people; and (f) providing antiretroviral drugs for HIV-positive people.

(iv) Project management. This component will manage the Project and includes project planning, monitoring, and evaluation.

Project Rationale and Linkage to Country/Regional Strategy

The potential for the spread of HIV/AIDS in the Pacific is high. All PDMCs have detected HIV infections and also have unreported and unidentified cases because of the lack of testing facilities and generally low levels of surveillance. Significant risk factors for HIV exist, including high prevalence of STIs, low condom use, high levels of interregional and intraregional mobility, prevalence of multiple sex partners, and high rates of transactional sex. The region has experienced highly disparate levels of development, resulting in variable levels of access to information and services. Some Pacific countries have poorly functioning health systems with weak capacity to operate safe blood supplies, treat STIs, provide counseling and testing, and prevent mother-to-child transmission.

The socioeconomic impacts of the HIV/AIDS epidemic are potentially significant. Social impacts include the pain and suffering of individuals and communities affected by the illness

and the death of family members. At the household and individual levels, economic impacts include decreased discretionary spending by households affected by loss of income together with increased expenditure on care, treatment, and funerals. Economic impacts arise from productive sector losses and from the added burden on the health sector. HIV/AIDS exacerbates poverty by limiting the opportunities of the poor to lift themselves out of poverty and by driving economically vulnerable people below the

poverty line.

The current response to HIV/AIDS in the Pacific is underfunded. Pacific governments have committed to a comprehensive regional strategy and various programs are under way. Existing efforts urgently need to be scaled up and extended.

Impact The impact of the Project will be to reduce the spread and impact of HIV/AIDS in the Pacific.
Project Outcome
Description of Outcome Improved management and delivery of HIV/AIDS prevention activities in the Pacific through the targeting of vulnerable populations
Progress Toward Outcome

Grant 21 commenced implementation in April 2006. The mid-term review in mid-2008 found that progress had been slow and disbursements well behind schedule. Remedial actions were put into place, and a mini-review held in Manila in September 2008 found that these had been effective. Subsequent to the review, a number of financial management issues were resolved, staffing has been stable, and recommendations from the July 2008 reprogramming exercise have been implemented. A review conducted in Manila in February 2010 found that sustained progress is being made with 2 activities requiring close monitoring--the MSIP condom social marketing (CSM) program and the seafarer drop-in centers (DICs).

Overall, progress and expenditure are in line with the term remaining for the grant. Major activities completed include the SGS reports, data store, laboratory capacity improvement through provision of technical assistance and equipment, STI comprehensive case management training, peer education mapping, and the development of targeted IEC materials. Most financial and technical support through the Grant ceased in June 2010; however, exceptions are the recently approved ongoing laboratory capacity development support, and existing activities such as the MSIP CSM program, WSB Love Patrol Series III, and the seafarer DICs. Specific strategies to maximize the potential for completion of these 3 activities by Grant completion date have been formulated during the August 2009 review.

There may be a change in the assumption that other funding partners will continue financial support for the CSM program in the region. It has recently been announced by MSIA that they intend to close the MSIP branch in Fiji (which is responsible for implementing both ADB and GFATM-funded CSM programs in the region) by end-December 2010.

Implementation Progress
Description of Project Outputs

1. Strengthening surveillance for HIV and STIs

2. Community-based response to HIV and STIs.

3. Targeted interventions for vulnerable groups

4. Project management

Status of Implementation Progress (Outputs, Activities, and Issues)

An ADB/SPC mini-review was conducted in Manila on 22 February 2010. Overall project implementation is progressing according to schedule: (i) SGS reports for 9 countries will have been completed; (ii) improving routine surveillance is an ongoing program that will be continued beyond the life of the Grant; (iii) laboratory capacity to test for chlamydia and gonorrhea has been strengthened in most laboraties; (iv) all Grant countries have been provided with behavior change and communication training, as well as technical and financial assistance; (v) there has been solid progress towards standardizing training, planning, and monitoring tools for health promotion in the Pacific, and the revised guide has been termed "Strategic Health Communications;" (vi) the MSIP condom social marketing program is fully underway in SOL and VAN, and a workshop is being planning for March 2010, in which MSIP staff will undergo training; (vii) a process review of Stepping Stones was completed in February 2010, and no further financial or TA assistance would be provided; (viii) Wan Smolbag is continuing its work on the Love Patrol Series III and remains on schedule; (ix) the roll-out of STI comprehensive case management training by regional partners at national level is almost complete; (x) all PDMCs now have access to STI testing for chlamydia and gonorrhea; (xi) information/education materials to support testing and treatment have been developed in line with country requests; (xii) activities targeting vulnerable groups have continued; (xiii) seafarer drop-in centers have experienced varying levels of success.

Cumulative disbursement at end of February 2011 is 95% of Grant value; actual expenditure at end-December 2010 was 88%. All Grant staff contracts will end as scheduled. Subcontracts with MSIP and Wan Smolbag ended December 2010. Overall project implementation is progressing and will close according to schedule.

Geographical Location
Safeguard Categories
Environment C
Involuntary Resettlement
Indigenous Peoples
Summary of Environmental and Social Aspects
Environmental Aspects The Project will not have adverse environmental effects.
Involuntary Resettlement No resettlement will be required.
Indigenous Peoples There are no impacts on indigenous peoples.
Stakeholder Communication, Participation, and Consultation
During Project Design

This proposal was developed through extensive consultative processes with stakeholders from ministries of health and civil and nongovernment organizations (NGOs) and with country coordinating mechanisms.

PDMCs that were consulted include Cook Islands, Fiji Islands, Kiribati, Federated States of Micronesia, Marshall Islands, Nauru, Palau, Samoa, Solomon Island, Tonga, Tuvalu, and Vanuatu. Regional organizations that were consulted include the Fiji School of Medicine, International Federation of Red Cross, Marie Stopes International, International Planned Parenthood Federation, the United Nations system, Institute of Applied Legal Studies, People Islands AIDS Foundation, Pacific Regional HIV/AIDS Project, and Wan Smol Bag.

During Project Implementation

The project design took into account the existing participation mechanism for developing the PRS. The stakeholders involvement will continue during project implementation. The PRS is the result of extensive consultation among national health representatives, regional organizations, and bilateral and multilateral donors. The Project will build on these existing mechanisms and ensure that a participation strategy is integrated into overall project implementation.

The targeting of vulnerable people in the Project will require extensive consultations, focus group discussions, surveys, and so on to design activities that are most appropriate for the target group. These activities will be incorporated into the Project.

Business Opportunities
Consulting Services All consulting contract will end as scheduled.
Responsible ADB Officer Anne Myongsook Witheford
Responsible ADB Department Pacific Department
Responsible ADB Division Transport, Energy and Natural Resources Division, PARD
Executing Agencies
Secretariat of the Pacific CommunityKelly RobertsonKellyR@spc.intHIV & STI Section, Public Health Directorate, Secretariat of the Pacific Community, BPD5 98848 Noumea-Cedex, New Caledonia
Timetable
Concept Clearance 03 Mar 2005
Fact Finding 20 Jun 2005 to 22 Aug 2005
MRM 16 Sep 2005
Approval 08 Nov 2005
Last Review Mission -
PDS Creation Date 20 Nov 2009
Last PDS Update 25 Feb 2011

Grant 0021-REG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
08 Nov 2005 18 Nov 2005 15 Feb 2006 30 Sep 2010 30 Jun 2011 25 Jul 2011
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 8.00 Cumulative Contract Awards
ADB 8.00 08 Nov 2005 7.20 0.00 90%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 08 Nov 2005 7.04 0.00 88%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - Satisfactory - Satisfactory

Safeguard Documents

See also: Safeguards

No documents found.

Evaluation Documents

See also: Independent Evaluation
Title Document Type Document Date
Regional: HIV/AIDS Prevention and Capacity Development in the Pacific Validations of Project Completion Reports Dec 2013

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