sudan multi-donor trust fund (mdtf) - world...

SUDAN MULTI-DONOR TRUST FUND (MDTF)

FINAL PROJECT PROPOSAL FOR A GRANT IN THE AMOUNT OF US$36.75 MILLION TO THE

GOVERNMENT OF SOUTHERN SUDAN FOR A PROPOSED HIV/AIDS PROJECT

November, 2007

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Project Name: Scaling Up the National Response to HIV/AIDS Applicant: Southern Sudan HIV/AIDS Commission (SSAC) on behalf of

Government of Southern Sudan (GoSS) Brief Description: This is a multisectoral project, which aims to strengthen a

coordinated national response to HIV/AIDS by building capacity at the GoSS, State and County levels of Southern Sudan, and scale up delivery of comprehensive HIV/AIDS services. The Project will support integration of HIV/AIDS into critical GoSS sectors. Key project components include capacity building of the SSAC at all levels; strengthening the line ministries’ and institutions’ response; strengthening civil society response; and strengthening the health sector response to HIV/AIDS.

Project Development Objective:

a) To strengthen the capacity of the SSAC to plan, coordinate and monitor the GoSS response to HIV/AIDS, b) To increase community access to comprehensive HIV/AIDS services, and c) To create awareness and measurable behaviour change regarding HIV/AIDS.

Sector: HIV/AIDS Location: Southern Sudan Project Cost: The project cost is US$ 36.750 million for 5 years (2008-2012):

GoSS contributions will cover 13.6% of the total costs, but could increase if GoSS resources improve during the life of the project.

Implementing Agency (ies)

1. Southern Sudan HIV/AIDS Commission (SSAC) 2. Selected Line Ministries 3. Civil Society Organisations 4. Ministry of Health (for health sector response component) 5. International NGOs and/or UN Agencies

Implementing Period:

5 years, starting first quarter 2008

Contact for further information

Dr. Gordon Angok Kuol, Executive Director, SSAC ([email protected]; Tel. 0122545650, +256477106016, +882 164.33.33.882)

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TABLE OF CONTENTS

I. STRATEGIC CONTEXT........................................................................................ 1 Introduction ............................................................................................................................1 Key Development Issues ........................................................................................................2 Rationale for MDTF Involvement ........................................................................................2

II. PROJECT DESCRIPTION ................................................................................ 3 Project Development Objectives and Key Performance Indicators ..................................3 Project Components ...............................................................................................................4

Component 1: Institutional and Capacity Building of the SSAC at all levels .................................... 6 Component 2: Line Ministries’ Response............................................................................................ 8 Component 3: Civil Society Response................................................................................................. 9 Component 4: Health Sector Response.............................................................................................. 11

Lessons learned and reflected in the project design..........................................................12 Project Cost...........................................................................................................................13

III. IMPLEMENTATION ....................................................................................... 14 Institutional and Implementation Arrangements..............................................................14 Program Management .........................................................................................................14 Program implementation.....................................................................................................15 Procurement arrangements.................................................................................................16 Financial management .........................................................................................................17 Monitoring and Evaluation of Outcomes/Results .............................................................17

IV. CRITICAL RISKS AND POSSIBLE CONTROVERSIAL ASPECTS .......... 21 Grant conditions and covenants..........................................................................................22 Social Issues ..........................................................................................................................22 Environmental issues ...........................................................................................................22

Annex 1: Implementation Arrangements..................................................................... 24

Annex 2: Project Costs by Component ......................................................................... 28

Annex 3: Procurement Assessment and Arrangements .............................................. 29

Annex 4: Detailed Financial Management Assessment and Arrangements .............. 35

Annex 5. Economic and Financial Analysis................................................................ 45

Annex 6: Social and Environmental Safeguards Policies........................................... 46

Annex 7: Civil Society Organizations (CSOs).............................................................. 48 Annex 8: Project Proposal Budget……………………………………………………51

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ABBREVIATIONS AND ACRONYMS AIDS Acquired Immune Deficiency Syndrome ANC Antenatal Care ART Antiretroviral Therapy ARV Antiretroviral Drugs BCC Behaviour Change Communication CAC County AIDS Coordination Committee CBO Community Based Organisation CBTF Capacity Building Trust Fund CDC Centers for Disease Control and Prevention CPA Comprehensive Peace Agreement CQ Consultants Qualifications CSO Civil Society Organisation DRC Democratic Republic of Congo EAA External Audit Agent EOI Expression of Interest ESMF Environmental and Social Management Framework FBO Faith Based Organisation FMR Financial Management Report GDP Gross Domestic Product Global Fund Global Fund to Fight AIDS, TB and Malaria GoNU Government of National Unity GoSS Government of Southern Sudan GPN General Procurement Notice HIV Human Immunodeficiency virus HMIS Health Management Information System HMSF HIV/AIDS Multisectoral Strategic Framework HNCG Health and Nutrition Consultative Group HRH Human Resources for Health IAPSO International Agency Procurement Services Office IAS International Accounting Standards IBRD International Bank for Reconstruction and Development ICB International Competitive Bidding IDA International Development Association IDP Internally Displaced People IEC Information, Education, Communication IFMIS Integrated Financial Management Information System IGAD Inter-Governmental Authority for Development? ISR Implementation Status Report JAM Joint Assessment Mission LAA Land Acquisition Assessment LCS Least-Cost Selection LIB Limited International Bidding LICUS Low Income Countries Under Stress M&E Monitoring and Evaluation MA Monitoring Agent MARP Most at Risk Population MDTF Multi Donor Trust Fund MoEWCT Ministry of Environment, Wildlife Conservation and Tourism

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MoFEP Ministry of Finance and Economic Planning MoH Ministry of Health MOU Memorandum of Understanding MWMP Medical Waste Management Plan NCB National Competitive Bidding NGO Non-Governmental Organisation OCHA Office of Coordinator of Humanitarian Assistance OI Opportunistic Infection OPC Operations Policy and Country Services OVC Orphans and Vulnerable Children PA Procurement Agent PAA Project Accounting Agent PCU Project Coordination Unit PDU Project Disbursement Unit PEPFAR President’s Emergency Plan for HIV/AIDS Relief PIM Project Implementation Manual PLWHA People Living With HIV/AIDS PMTCT Prevention of Mother to Child Transmission of HIV Infection PSI Population Services International PSM Procurement and Supply Chain Management PTF Project Task Force PWC PricewaterhouseCoopers . QCBS Quality-and-Cost-Based Selection RPF Resettlement Policy Framework SAP Strategic Action Plan SBD Standard Bid Documents SMC Safeguards Management Committee SOE Statement of Expenditure SPLA Sudan People’s Liberation Army SPLM Sudan People’s Liberation Movement SPN Specific Procurement Notices SSAC Southern Sudan HIV/AIDS Commission SSS Single-Source Selection STI Sexually Transmitted Infection TA Technical Assistance TB Tuberculosis UN United Nations UNAIDS Joint United Nations Programme on HIV/AIDS UNDP United Nations Development Plan UNESCO United Nations Education Fund UNFPA United Nations Population Fund UNGASS United Nations General Assembly Special Session UNHCR United Nations Commission for Refugees UNICEF United Nations Children’s Fund UNOPS United Nations Office for Project Services US United States USAID United States Agency for International Development VCT Voluntary Counselling and Testing VSAT Very Small Aperture Terminal WHO World Health Organisation

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I. STRATEGIC CONTEXT Introduction

1. On January 9, 2005, a Comprehensive Peace Agreement (CPA) was signed between the Government of Sudan and the Sudan People’s Liberation Movement (SPLM). The civil war has had a devastating toll in terms of loss of human life, displacement, and destruction of infrastructure and social fabric. The people are yearning for better lives and have high expectations of benefiting from the peace dividends. It is a historic opportunity to overcome the devastation of war and the neglect of human development by developing policies and programs to address critical and urgent needs. This opportunity comes with substantial domestically generated oil revenues as well as the expectation of increased donor flows and international support. 2. At the request of the Government of Sudan and the Sudan People’s Liberation Movement (SPLM), the World Bank and the United Nations carried out a Joint Needs Assessment (Joint Assessment Mission (JAM) Report - Volumes I, II and III dated March 18, 2005). The JAM led to a Framework for Sustained Peace Development and Poverty Eradication. It also identified many challenges that require support by domestic efforts and resources of development partners. 3. The financing needs amounted to US$ 7.9 billion (US$ 4.3 billion for the North and US$ 3.6 billion for the South). Two Multi Donor Trust Funds (MDTF) were established, one to support the reconstruction, capacity building, and policy framework activities for the Government of National Unity (GoNU) and the other, to support the Government of Southern Sudan (GoSS). A Technical Secretariat, managed by the World Bank, has been established to provide technical support and assume fiduciary responsibilities for each MDTF. 4. The GoSS, consisting of 23 Ministries, was formed on October 23, 2005. Parliament has been elected and is in session. The Minister of Finance has committed to contributing counterpart funds to support the MDTF. 5. The GoSS proposes to avail itself of MDTF resources for health, education, rural development, transportation infrastructure, private sector development, and capacity building development in all sectors.

6. Although data are few, it is believed that the incidence and prevalence of HIV in Southern Sudan are lower than in neighboring countries because the two-decade-long civil war restricted labor migration, trade and travel thereby containing HIV transmission. Epidemiologically, Southern Sudan could be referred to as the last untouched pocket of HIV transmission in Africa. However, the country faces a massive threat from HIV because: i) it is surrounded by countries with high HIV prevalence, ii) has up to four million displaced people, some living in high prevalence countries in the region, who will be returning home, iii) has high levels of poverty, low school enrolment, a rudimentary health system, and iv) women and girls have low status in the society.

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7. In recognition of this threat, the GoSS established the Southern Sudan HIV/AIDS Commission (SSAC) in 2006 to coordinate the GoSS response. Thus, the SSAC has developed a MDTF HIV/AIDS project proposal in consultation with representatives of GoSS, UN Agencies, Civil Society and other key development partners. Components of the proposal include; capacity building of the SSAC at all levels; strengthening the Line Ministries’ response; strengthening the Civil Society response; and strengthening the health sector response. Key Development Issues

8. The strategic objective of the GoSS for this project is to ensure an effective response to the HIV/AIDS epidemic through a multisectoral approach which involves Government and Civil Society. 9. Decades of war, poverty, and lack of access to basic services have left communities and families extremely vulnerable to HIV infection. Women and children are more vulnerable to HIV infection, because of widespread sexual and gender-based violence, and the breakdown of families and communities. Cross-border trade and mobility, and an expected increase in the return of internally displaced people (IDPs) and refugees to their communities, are likely to result in rapid HIV transmission. However, the returning population have more information and better knowledge about HIV/AIDS, which would benefit areas of return. 10. The impact of war, displacement and poverty has increased the vulnerability to HIV/AIDS, and has hampered a consolidated GoSS response. During the conflict, the response relied on civil society (CBOs, FBOs), international relief and UN organisations, which mostly focused on general awareness raising and the provision of basic care and support in principal towns and villages. Overall, the response remained scattered and was characterised by insufficient coordination, low coverage and the absence of comprehensive and integrated approaches. 11. Given the anticipated rise in HIV/AIDS incidence, preventing the further transmission of HIV infection is one of the greatest challenges of post-war Southern Sudan. Although reliable data are not available, there is sufficient evidence that Southern Sudan already faces a generalised epidemic that needs an immediate response.

Rationale for MDTF Involvement

12. The MDTF was established to help finance the reconstruction and development of Southern Sudan through a collaborative framework, which brings together several key development partners. The SSAC acknowledges that HIV/AIDS is a major development challenge for Southern Sudan and therefore needs a comprehensive and multisectoral response. 13. Limited data suggest that HIV prevalence rates in Southern Sudan are lower than in neighbouring countries, and it has been suggested that the war may have contained the HIV transmission. However favourable conditions for concentrated and/or generalized HIV epidemics exist in many parts of the country. HIV prevalence rates are substantially higher in areas bordering high HIV prevalence countries

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compared to more isolated interior areas. In 2002, the only community-based seroprevalence studies that have been conducted, showed the HIV seroprevalence rate in Yei town, near the Uganda and DRC borders, to be high (4.2%), compared to 0.4% in Rumbek (interior of the country). The few surveys of HIV/AIDS knowledge, attitude, and behavioural practices conducted to date have shown low awareness and knowledge and high-risk sexual behaviours. Increased trade and travel including the return of IDPs and refugees associated with peace may result in rapid increase in HIV transmission. 14. The project is designed to complement funding from other sources supporting the development of the Health Sector. Specifically, significant funding is expected from the Global Fund Round 4 Grant (US$ 28.4 million over 5 years) and Round 5 Grant (US$ 27 million over 5 years). However, the Round 4 Grant will be limited to only twenty of the country’s ninety three counties and the Round 5 grant will only support HIV/Tuberculosis collaborative programs by the Ministry of Health. Given the high risk of rapid HIV transmission and limited investment in health and HIV/AIDS, the Global Fund support will not adequately address comprehensive HIV/AIDS interventions. 15. This proposal will complement existing and planned HIV/AIDS support in line with the new Multisectoral HIV/AIDS Strategy and HIV/AIDS Policy being developed by the SSAC. In particular, it will complement activities funded by other donors and increase the capacity of the SSAC, MOH, other line ministries and civil society to utilise available resources for HIV/AIDS. The project will also contribute to strengthening decentralisation in GoSS, a key component for the success of the Comprehensive Peace Agreement (CPA).1 The project aims to add value to the current response by strengthening the Government’s leadership role in driving and supporting the countrywide scale up and continuity of the GoSS response to HIV/AIDS. II. PROJECT DESCRIPTION Project Development Objectives and Key Performance Indicators

16. The project development objectives are to (i) strengthen the capacity of the SSAC to plan, coordinate and monitor the GoSS response to HIV/AIDS, (ii) increase community access to comprehensive HIV/AIDS services, and (iii) create awareness and measurable behaviour change regarding HIV/AIDS. 17. During its five-year implementation period, the project will achieve its development objectives through:

i. Incremental strengthening of the SSAC at all levels; ii. Phased expansion of the geographic coverage of successful approaches to all

States of Southern Sudan; iii. Phased mainstreaming HIV/AIDS into the priority Government sectors; and

1 Joint Assessment Mission

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iv. Phased expansion of the scope of programs toward the achievement of comprehensive service provision.

18. At the completion of the project, it is expected that:

i. SSAC offices at the GoSS, State and County levels would be in place, with a clear mandate, institutional capacity and human resources to effectively coordinate and monitor the multisectoral response to HIV/AIDS;

ii. The capacity of SSAC will be more strategic allowing prioritization of activities that will have greatest impact on the epidemic;

iii. Budgeted HIV/AIDS Strategic Plans will be in place at GoSS and State levels and will respond to local priorities;

iv. An HIV/AIDS Monitoring and Evaluation System will be in place, and will collect strategic information at all levels for decision making by all stakeholders;

v. There will be increased capacity among Government Ministries and Civil Society Organizations to deliver comprehensive HIV/AIDS services;

vi. There will be increased population coverage of accessible, affordable and sustainable prevention, care, support and treatment services;

vii. HIV/AIDS will be integrated into the policies, work plans and budgets of priority Line Ministries and Departments at the GoSS and State levels;

viii. The capacity of the Ministry of Health to respond to HIV/AIDS will be increased at the GoSS and State levels.

Project Components

19. The proposed MDTF grant of US$36.75 million would finance a five-year program. The direct beneficiaries are: a) populations at high risk of HIV transmission including IDPs, returnees, youth, and women; b) people living with HIV and AIDS (PLWHA); c) orphans and vulnerable children; and d) the general population. The project will have the following four (4) main components:

i. Institutional and capacity building of the SSAC at all levels. ii. Line Ministries’ response.

iii. Civil Society response.

iv. Health Sector response.

20. A five-year (2008-2013) phased implementation of the project will take place in close collaboration with other ongoing and/or planned HIV/AIDS programs. 21. The Project will be strategic and selectively leverage the achievements of other programs which are relevant to implementing the project. 22. The phased approach involves i) prioritising the development of institutional and policy frameworks; ii) building managerial and technical capacity; iii) initiating delivery of targeted basic service packages to priority most-at-risk people (MARP) in

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selected geographical areas; and iv) expanding the scope of services to a more comprehensive package. The four components are described in more detail below.

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Component 1: Institutional and Capacity Building of the SSAC at all levels 23. The Project will build the capacity of the SSAC at the GoSS, State and County levels in the following strategic areas: (a) Human resources

(b) Policy and planning

(c) Infrastructure

(d) Monitoring and evaluation

(e) Procurement and financial management.

(a) Human Resources 24. Human resources is a cross-cutting challenge in the entire GoSS.2 The SSAC is a new organization that has been in operation for less than two years. Under a Global Fund Round 4 Grant, SSAC has recruited six key staff at the GoSS level. In addition, the government will recruit six mid-level program staff who will be mentored by the key staff funded by the Global Fund at GoSS level.

The Project will support institutional, managerial and technical capacity building of the SSAC in a phased approach, prioritising the GoSS level and then supporting State and County HIV/AIDS Commissions. In the first phase, priority will be given to strengthening the institutional framework and managerial and technical capacity of SSAC. In the second phase, the Project will focus on strengthening existing SSAC sub-offices (currently being established in a number of States). The SSAC under a Global Fund Round 4 Grant will recruit two HIV/AIDS Officers in each of the ten States. The Project will complement this effort by recruiting four national consultants in each of the ten States. These will include a Program Specialist, an M&E Specialist, a Procurement Specialist, and Financial Management Specialist, as appropriate. The Project will also support HIV/AIDS technical and program management training at State level. County HIV/AIDS Coordination Committees (CACs) have been set up in five counties with UNDP support. In the third phase, the Project will further strengthen SSAC sub-offices and scale up technical and financial support to CACs in a larger number of counties. The Project will support the recruitment of County HIV/AIDS focal persons and provide HIV/AIDS and program management training for CAC persons, CBOs and local NGOs. It is imperative that the capacity of SSAC and its decentralised units be rapidly developed for effective coordination of the multisectoral HIV/AIDS response being funded by this project.

2 The planned MDTF Umbrella Health Program ($225 million) has a specific component to strengthen human resources for health (HRH) at all levels of health care delivery. The Italian Cooperation has also proposed working with the MOH on decentralization and capacity building for the health sector.

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(b) Policy and Planning 25. The SSAC is developing an HIV/AIDS Multisectoral Strategic Framework (HMSF) and GoSS HIV/AIDS Policy to guide the national response. Technical support for this activity is being provided by UNDP, UNAIDS and other development partners. The HMSF is expected to be launched in November 2007. The Project will provide additional funds as necessary to support development of the HMSF. In particular, the Project will support the implementation of the HMSF by supporting the development of annual action plans at national and state levels, and the dissemination of the HMSF and State HIV/AIDS Strategic Action Plans (SAP) in all counties. In addition, the Project will provide technical assistance in the development of evidence-based County HIV/AIDS work plans and proposal writing in line with the HMSF and SAPs. (c) Infrastructure development 26. The SSAC is currently accommodated in small and unsuitable rented offices. Support for payment of office space is being provided by CDC, PSI, and UNAIDS. The GoSS in its capital budget plans to construct new offices for SSAC. Space has been identified but funding is not yet available. In the interim, CDC has pledged to support procurement of temporary prefabricated offices at the new SSAC site. Other partners including UNAIDS, UNHCR, UNDP, UNESCO, UNFPA and UNICEF have provided office equipment (computers, photocopy machines, servers, VSAT, printers) and office furniture. 27. Currently, there is no committed funding for the establishment of offices at the state level. The Project will procure and equip prefabricated offices to house SSAC staff at state level. In addition, each state SSAC will be provided with communication equipment (VSAT) to improve communication with counties and the national level. The Project will also procure two vehicles in each state for program support and supervision. At the county level, the Project will provide bicycles and/or motorcycles for the focal persons. If the GoSS find it necessary to request project support to complement its contribution to the planned civil works, the request will be reviewed in the context of existing commitments and the project would then make the appropriate allocations for such support. (d) Monitoring and Evaluation 28. The need to harmonise the SSAC-led national M&E framework with the Health Sector M&E system has been identified as a key priority. The SSAC, under Global Fund Round 4 Grant, will recruit M&E Officers and support the establishment of an M&E system at the GoSS level. UNAIDS and its co-sponsors are contributing to the establishment of the M&E System (development of UNGASS, Universal Access and National Indicators, and the M&E framework). CDC is also supporting the implementation of antenatal sentinel surveillance. A national seroprevalence and behavioural surveillance is planned for 2008 with multi-agency funding and technical support. This will provide more reliable data on the prevalence of HIV/AIDS in North and Southern Sudan. Concurrently, the Health Systems, Research and Development Directorate of the MOH is in the process of developing an M&E framework for the Health sector.

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29. The Project will provide relevant technical support to complement current and/or planned activities. In addition, the Project will support the establishment of M&E support teams in the SSAC at GoSS and state levels, and an overall M&E framework and implementation plan. The system aims to strengthen the coordination of M&E-related data flows and easy access, and use of information for evidence-based decision making. In the first phase, priority will be given to developing the unified M&E framework and plan; and the establishment and functioning of a central M&E support team (based at SSAC), including equipment and capacity building. In the second phase, M&E support teams at the state level will be established and supported through capacity building and equipment. The third phase will focus on strengthening M&E capacity at the county levels. The Project will closely coordinate its technical and financial support with existing initiatives in support of establishing a unified M&E system. Overall, the Project will prioritise support for the establishment of systems and support structures. Once the systems are up and running, follow-up support will be given to implementing key M&E functions, including systematic second-generation surveillance and resource tracking. (e) Procurement and Financial Management 30. The Project will provide training of staff at GoSS and state levels on World Bank and/or GoSS procurement and financial management guidelines and procedures. Staff at all levels will receive training in project planning, budgeting and financial management. In addition, the Project will, in collaboration with MOH, support the establishment of GoSS procurement policies and guidelines including technical procurement and supply management (PSM) training. Component 2: Line Ministries’ Response 31. The Project will provide technical and financial support to mainstream HIV/AIDS in policies, development plans and budgets of strategic sector Ministries at the GoSS and state level, and strategic government departments at county level in line with the HMSF and National HIV/AIDS Policy. There are 23 line ministries and 16 independent commissions and chambers in the GoSS. The sectors are at varying stages of integrating HIV/AIDS into their core business. 32. In the initial phase, the Project will prioritise technical support for mainstreaming HIV/AIDS in policies, plans and budgets of a few strategic line Ministries at the GoSS level, including the following:

i. Ministry of SPLA Affairs (Military) ii. Ministry of Interior (Uniformed Services)

iii. Ministry of Gender, Social Welfare and Religious Affairs iv. Ministry of Transport and Roads v. Ministry of Culture, Youth and Sports

vi. Ministry of Education, Science and Technology vii. Ministry of Information and Broadcasting

viii. Relief & Rehabilitation Commission ix. Disarmament, Demobilisation and Reintegration Commission x. War Disabled, Widow & Orphans Commission

xi. Relief & Rehabilitation Commission xii. Local Government Commissions

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xiii. Ministry of Agriculture &Forestry xiv. Ministry of Animal Resources & Fisheries

The Ministry of SPLA Affairs (Military) has already begun integrating HIV/AIDS into its activities with technical support from Intra-Health under US Government PEPFAR funding. Current activities are focussed on prevention, treatment and care (Voluntary Counselling and Testing, Behaviour Change Communication, and management of Opportunistic Infections) in Juba. CDC has supported the Ministry of SPLA Affairs to establish an HIV/AIDS Secretariat. Twenty-nine focal persons have been trained to conduct outreach awareness campaigns and peer educator training. In addition five VCT centers have been established in Juba, Nimule, Lanya, Yei and Rumbek. The Project will support expansion of these activities to other areas outside Juba. The Global Fund Round 4 Grant has a significant component to support the Ministry of Education to set up an in- and out-of school youth HIV/AIDS program. Other line ministries are still evolving and have no HIV/AIDS planned activities. The MDTF resources will only be used to support priority activities that are not supported by the Global Fund, and for technical assistance to document and share lessons learned in implementing activities in different line ministries. Given the significant role to be played by the Ministry of Education in prevention activities, it is expected that support to this Ministry will be considered a priority. 33. The SSAC will collaborate with the States to identify strategic line ministries for HIV/AIDS integration at state level. The Project will support the appointment of HIV/AIDS focal points in each sector ministry. In view of the potential lack of experienced national staff to take up the position of focal points, the Project will support short to long-term TA as needed in the strategic line ministries. 34. The HIV/AIDS focal points or technical assistance will ensure the inclusion of HIV/AIDS funding allocations, policy development, and specific and targeted interventions through involvement within the Budget Sector Working Groups at the GoSS level. The project will subsequently support the implementation of these sectoral policies and plans, complementing sector budgets where necessary. In addition, involvement in the Strategic Planning Process at the state level in the development of sectoral policies and plans will be supported. Component 3: Civil Society Response 35. During the war, most health services at the community level were supported by local, regional, and international NGOs, some of which have significant skills in community service delivery. Thus, at the community level, the Project will promote and support existing, and develop new, partnerships between government institutions, civil society3, and international organisations (NGO, UN) to scale up the coverage of prevention, care, treatment and support services for MARP groups and the general population4. Services should build on, complement, and strengthen existing programs 3 In the future, an emerging private sector may be involved in these public-private partnerships, but is currently still very weak. Special emphasis will need to be given to the involvement of the local private sector. 4 The packages may include: awareness raising and targeted BCC for MARP groups; condom promotion, including free distribution or social marketing; VCT services; PMTCT services; syndromic treatment of STIs; treatment of OIs, including TB; PLWHA self-help and support groups; home-based care for PLWHAs; social service networks for OVCs (including food, clothing, school fees etc.) and households headed by women, children or grandparents;

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(where available), applying local lessons learned, and ensuring proper coordination and collaboration with other local implementing institutions. Programs should also maximise harmonisation with other MDTF Projects, and build on improved infrastructure, capacity and services; e.g., in the Health sector, by establishing effective and efficient referral systems and linkages (e.g. VCT, ART, PMTCT). 36. To this effect, the MDTF HIV/AIDS Project will finance programs at the state level implemented by consortia of international and local civil society organisations (CSOs), faith-based organisations (FBOs) and/or UN agencies through grants to CSOs – in close collaboration with upcoming local Government departments and SSAC sub-offices. These programs will integrate capacity building and service delivery, and ensure active involvement of local communities and local State and County government ministries and departments. The scale up of service delivery will follow a phased approach. Participatory operational research will be the basis for the development of service packages. Services and programs will be rolled out in a gradual manner, starting in a limited number of counties, and gradually scaling up to more counties in each state, as experience and capacity to deliver increase. Programs and services will gradually expand from basic packages for priority MARPs5, to more comprehensive packages, including the general population. The gradual scale up and expansion will go hand-in-hand with an ongoing (local) capacity-building component – involving communities and upcoming government structures – to ensure local ownership and sustainability of the programs and services. 37. In addition to community-based programs and services, the Project will support delivery of specific services targeting MARPs including, but are not limited to, programs for: PLWHA (e.g. strengthening PLWHA networks); young people; women and girls; orphans and vulnerable children; sex workers; (returning) IDPs/refugees, including repatriation corridors and cross-border programs; uniformed personnel; truck drivers and other mobile populations; condom social marketing; mass media interventions; policy and legal advocacy; human rights; stigma and discrimination; traditional and political leaders; traditional healers; as well as mainstreaming gender in all programs. Implementation of these programs will be contracted out to individual organisations or consortia of NGOs, CBOs, FBOs UN and/or government organisations.

38. Due to capacity limitations at the community level, regional or international organizations with experience in community development will be contracted to build the technical and managerial capacity of local CBOs/FBOs, disburse and monitor utilisation of grants. The grant making will be done in phases, starting with small grants and increasing the amount based on absorptive capacity and results. The design of this component will include lessons learned in implementing similar activities in the region.

Income-generating activities (IGAs) for PLWHAs and other vulnerable groups; ARV treatment. The exact composition and roll-out mechanism depends on local needs and circumstances. 5 Priority most-at-risk population (MARP) groups may include PLWHAs; women and girls; orphans and vulnerable children (OVCs); returning internally displaced persons (IDPs) and refugees; sex workers, and women/girls engaging in transactional sex; uniformed services; youth; truck drivers and other mobile groups; and other vulnerable populations.

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Component 4: Health Sector Response 39. HIV/AIDS is a cross-cutting issue that requires an expanded response across all sectors. However, the support to these sectors should not come at the expense of investment in strengthening the capacity of the health sector to respond. Experience from other countries has shown that a number of prevention, treatment, care, support and impact mitigation interventions rely on a strong health sector for an effective response. 40. The current health sector response is limited in scope and coverage. However, the MOH is in the process of developing a Health Sector HIV/AIDS Strategy and Implementation plan. This Project will strengthen MOH capacity to deliver HIV/AIDS services at all levels in a phased approach, starting with building capacity at the GoSS and state levels and subsequently at county levels. This Project will be strategic and selective in strengthening institutional capacity through the recruitment, and technical training of focal persons in the HIV/AIDS and TB directorates and health workers in general. The Project will also complement activities financed by the World Bank IGAD Regional HIV/AIDS Partnership Program which aims to improve HIV/AIDS prevention, care, treatment and mitigation programs for cross border and mobile populations, refugees, IDPs and returnees in a few selected counties in Southern Sudan. 41. The MOH is experiencing tremendous challenges in addressing human resources with shortages at all levels of its evolving health care delivery system as detailed in the Umbrella Health Project aide memoire dated February 6 – March 5, 2007.6 As previously noted, the MDTF Umbrella Health Project ($225 million) has a specific component to strengthen human resources at all levels of health care delivery. The MOH has recently established its organisational structure at central level which places its work on HIV/AIDS within the Directorate of Preventive Medicine. Although an interim focal point has been appointed, program managers are yet to be recruited. It has been very difficult to find appropriately qualified nationals to fill the new positions. States are at different stages of recruiting HIV/AIDS focal points. 42. As a sub-recipient under the Global Fund Round 4 Grant, WHO will provide technical assistance to the MOH to develop policy and program guidelines for HIV/AIDS prevention, treatment and care service delivery in twenty counties.

6 The critical shortage of health workers in South Sudan remains the greatest challenge to the effective and immediate delivery of primary and referral healthcare. The HRH Baseline Survey (2005) provides the best evidence of the current number and types of health workers available in Southern Sudan. With a current estimated population of ten million, the 2005 figures show that there is less than one health worker (0.4) for every thousand people in the country. This constitutes an absolute shortage of personnel and will certainly have an impact on health outcomes and on the ability of the country to achieve its priority health goals. In addition, there are large differences in distribution within and between States with an urban bias showing a quarter of all health personnel in three towns, Wau, Juba and Malakal.

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Lessons learned and reflected in the project design

43. Similar HIV/AIDS projects provide important lessons for this project. These include but are not limited to the Ethiopia, Kenya and Tanzania Multi-Country AIDS Programs and the World Bank Independent Evaluation Group Report on Committing to Results: Improving the Effectiveness of HIV/AIDS Assistance (2005). (a) The establishment of HIV/AIDS coordinating institutions does not automatically

ensure deep or sustained commitment by the multitude of actors to an effective response.

(b) Given the complex nature of the disease and the multiplicity of players involved,

simple HIV/AIDS project design is critical in order to achieve an effective response. In addition, project design and implementation that focuses primarily on process rather than results will undermine the effectiveness and efficiency of MDTF’s financial support.

(c) Financial allocations and disbursements are necessary for successful NGO

participation in the fight against HIV/AIDS. However several factors can undermine NGO contributions, even when funding is accessible, including: the absence of a capacity building strategy based on in-depth assessment; the lack of baseline knowledge about the numbers and coverage of target populations; inadequate monitoring and evaluation of NGO activities; and the absence of viable mechanisms for coordination of public private partnerships, in line with their comparative advantages.

(d) Failure to establish key baseline data and to design a monitoring and evaluation

framework during project design is a missed opportunity for creating a targeted, results based approach.

(e) The creation of a multisectoral institution does not necessarily foster a multisectoral

approach and, if not founded on local institutional analysis, risks alienating key actors, such as the Ministry of Health. Within the context of a multisectoral approach, the prominence of the health sector as a major leader and implementer in the fight against HIV/AIDS is unequivocal.

(f) Selecting and supporting existing institutions as implementing partners is a key

success factor. Whenever possible, it is more effective and efficient to use existing institutions and enhance their capacity than to establish new ones.

(g) Capacity building is a long term process that takes time, resources, and effort, and

requires a clear strategy and sustained funding due to the dynamic nature of the disease.

(h) Due to competing priorities for limited resources, national programs should develop

high-quality resource mobilization strategies to ensure sustainability of existing programs.

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(i) The fight against HIV/AIDS will be won or lost at the community level. It is, therefore, important for the government to involve other players including NGOs/CBOs, the private sector, and bilateral and multi-lateral agencies.

Project Cost

44. The project cost is US$36,750,000 for 5 years (2008-2013). Indicative five year funding includes MDTF (US$31,750,000= 86.4%) and GoSS (US$5,000,000= 13.6%). The proportion of GoSS contributions will be one million dollar per year. 45. Existing funding for HIV/AIDS for the next 4-5 years through Global Fund, bilateral donors, and UN agencies amounts to more than US$60 million but coverage of these combined programs is limited, and a substantial amount of MDTF funds will be needed to build Government capacity to coordinate and implement an effective national response that scales up coverage to fill current gaps. To date, efficient disbursement of HIV funds through existing programs has faced many problems, mainly due to limited management and absorptive capacity at all levels. However, as experience in the context of existing HIV/AIDS and other development programs increases, the MDTF HIV/AIDS project will be able to leverage and build on the increased management and technical capacity of government, CSOs, and UN agencies.

Total Project Costs by Contributing Agency

Contributing agency Amount contributed (US$) MDTF 31,750,000 (86.4%) GoSS 5,000,000 (13.6%) Total 36,750,000 (100%)

Total Project Costs by Component Component Cost (US$) 1. Institutional and capacity building of the SSAC at all levels 9,187,500 (25%) 2. Line Ministries’ responses 3,675,000 (10%) 3. Civil Society Response 18,375,000 (50%) 4. Health Sector Response 5,512,000 (15%) Total 36,750,000 (100%) 46. The project will have a strong focus on institutional strengthening and managerial and technical capacity building – particularly in the first year – of the institutions involved in all project components: SSAC (Component 1), Line Ministries’ Response (Component 2), Civil Society Response (Component 3), and the Health Sector Response (Component 4). As the Project progresses and successfully establishes support systems and strengthens implementation capacity on the ground, absorptive capacity for scaling up program and service delivery in years 2 to 5 will increase. The Project’s strong focus on capacity building is reflected by the 25% of the budget

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allocated to Component (1): Strengthening human and institutional capacity of SSAC and its decentralised structures. Furthermore, capacity building will be a strong, integrated component of implementation of programs and services in the context of Component 3 (Civil Society Response) to which 50% of the budget is allocated, as well as Component 4 (Health Sector Response) which is allocated 15% of Project budget. III. IMPLEMENTATION Institutional and Implementation Arrangements

47. Institutional arrangements for implementation of the MDTF HIV/AIDS project are based on a number of principles intended to accelerate implementation; build capacity within GoSS; and strengthen partnerships among government, donors, implementing agencies, and civil society. Program Management

48. In accordance with GoSS regulations, the Ministry of Finance and Economic Planning (MoFEP) will have overall final responsibility for procurement and financial management of the MDTF HIV/AIDS funds. SSAC will establish a Procurement Unit which will be responsible for the procurement of works, non-health goods and consultancy services. Procurement for the health sector response will be managed through the existing Procurement Unit in the Health MDTF project.

49. The SSAC will be the principal grant implementer and therefore responsible for the overall coordination of the project. SSAC is a corporate body established by Presidential Decree No. 55/2006 under the Office of the President. The SSAC Board –chaired by a Presidential appointee -- is composed of 8 members from GoSS and civil society. The Board is responsible for the supervision, coordination and planning of the national HIV/AIDS response. The technical responsibilities of the SSAC Board are carried out by the SSAC Secretariat which reports to and supports the Board. The Secretariat is led by an Executive Director, also appointed by the President. The Executive Director is responsible for the overall coordination of the project implementation. The Secretariat does not have a direct role in implementation. Due to limited capacity and the need to provide services urgently to the community, an experienced technical team will be hired by SSAC to complement existing capacity to accelerate implementation. International/regional staff will be contracted directly by SSAC. Contracting an international/regional staff is justified because the SSAC Secretariat is still in the process of being staffed and requires on-the-job capacity building. Preference will be given to staff who have experience managing other HIV/AIDS programs in the region, and they will work in close collaboration with the SSAC Secretariat to build its capacity to manage future projects and funds. The SSAC senior and middle managerial organisational structure is shown below.

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Organisational structure of SSAC secretariat

EXECUTIVEDIRECTOR

BOARD

DIRECTORPROGRAMMES

STATEDIRECTOR

DIRECT ORFINANCE AND

ADMINIST RAT ION

DIRECT ORPOLICY AND

PLANNING

DIRECT ORMONIT ORING AND

EVALUAT ION

M&EOFFICER

FINANCE ANDADMIN OFFICER

PROGRAMMEOFFICER

Program implementation

50. Implementation of the four main (technical and management) project components will take place through a number of strategies: Component 1: 51. Strengthening the human and institutional capacity of HIV/AIDS Commissions at GoSS, State and County levels. Where contracting out to individuals or firms will be appropriate, preference will be given to individuals, CSOs, firms or UN agencies with a proven track record in implementing relevant programs in Southern Sudan or other developing countries. Component 2: 52. Support to Line Ministries and other Government agencies to mainstream HIV/AIDS in policies, plans and budgets. The annual HIV/AIDS work programs of the respective Ministries or Government Agencies will be used as the basis for providing funding to the Line Ministries. Project funds will complement sectoral funds for the implementation of sector-specific HIV/AIDS programs. To this effect, specific criteria will be developed to guide Line Ministries in the submission of sectoral HIV/AIDS work plans. Line Ministries may opt to sub-contract civil society organizations or other agencies to assist them in developing and implementing their sectoral HIV/AIDS work plans. Component 3: 53. Contracting Civil Society Organizations (CBOS, NGOs, FBOs, etc. - local and/or international as applicable), the private-for-profit sector, to implement HIV/AIDS programs and activities that are consistent with the GoSS HIV/AIDS strategy. These organizations will be invited to submit proposals for scaling up delivery of HIV/AIDS programs and services at the GoSS, state, county or community levels. Guidelines will be provided on the broad format and content that the proposals will need to contain, as well as evaluation criteria for selection of the CSOs. The SSAC and its various levels, will take the lead in the approval process for the proposals submitted under this component.

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Component 4: 54. Strengthening the MOH to lead the implementation of the health sector response to HIV/AIDS. This will include the health sector response to HIV/AIDS in terms of diagnosis, treatment, care, support, surveillance and the accompanying health sector institutional strengthening to be able to deliver this response. Where contracting out to individuals or firms will be appropriate, preference will be given to individuals, firms or UN agencies with a proven track record in implementing relevant programs in Southern Sudan or other developing countries. Procurement arrangements

55. Under the Multi-Donor Trust Fund for South Sudan (MDTF-S), a Monitoring Agent, has been retained by the World Bank, since December 2005, with, among others, the responsibilities for pre-screening, and monitoring the procurement of goods, works and services; and pre-screening and recommending withdrawal applications for the Bank’s approval and payment and ensuring that reimbursements claimed are consistent with the Grant Agreement and eligibility criteria. In addition, a Procurement Agent hired by the Ministry of Finance and Economic Planning of GoSS under the Rapid Impact Emergency Project (RIEP) in December 2006, has the role of conducting procurement of works, goods, and services, centrally, for all ministries and government agencies which don’t have adequate capacity to perform the procurement function. This is in line with the GoSS Interim Public Procurement and Disposal Regulations approved in June 2006. 56. As per the Interim Public Procurement and Disposal Regulations, the final responsibility for both public procurement and procurement oversight lie with MoFEP. The responsibilities include centralized procurement, monitoring, and regulation of the national procurement system. MOFEP currently performs all these roles through its Procurement Policy Unit (PPU). However, for PPU, being located within the MOFEP which has the responsibility for centralized procurement activities, it (PPU) is in a conflict of interest situation when it also monitors public procurement, and has to intervene in cases of non-compliance, fraud and corruption as well as handling procurement complaints. Therefore, the regulations also establish a system for progressive decentralization of procurement to GoSS ministries and agencies. This will be done by the ministry/agency establishing a Procurement Unit manned by procurement proficient staff as well as a Procurement Committee of not less than five members. A ministry/agency with whose Procurement Unit and Committee are functional will be declared a Procuring Entity, to which procurement responsibility can be delegated by MOFEP. 57. The Scaling Up the National Response to HIV/AIDS Project will assist SSAC to become a Procuring Entity, by financing the position of a Procurement Specialist for the duration of the Project. However, under the project, pharmaceuticals and medical supplies will be procured using the existing procurement arrangements for the Umbrella Program for Health System Development project. The SSAC Procurement Unit will handle project procurement of non health sector goods, works, and services, and will take over the procurement of pharmaceuticals and medical supplies if the Umbrella Program for Health System Development project closes. The SSAC Procurement Entity will be in position to submit packages for Bank’s review and ‘no objection’ under the project without need for vetting by the Procurement Agent. The

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project will finance goods and commodities including condoms, drugs and commodities for youth-friendly sexual-and-reproductive health packages; drugs for STIs, OIs/TB and palliative care; ARV drugs; IEC materials; HIV-test kits; computers and technical equipment; furniture; vehicles. Consultancy services may include hiring international/regional/local NGOs or UN agencies to build capacity of CBOs and FBOs to strengthen the community participation in procurement in accordance with paragraph 3.17 of the Procurement Guidelines. For small quantities of off-the-shelf medical supplies; and specialized products where the number of suppliers is limited such as vaccines or drugs, specialised UN agencies, such as IAPSO, UNICEF, UNOPS or UNFPA may be contracted in accordance with provisions of paragraph 3.9 of the Procurement Guidelines and current arrangements with the Bank. 58. In keeping with the procedural guidelines under OB/OP 8.00, only simplified procurement capacity assessment has been applied on the national procurement system, the implementing agencies as well as the communities in finalizing the FPP. The Project implementation manual currently being drafted, which is a “living document” and will be regularly updated with lessons learned, will provide details of how the national procedures will be applied to ensure that all procurement activities under the project meet the minimum standards in the World Bank Procurement Guidelines. Each procurement procedure described in the operational manual shall be dated, and subject to the World Bank’s prior review and “no objection” before it can be used for project procurement. Financial management

59. The project financial management arrangement is designed on the basis of pooling of resources, with common accountability and reporting relationships. The fiduciary accountability systems which have been put in place for all the projects in the Southern Sudan portfolio will similarly apply to this project. The MoFEP will play a central role as the grant recipient of the MDTF HIV/AIDS Project and will have overall responsibility for the financial management of funds. The fiduciary accountability arrangement, which is comparable to fiduciary controls established in other post-conflict environments, includes a Monitoring Agent (MA) for the MDTF; Project Accounting Agent (PAA); procurement Agent (PA); and External Audit Agent (EAA). Monthly, quarterly and annual reports will be prepared for the purpose of monitoring project implementation. The reports will be submitted to the MA, SSAC, MoFEP, and to the World Bank Monitoring and Evaluation of Outcomes/Results

60. Southern Sudan’s second generation surveillance system can be classified as rudimentary in its current form. Biologic and behavioral data is scant, and currently program monitoring and evaluation is scattered and “project based” focusing on specific interventions of implementing agencies.

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The project stands to benefit from current work underway to build a national monitoring and evaluation system, in addition to drawing on the lessons and experiences of international and local groups:

1) The MOH current’s process of developing a Health Management Information System (HMIS) for the health sector interventions;

2) The Antenatal Care Surveillance, supported by the Centers for Disease Control and Prevention (CDC);

3) National Bio-behavioral Surveillance Survey planned for 2008; and 4) Development of national M&E framework and Universal Access Targets and

indicators.

In order for the HIV/AIDS response to have an effective and successful monitoring and evaluation system, all of the current evolving elements, currently under development, need to be integrated into a cohesive and coherent monitoring and evaluation system to assist with progress measurement, accountability, learning and planning at all levels. During the implementation of the project, the SSAC will work to achieve the following Monitoring and Evaluation Objectives: (a) Integrate, in a cohesive manner, the elements of an M&E system which is currently being developed as listed above. This will be measured by the development, dissemination and use of a single national monitoring and evaluation framework and a costed operational plan for monitoring and evaluation; which will be agreed by all partners. (b) Implement an effective project monitoring system which will be based on several sources:

(i) GoSS, state and county level capacity building efforts will be measured using data from quarterly GoSS, state and county progress reports, (ii) health services will be tracked using data from the Health Management Information Systems (HMIS) and episodic health facility surveys, (iii) CSO subproject and line ministry funding records from SSAC financial reports, (iv) reporting forms and systems will be developed to track services provided outside the health sector, and (iv) geographic and target group intervention coverage reports, particularly of MARPs will be assessed using coverage modules in behavioral surveys.

(c) Surveillance, which will be strengthened in the following ways: (i) current and planned surveillance surveys will include key geographic areas and target groups covered under the project funding; and (d) Data analysis and use to improve policies and programs will receive major emphasis. Data from each of the above sources will be analyzed in an integrated manner, to produce a holistic understanding of Southern Sudan’s HIV epidemic and responses. Important findings will be shared widely through regular dissemination fora and used to strengthen GoSS and state level planning and programming. Due to the dearth of behavioral data, and the consequent lack of baseline data, it is proposed that progress could be tracked using an approach that recognizes the implementation plans of the project both in terms of building capacity for an effective

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response as well as the ability to influence outcome behavioral indicators over time. Thus it is proposed that the project would apply a “ladder approach” to incrementally measure program progress, outputs and outcomes over the period of support. The achievement of these measures could also provide confidence in assessing the ability of the program to absorb funds.

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Ladder of Achievement for HIV/AIDS Multi-Donor Trust Fund Project

Year 1 Year 2 Year 3 Years 4 and 5 Functional SSAC, State and County

AIDS Offices +

Systems developed and mechanisms in place

+ Selected CSO subprojects funded

+ Selected Line Ministries Funded

Functional SSAC, State and County AIDS Offices

+ CSO and Line Ministries subprojects

and Line Ministry Action plans implemented

+ Coverage of MARPs

+ Disbursement

+ Baseline Behavioral data generated

Functional SSAC, State and County AIDS Offices

+ CSO and Line Ministries subprojects and

Action Plans implemented +

Behavioral outcomes +

Coverage +

Disbursement

HIV impact (measured at national level only, project not accountable)

+ Functional SSAC, State and County AIDS

Offices +

CSO and Line Ministries subprojects and Action Plans implemented

+ Behavioral outcomes

+ Coverage

+ Disbursement

Indicators Behavioral outcomes

1. Increased safe sexual practices 2. Increased knowledge of HIV 3. Accepting attitudes towards PLWHA

Behavioral outcomes 1. Increased safe sexual practices 2. Increased knowledge of HIV 3. Accepting attitudes towards PLWHA

Behavioral outcomes 1. Increased safe sexual practices 2. Increased knowledge of HIV 3. Accepting attitudes towards PLWHA

Coverage 1. Percentage of MARPs reached by interventions 2. Number of service sites established



Coverage 1. Percentage of MARPS reached by interventions 2. Number of service sites established

Project 1. SSAC functional 2. Number of state AIDS Commissions established and functional 3. Number of County AIDS Offices established and functional 4. Systems developed and mechanisms in place 5. Percent resources disbursed

Project 1. Number of state and county AIDS Commissions functional 2. Number of CSO subprojects funded 3. Number of line ministry Action plans implemented 4. Percent resources disbursed 5. Baseline behavioral data established

Project 1. Number of state and county AIDS commissions functional 2. Number of CSO subprojects funded 3. Number of line ministry Action plans implemented 4. Percent resources disbursed



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IV. CRITICAL RISKS AND POSSIBLE CONTROVERSIAL ASPECTS Risks Risk

Rating Risk-Mitigating Measures

Southern Sudan is emerging from decades of war with a severe shortage of infrastructure, services and skilled human resources that may undermine effective project implementation.

H

Strong focus on capacity building to develop skilled human resources at all levels

Lack of technical and managerial capacity due to the absence of adequate basic and advanced education systems will likely have a negative impact on the adequate staffing of key project components.

H Long-term technical assistance contracted directly by SSAC or through an international/regional firm to build capacity of local staff

Emerging Government structures that are still in the process of being established.

H Significant resources allocated for capacity building

Weak governance and accountability in both Government and Civil Society

H Significant resources allocated for capacity building

Political instability and/or delays in disbursing funds from oil revenues from the North may hamper smooth implementation of the CPA which may have a negative impact on Project implementation as it depends on continuity of GoSS contributions to MDTF.

S Strengthening the active involvement of donors and international partners in the peace and development process in both Southern and North Sudan to ensure political stability and develop alternative short-term funding mechanisms to fill urgent gaps through bilateral or multilateral funding.

The responsiveness and strategic value of the project may be further hampered by the lengthy MDTF approval procedures.

H Strong commitment from GoSS and the Oversight Committee to accelerate the implementation of HIV/AIDS activities given the potential devastation of the epidemic

Overall H

Legend: H – High risk; S – Substantial risk; M – Moderate risk; N – Low or negligible risk

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Grant conditions and covenants

(i) Conditions for effectiveness

1. The HIV/AIDS Multisectoral Strategic Framework (HMSF) is developed and approved by the GoSS

2. The GoSS has designated a Financial Management Specialist and Procurement

Specialist to be responsible for the fiduciary management of the HIV/AIDS Project.

(ii) Covenants

1. Maintain a fiduciary unit within the Ministry of Finance and Economic Planning of the GOSS with functions, staff and responsibilities satisfactory to the World Bank.

2. Prepare and furnish to the World Bank, on a quarterly basis, a financial monitoring report, in form and substance satisfactory to the World Bank. 3. No later than December 31 of each year during Project implementation, furnish to the World Bank for its approval, the Annual Work Plan for the following year.

Social Issues

61. To adequately address the social issues related to the implementation of the project, a meeting of various stakeholders will be organized to allow all stakeholders to present their points of view regarding the proposed project. Government officials, UN agencies, bilateral and multilateral donors, and civil society organizations (local and international), will be invited to participate in this stakeholder meeting. Based on discussions with stakeholders during the preparation of similar projects in Southern Sudan, a number of issues are becoming evident and will be taken into account in this Project. Geographical targeting mechanisms and supportive measures in favor of the poorest and most vulnerable regions have been identified as mechanisms to increase the social benefits of the Project. This Project will operate at the GoSS, state, county and community level, which offers opportunities to target the poorest and most vulnerable at all levels. The Project is expected to have a positive social impact by assisting and empowering people and institutions to deal more effectively with the HIV/AIDS. The Project will support GoSS efforts to legally protect PLWHA. PLWHA and their families are vulnerable to economic and human rights abuses in the absence of legislation and social norms that can protect them PLWHA and their families will have an opportunity to receive better social support from their communities, civil society organizations, and the GoSS. The Project will involve key stakeholders, including civil society organizations and PLWHA in the development of such protective measures. Environmental issues

62. Project environmental and social issues are expected to arise from the renovation of old and the construction of new buildings such as offices for the SSAC,

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Voluntary Counseling and Testing rooms and STI clinics. Biomedical waste management issues arise from the management of medical supplies associated with the provision of clinical management of PLWHA. As part of the preparation of the South Sudan Umbrella Program for Health System Development, similar issues were raised. This Project will follow the safeguards that were approved for that project. This includes the Environmental and Social Management Framework (ESMF) that provides common-sense environmental site selection, design and construction guidance, and a procedure for ensuring that this guidance is followed before construction is approved. A Safeguards Officer appointed by MoH will ensure adherence to the ESMF provisions and provide environmental approval for subprojects. It is planned that the ESMF will be applicable to all MDTF projects. In addition, a Medical Waste Management Plan will be implemented to ensure the effective collection and disposal of hazardous medical waste (e.g. used needles). The Ministry of Environment, Wildlife Conservation and Tourism (MOEWCT) coordinates a MDTF Safeguards Management Committee comprised of Safeguards Officers from each ministry benefiting from the MDTF.

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Annex 1: Implementation Arrangements

• Acceleration of Implementation: The Rapid Results Approach was used identify activities and concrete results for the first 100 days of project effectiveness: 1. Establishing a functional SSAC sub-office in each State 2. Developing annual work plan for each State. The framework for the work plan and

illustrative results, benchmarks and activities were identified during the Rapid Results Approach workshop

3. Providing international TA to SSAC at GoSS level to establish procurement and financial management procedures, and to identify competent Southern Sudanese professionals to take over those positions within the first year of program implementation.

4. Launch the first HIV/AIDS Multisectoral Strategic Framework (HMSF) at GoSS and State levels to guide implementation and coordination. The HMSF is under development and will be finalized by November 2007

5. Establishing effective implementation modalities for each component of the program including identifying and contracting umbrella NGOs to manage the Civil Society component

6. Bolster the multisectoral response by hiring program staff in the Ministry of Health and strengthen HIV/AIDS service delivery • Capacity building:

1. Providing training for SSAC staff and GoSS and state level on procurement and financial management

2. Providing managerial and technical training for SSAC staff at GoSS and state level 3. Establishing and supporting a monitoring and evaluation system to generate data for

decision making 4. Ensuring that international TA build capacity of Southern Sudanese professionals

within the first year of project implementation • Partnership and coordination:

1. Supporting the establishment of a consultative forum for different partners working in the area of HIV/AIDS at GoSS and state level to share information, leverage technical and financial resources, and apply lessons learned during implementation.

2. Identifying service delivery gaps and mobilizing resources to address those gaps

Project Implementation Period: It is anticipated that the project will become effective in January 2008 and be implemented from February 2008 to January 2013 Project Implementation and Management: The Project will operate within the proposed framework of responsibilities for project organization and management as negotiated with GoSS and MoFEP. Under these arrangements, MoFEP will have overall responsibility for procurement and financial management. The Southern Sudan HIV/AIDS Commission (SSAC) will be the principal grant implementer. The SSAC has a Board composed of 8 people, which serves as the Steering Committee with overall responsibility for project implementation. The management structure of the SSAC operates under the authority of the Board. The

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technical responsibilities of the SSAC Board are carried out by the SSAC Secretariat. Due to limited capacity and the need to urgently provide services to the community, a technical team will be hired at the SSAC Secretariat, which will be responsible for program implementation. Contractual staff is crucial because the SSAC Secretariat is still in the process of being staffed, and requires on-the-job capacity building. The option of contracting an existing project firm, already responsible for the management of other HIV programs in the region may also being considered. The technical team will work under the supervision of the SSAC Secretariat and will be expected to assist in building the implementation capacity of the SSAC Secretariat. Strategic Oversight: To provide overall strategic guidance and donor coordination, MDTF has established a Project Task Force (PTF), headed by the Minister of Finance and Economic Planning with representatives of the Technical Secretariat, GoSS, UN OCHA, and representatives of all interested implementing ministries/agencies. The MoH, which will lead the health sector response for this Project, has established the Health and Nutrition Consultative Group (HNCG) to coordinate the activities of development partners including donors, UN agencies and NGOs. It will organize, support and provide advice to promote the achievement of MoH's policies and strategies and to ensure that the different initiatives and funding mechanisms operate in complementarity and make reference to a common framework. The Project will contribute by financing at national, state, and county levels: (i) quarterly supervision and review of program and project implementation; and (ii) annual planning and budgeting to ensure effective and efficient use of resources, particularly those of the MDTF which can be more flexibly used to fill gaps, respond to new priorities or initiatives, etc. Implementation Arrangements for each component: The SSAC is a relatively new organization which was created over the last year. There is, therefore, a significant need for capacity building for the Commission to effectively coordinate project implementation. Component 1: Institutional and capacity building of the SSAC at all levels The SSAC Secretariat will take the lead in the implementation of this component. Procurement of the works, goods, training, services and operational costs will be delegated to SSAC by the MoFEP. However, in preparing the technical specifications and program related documents required for procurement and financial management SSAC may seek assistance of MoFEP. This is to ensure procured commodities meet the technical needs of the SSAC, and that the SSAC receives the necessary procurement support of MoFEP for smooth procurement and financial management. Component 2: Line Ministries’ response Government Line Ministries routinely prepare annual work plans for their respective Ministry functions. It is expected that these Line Ministries will prepare HIV/AIDS work plans as part of the respective Ministry’s work plan preparation process. The work plan should include HIV/AIDS activities for the internal clients of the Ministry (its own staff and their families) and for the external clients of the Ministries (its target populations). Each Ministry then uses its HIV/AIDS work plan as the basis for requesting project funds from the SSAC Secretariat, to support all or parts of the Ministry’s HIV/AIDS work plan. Responsibility for the implementation of the

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Ministry HIV/AIDS work plan lies with the respective Ministry, which will designate a focal person in the Ministry to be responsible for ensuring the implementation of the plan. Ministries will also be required to form Ministry HIV/AIDS Committees to support the focal point in the implementation of the Ministry HIV/AIDS work plans. The Ministries have the option to contract a CSO or other organization to assist in the preparation and/or implementation of the Ministry annual HIV/AIDS works plans. For coordination purposes, the line ministries have agreed to form a Line Ministry Forum which will meet quarterly to share implementation experiences. Component 3: Civil Society response The term “Civil Society Organizations” covers Non-Governmental Organizations (NGOs), faith-based organizations (FBOs), community-based organizations (CBOs), various ‘community’ associations such as people living with HIV/AIDS (PLWHA) and, an entity in the private sector. Civil society organizations would be funded by the project, either through proposals that they submit directly to the SSAC, through an umbrella NGO mechanism or through sub-contractual arrangements with other implementing agencies (e.g. Line Ministries). To be eligible for participation a Group should:

• Be an established group (either local and/or international) that is registered through a relevant Government agency, or have international recognition or have a demonstrated history of community work;

• Have experience in community work and be endorsed by community leaders or local administration; and

• Have a verifiable management and accounting structure or make arrangements with another entity which can provide these services.

The SSAC Secretariat would check the evidence of eligibility and inform the CSO (or request additional information). The SSAC Secretariat may, in some cases, help attain eligibility or recommend twinning and/or mentoring arrangements with an eligible group. This would facilitate the broadest possible participation of civil society in the HIV/AIDS prevention and control campaign. The SSAC Secretariat will develop a transparent process for reviewing proposals from CSOs and make the information on the proposals available for review by interested stakeholders. Component 4: Health Sector Response The health sector is a key stakeholder in the implementation of the Project. The MoH will take the lead for the management of this component. The Project will support the building of the capacity of the MoH and other relevant health sector stakeholders, to respond to HIV/AIDS. The Project will support health sector HIV/AIDS related services for prevention, treatment, care and support including Voluntary Counseling and Testing (VCT), condom promotion and provision; control of sexually transmitted diseases, management of opportunistic infections, home based care for PLWHA, prevention of mother to child transmission of HIV (PMTCT), support of nutritional interventions for PLWHA, anti-retroviral treatment (ART), strengthening of laboratory capacity, training of health workers to respond to HIV/AIDS, blood safety and support to medical waste management.

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Implementation Plan for Year 1

Description Implementation Plan Specific Modalities Institutional and Capacity Development

Upgrading and establishment of offices and equipment at GoSS and State levels Intensive training of technical and program staff Establish an HIV/AIDS policy and NMSF framework to guide implementation of the multi-sectoral response at GoSS and State level

Immediate upgrading and establishment of offices and installation of equipment Hiring and training of technical staff of GoSS and State SSAC staff on HIV/AIDS technical information, procurement and financial procedure Dissemination of the HIV/AIDS Policy and HMSF

TA and training to be contracted to firms or individuals Stakeholders meeting at GoSS and State levels

Mainstreaming HIV/AIDS into Line Ministries Establishment of technical capacity within selected line ministries to mainstream HIV/AIDS Develop an annual plan and budget for mainstreaming HIV/AIDS into priority line ministries

Immediate identification of HIV/AIDS focal points responsible for planning and coordinating HIV/AIDS activities. Develop and disseminate IEC materials targeted at line ministry staff. Establish an interministerial forum at GoSS level, that meets quarterly to share lessons learnt in HIV/AIDS mainstreaming

TA and training to be contracted to firms or individuals Quarterly meetings at SSAC

Strengthening of the Civil Society response Support for evidence-based community HIV/AIDS interventions (prevention, care, support and impact mitigation.) Establish a grant making mechanism through umbrella regional or international NGOs and/or UN Agencies

Contracting of NGOs, CBOs and FBOs to conduct targeted community-based HIV/AIDS activities to raise awareness and mitigate the impact on communities

International or national competitive bidding for a limited number of contractors for defined geographic coverage areas

Strengthening the Health Sector HIV/AIDS response Strengthening of comprehensive HIV/AIDS prevention, treatment and care service delivery by the MoH at all levels Integrating HIV/AIDS technical training into the planned capacity building plans in the Umbrella Health Project

Immediate recruitment of HIV/AIDS technical officers in the MoH at GoSS at State levels responsible for planning and coordinating HIV/AIDS activities Develop and disseminate HIV/AIDS technical guidelines

WHO and other UN Agencies to provide TA Additional TA and training to be contracted to firms or individuals Dissemination of technical guidelines at GoSS and state level

Surveillance, Monitoring and evaluation Development of a multisectoral HIV/AIDS M&E system integrated with the HMIS and support appropriate assessments, surveys and studies to understand the drivers of the HIV epidemic in Southern Sudan. Support for information use through regular supervision/review and annual planning Monitoring of the performance of contracted firms/NGOs, particularly those supporting the community response

Immediate establishment of periodic supervision/review and coordination meetings at different levels Immediate/Medium-term development of planning skills in SSAC at GoSS and State levels

TA, studies, support for review/planning to be contracted to firms

Program implementation Technical support/operational costs for program coordination and management/implementation of components, procurement, financial management, audit. Implementation of social/environmental safeguards

Ongoing implementation assistance to be integrated technically with SSAC operations

Coordination with other MDTF capacity building TA to be contracted to firms or individuals with specialized skills

Fiduciary arrangements Establishment of procurement and financial management capabilities in SSAC at GoSS level

Establish a procurement unit and procedures. Establish financial management unit and procedures. Train relevant SSAC staff at GoSS and State level in procurement and financial management

MoH will procure pharmaceuticals using mechanisms in the Umbrella Health Project. SSAC at GoSS will procure non-health commodities

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Annex 2: Project Costs by Component The Project total costs are US$ 36.75 million. The MDTF will contribute US$ 31.75 million while the GoSS will contribute US$ 5 million over a five year period.

Total Project costs by contributing agency

Contributing agency Amount contributed (US$) MDTF 31,750,000 (86.4%) GOSS 5,000,000 (13.6%) Total 36,750,000 (100%)

Total project costs by component Component Cost (US$) 1. Institutional and capacity building of the SSAC at all levels 9,187,500 (25%) 2. Line Ministries’ response 3,675,000 (10%) 3. Civil Society Response 18,375,000 (50%) 4. Health Sector Response 5,512,000 (15%) Total 36,750,000 (100%)

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Annex 3: Procurement Assessment and Arrangements A. General 1. Procurement for the proposed project would be carried out in accordance with the World Bank’s "Guidelines: Procurement under IBRD Loans and IDA Credits" dated May 2004 revised in October 2006; and "Guidelines: Selection and Employment of Consultants by World Bank Borrowers" dated May 2004 revised in October 2006, and the provisions stipulated in the Legal Agreement. Donor funds have been contributed into Multi Donor Trust Funds (MDTF), part of which will be used for this project. The World Bank also provided Trust Funds to finance activities in critical areas in capacity building including in the area of Public Sector Management, Public Financial Management and Public Procurement. The MDTF is administered by the World Bank, and the Donors have agreed that all procurement financed under the MDTF would follow World Bank Procurement Guidelines. The various items under different expenditure categories are described in general below. For each contract to be financed by the Grant, the different procurement methods or consultant selection methods, the need for pre-qualification, estimated costs, prior review requirements, and time frame are agreed between the GOSS and the Bank in the Procurement Plan. The Procurement Plan will be updated twice annually or as required to reflect the actual project implementation needs, and improvements in institutional capacity. 2. Procurement of Works: Works procured under this project would include: rehabilitation and/or construction of, rehabilitation of buildings and associated services for administration, VCT rooms and STI clinics. a. The Bank’s Standard Bidding Document (SBD) for the procurement of works (smaller contracts) will be suitably adapted and used for all National Competitive Bidding (NCB), and Solicitation Documents agreed with or satisfactory to the Bank will be used for small civil works contracts centrally procured, or procured with community participation in procurement. 3. Procurement of Goods: Goods procured under this project would include: (i) pharmaceuticals and medical supplies; (ii) training and field equipment and materials; (iii) staff uniforms and equipment; (iv) furniture and supplies for VCT rooms; and (v) STI clinics and offices furniture. Schedules of these goods will be prepared as part of the Annual Work Plans at each level of preparation and the procurement plan appropriately updated. a. The procurement will be done using the Bank’s Standard Bidding Documents (SBD) for all ICB and simplified SBD agreed with or satisfactory to the Bank. b. Procurement from UN Agencies. Goods may be procured from United Nations agencies such as the International Agency Procurement Services Office (IAPSO), United Nations Children’s Fund (UNICEF), United Nations Fund for Population Administration (UNFPA), or the United Nations Office for Project Services (UNOPS) in accordance with the provisions of paragraph 3.9 of the Guidelines, subject to IDA prior approval.

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c. Procurement for readily available off-the-shelf goods that cannot be grouped; standard specifications commodities; or procurement of items that is locally available to be supplied within the communities for individual contracts of less than US$20,000 equivalent may be procured under Shopping procedures consistent with paragraphs 3.5; 3.6 and 3.17of the Guidelines: Procurement under IBRD Loans and IDA Credits, May 2004 revised October 2006 and June 9, 2000 Memorandum “Guidance on Shopping” issued by the Bank. d. Community Participation: Goods, works and services required for community activities may be procured following procedures to be detailed in the Project Implementation Manual, and in accordance with the provisions of Section 3.17 of the Guidelines. 4. Selection of Consultants: Consultancy services under the project will involve extensive use of technical assistance to support SSAC in managing the project technical and administrative tasks. a. The Bank’s Standard Request for Proposals (SRFP) would be used for all consulting assignments estimated to cost US$100,000 equivalent or more. For assignments less than US$100,000, unless acceptable simplified Standard Request for Proposal documents are developed, Bank’s SRFP document will be used. Short lists of consultants for services estimated to cost less than $100,000 equivalent per contract may be composed entirely of national consultants in accordance with the provisions of paragraph 2.7 of the Consultant Guidelines. The appropriate selection method of each consulting contract would be established in the Procurement Plan. 5. Operating Costs: The operating costs that shall be financed by the Project are to be detailed in the project implementation manual. 6. Capacity Building and Training to be financed under the project: The capacity building and training activities will cover training in fiduciary aspects associated with the project components as well as building the capacity for the communities response through NGOs, CBOs, and FBOs. All training and workshops will be carried out on the basis of programs, which shall have been approved by the Bank on an annual basis, and which shall, inter alia, identify: (a) the training and workshops envisaged; (b) the target audience; (c) the institutions which will conduct the training; (d) the duration of the proposed training; The detailed annual training program outline categories of training, number of trainees, duration of training, staff months, timing and estimated cost. B. Assessment of the agencies’ capacity to implement procurement 1. Procurement activities will be carried out by the consultant Procurement Specialist to be recruited into the SSAC, as well as the Procurement Specialist of the Umbrella Program for Health System Development Project with support from the PPU of MOFEP as necessary. The organization of the SSAC procurement unit, internal technical & administrative controls, anti-Corruption measures, and their appeal mechanisms for bidders are all yet to be established. The MA will be used to follow up the establishment and creation of a functional procurement unit at SSAC while the PPU will be supported to provide the necessary oversight.

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Procurement Environment 1. The UN, the World Bank, the Government of Sudan and the SPLM formed a Joint Assessment Mission (JAM) which prepared a “Framework for Sustained Peace, Development and Poverty Reduction (March 2005)”. This document establishes reconstruction and development requirements for the Sudan as envisaged in the Peace Agreement. In order to assist in the financing of reconstruction and development, Donors have agreed to contribute funds into two separate Multi Donor Trust Funds (MDTF), one for the North and the other for the South. The World Bank is the Administrator of the MDTF funds. World Bank procedures for project preparation and implementation will be used for MDTF programs. 2. The JAM identified public procurement system in Southern Sudan as non existent. The Civil service itself (including the staffing of the Ministry of Health) is very weak and would be developed from a very low base. There are no official procurement procedures, institutional framework and capacity to support procurement under the SPLM-led Administration. Other constraints that affect procurement include: (i) severe lack of communications (postal and telecommunication services), (ii) poor physical infrastructure, (iii) limited media (e.g., to advertise), (iv) low capacity of local suppliers in the private sector, and (v) low capacity of a supporting regulatory environment (e.g., customs, banking) that has barely started to emerge. As these constraints will affect the GoSS absorption capacity in the early days of the reconstruction and development program, JAM recommended centrally managed procurement as an interim measure. As soon as a more comprehensive procurement system is put in place and the capacity of government entities is built, the next step will be to phase out the centralized arrangements and transfer the procurement responsibility to line ministries and other arms of Government. 3. JAM concluded that Southern Sudan would require assistance to build capacity in public procurement systems as well as to carry out procurement tasks under programs financed by Government and the MDTF funds. The Challenge for the Donors and the GoSS is to put in place mechanisms that will ensure Government and Donor resources are used properly (achieve value for money) for the intended purposes with due care to economy and efficiency. Such mechanisms must also guard against the potentially high risk of corruption in public procurement, which could skim off a lot of public funds and undermine the reconstruction and development programs. Risk Rating for project procurement management 1. The procurement capacity of the key GoSS institutions that will implement this project, i.e. in particular SSAC is insufficient due to lack of procurement experience and adequate staffing, as well as possible limited interest in the South Sudan market by experienced foreign contractors and suppliers. The procurement capacity is therefore assessed as very low and the overall project risk for procurement is HIGH.

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Risk mitigation and Capacity Enhancement measures 1. The key issues and risks concerning procurement for implementation of the project have been identified and to mitigate the risks:

(i) The SSAC would be assisted to qualify to be delegated procuring authority by MOFEP by recruiting a consultant Project Procurement Specialist, whose qualifications and experience are acceptable to the Bank, to manage the procurement function under the project. (ii) The above mentioned Procurement Specialists would be recruited before project start up. (iii) The staff of the SSAC who will be involved in the procurement activities will be trained in procurement as a way of building capacity. The TORs of the Project Procurement Specialist will include training of SSAC staff. Eligible staff of the SSAC will be provided opportunity to attend the World Bank supported procurement courses offered by Ghana Institute of Public Administration (GIMPA), Accra and/or Eastern and Southern Africa Management Institute (ESAMI), Arusha. (iv) The project Procurement Specialist will work closely with the Procurement Specialists of the other ongoing MDTF projects to share experiences and encourage cross learning of procurement issues under World Bank guidelines. (v) Hand-holding training will be provided during the preparation of detailed project procurement plans for Bank’s approval (vi) Support of the PPU, the MDTF financed Procurement Agent and the Monitoring Agent will be availed to SSAC in order to ensure that the timelines in the Procurement Plans can be kept. (vii) All procurement documents and records for this project will be in English. Details for the contents of procurement files will be included in the project implementation manual.

C. Procurement Plan 1. The SSAC is preparing a schedule of the goods, works and services required for the project as part of the annual work plans and budget. These schedules will be used by the Procurement Specialist to prepare annual procurement plans in a format acceptable to the Bank. Progress on each procurement plan will be updated regularly by indicating actual dates on which activities were completed against the planned date for the activities under each item on the plan. Procurement applying community participation will be specified in the subproject proposal, including a simplified plan on how contracts would be processed following simplified procedures in the Project Implementation Manual. A draft procurement plan is included below. D. Review by the Bank 1. All supply and installation and civil works contracts estimated to cost US$250,000 equivalent or more and goods contracts estimated to cost US$150,000 equivalent or more will be subject to the Bank prior review in accordance with the procedures set in Appendix I of the Procurement Guidelines. Any amendments to

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existing contracts raising their values to levels equivalent or above the prior review thresholds are subject to the Bank’s prior review. All contracts awarded on the basis of direct contracting will require prior review and clearance of the Bank. The review by the Bank of the individual contracts is detailed in the Procurement Plan in this Annex. 2. Consultancy contracts with firms with estimated value of US$100,000 or more, and consultancy contracts with individuals estimated value of US$50,000 equivalent or more will be subject to prior review by the Bank in accordance with the procedures set in Appendix I of the Consultants Guidelines. All single source selection as well as Terms of Reference (TOR) for all consultancy contracts irrespective of the contract value, will be subject to the Bank’s prior review. All training and workshops will be carried out on the basis of programs, which shall have been approved by the Bank on an annual basis, 3. The above limits are in accordance with the risk rating. 4. Post reviews of contracts awarded below the above threshold levels will be carried out selectively by the Bank or its consultants during supervision missions and/or by an independent procurement auditor. E. Frequency of Procurement Supervision 1. In addition to the prior review supervision to be carried out from the Bank office, there will be annual ex-post procurement reviews of a minimum of 20% of all contracts below the prior review threshold; plus regular sampling of contracts for ex-post review during the supervision missions and as part of annual financial audits. F. Advertising, Contract Award Disclosure Requirements 1. Advertising: Immediately after negotiations, a General Procurement Notice (GPN) will be published online in dgMarket and UN-Development Business and in at least two national news papers of wide circulation. The GPN will provide a description of the Project and an indication of contracts for the works and goods that will be procured under ICB, and consultants’ services estimated at more than US$100,000. EOI will be advertised for consulting services above US$100,000 will in addition be advertised online in dgMarket. Specific Procurement Notices (SPNs) for bidding opportunities will be published in national news papers of wide circulation. 2. Publication of contract awards in UNDB online and dgMarket would be required for all ICB, NCB, Direct Contracting and the Selection of Consultants for contracts exceeding a value of US$100,000. In addition, where prequalification has taken place, the list of pre-qualified bidders will be published. With regard to ICB, and large-value consulting contracts, the Borrower would be required to assure publication of contract awards as soon as the Bank has issued its “no objection” notice to the recommended award. With regard to Direct Contracting and NCB, publication of contract awards could be in aggregate form on a quarterly basis and local. All consultants competing for an assignment involving the submission of separate technical and financial proposals, irrespective of its estimated contract value, should be informed of the result of the technical evaluation (number of points that each firm received),

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before the opening of the financial proposals. The implementing agency would be required to offer debriefings to unsuccessful bidders and consultants. G. Fraud, Coercion and Corruption 1. All procuring entities as well as bidders, suppliers and contractors shall observe the highest standard of ethics during the procurement and execution of contracts financed under the project in accordance with Paragraph 1.14 of the Guidelines: Procurement under IBRD Loans and IDA Credits, May 2004 revised October 2006: and Paragraph 1.22 of the Guidelines: Selection and Employment of Consultants by World Bank Borrowers, May 2004 revised October 2006. H. Details of the Procurement Arrangements under the Project The project’s detailed activities for the first 18 months of implementation are detailed in the procurement plan that will be discussed and agreed between the Bank and the GOSS during negotiations and will be incorporated in the project implementation manual.

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Annex 4: Detailed Financial Management Assessment and Arrangements The World Bank’s Operational Policy 10.02 requires the borrower and the project implementing agency/agencies to maintain adequate financial management arrangements – including accounting, financial reporting, internal controls, budgeting and auditing arrangements – to ensure that accurate and timely financial information can be provided regarding project resources and expenditures. A financial management (FM) assessment is undertaken to ensure that the project has acceptable financial management arrangements to ensure that funds are used only for the intended purposes. This assessment is also to determine if there are systems that ensures efficient and economical use of funds, adequate capacity for the preparation of accurate, reliable and timely Interim Un-audited financial Reports (IFR), existence of arrangements capable of correctly and completely recording all transactions relating to the project, adequate safeguards for the entities’ assets and that the project activities are subject to auditing arrangements acceptable to the Bank. This assessment has been carried out in accordance with OPCS guidelines titled “Assessment of Financial Management Arrangements in World Bank-Financed Projects – Guidelines to Staff” issued by the Financial Management Sector Board on June 30, 2001, and Financial Management practice manual dated November 3, 2005. Country Issues The Government of South Sudan was formed after the CPA and has been putting in place structures of Government after that. The only assessment that exists of the public financial management system of GoSS was the one undertaken as part of the World Bank/UN Joint Assessment Mission (JAM) at the beginning of 2005. This assessment concluded that the entire public financial management system needed to be built from the ground up. Subsequently, a report by PricewaterhouseCoopers (PwC) for the MDTF has confirmed the need for extensive development of the system. The human resource capacity for project implementation and monitoring is weak and the Southern Sudan HIV/AIDS Commission (SSAC) has recently been formed and key staff in the process of being appointed. Project activities are also expected to take place at the State and other decentralized level of Government. Summary Risk Assessment The summary risk analysis is based on the above, on-going projects in Southern Sudan and this project’s implementation arrangements.

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Risk Assessment and Mitigation Measures Risk

Risk Rating

Risk Mitigating Measures incorporated into the Project Design

Conditions of Effectiveness / Disbursement (Yes or No)

Inherent Risk Country Level

H

GoSS has weak fiduciary capacity, inadequate systems and so the risk is being mitigated through an interim arrangement of a framework of fiduciary agents to mitigate the high risk environment. These measures include the appointment by GoSS of: i) a Project Accounting Agent (PAA) with responsibility to manage all the actual accounting and financial reporting for GoSS and MDTF expenditures; ii) of an External Audit Agent (EAA) to support the Auditor General to undertake independent external audit; and (iii) a Monitoring Agent (MA) to monitor all expenditures out of the MDTF. Domestic capacity is also being built concurrently through projects supported by USAID, DFID and other donors

No

Entity Level

H

The Project Accounting Agent (PAA) will provide accounting and financial management support to the implementing entities under the project. The project will also provide short term skill TA support and training to staff to the implementing entities.

No

Project Level

M

The decentralized operations under the project will require additional control measures to ensure resources sent to decentralized locations are used for the project purposes and accounted for on timely basis. Additional procedures will be required to achieve this and this will be a disbursement condition for release of funds to the decentralized location..

Yes Disbursement Condition for funds

to States

Overall Inherent Risk H Control Risk Budgeting H The budget systems in GoSS and its implementing agencies are weak. These

systems are being built and strengthened. The Bank team will support the implementing agencies to prepare realistic budgets under the project and monitor its implementation.

N

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Accounting S Overall project accounting will be provided by the PAA, however since there will be funds to decentralized location, agencies would be required to submit their statements to PAA at the center. The project would provide funds for implementation agencies to hire financial support to carry out these FM activities.

N

Internal Control S There are no established systems documented for use by Government agencies. Most of the agencies to implement this project have just been established. The project will support them document and implement acceptable FM procedures including specific procedures for funds management at the decentralized locations.

N

Funds Flow H Strict procedures would be followed in the release and accounting of funds sent to the States. These procedures would be documented in procedures manual for use by project. Staff will be recruited where States do not have the required caliber of staff. The project will also provide training to all fiduciary staff at the State levels.

Yes Procedures manual with funds flow to States is condition for disbursement.

Financial Reporting S The PAA will be responsible for overall financial reporting under the project. States would be required to submit their reports to enable PAA prepare these reports and these are expected to delay due to weak State level capacity. Simple formats will be used and training provided to help improve the timeliness of reporting. The procedures would also require that any state with outstanding unaccounted for balances would not get new releases.

N

Auditing S The EAA would be responsible for the audit of the project as well as all other projects in the MDTF-S portfolio.

N

Overall Control Risk

S

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Strengths and Weaknesses Strengths: The transition to the formation of a Government of South Sudan (GoSS) has been relatively smooth. New institutional arrangements are being formalized in an organized and efficient manner. The availability of substantial quantities of oil resources is a huge advantage if they are used in an economically efficient, transparent and accountable manner. A particular area of strength is the willingness of GoSS to interact effectively with the international community at this formative stage so that lessons of good practices from Africa and elsewhere can be adapted quickly to the situation in South Sudan. The contracting of reputable international accounting and monitoring agencies with experience of the Bank’s financial procedures is a strength. Weaknesses: Institutional and governance capacity is weak, with basic financial management systems and procedures still to be established. The limited human resources capacity is critical as can be expected in a post conflict situation. There is very limited familiarity with Bank procedures or guidelines. The banking system is virtually non existent, increasing the challenge of establishing a payment mechanism or entering into commercial transactions. Project Financial Management Arrangements The project financial management arrangement is designed on the basis of pooling of resources with common accountability and reporting relationships. The fiduciary accountability systems which have been put in place for all the projects in the Southern Sudan portfolio will similarly apply to this project. The fiduciary accountability arrangement, which is comparable to fiduciary controls established in other post conflict environments, includes; • A Monitoring Agent (MA) for the MDTF has been contracted. The MA will monitor actual expenditures to ensure that funds are being utilized for the purpose intended. The MA will ensure that fiduciary standards are complied with, and report on all cases of non compliance. PricewaterhouseCoopers (PwC) has been contracted as the MA for Southern Sudan. • A Project Accounting Agent (PAA) has been appointed. The PAA will be responsible for ensuring that reliable and robust accounting systems are in place to ensure proper accounting and reporting of transactions in accordance with international accounting standards. The PAA will take fiduciary responsibility for release of funds. • A Procurement Agent (PA) has been recruited to ensure that procurement is conducted in a transparent and accountable manner, and as per MDTF requirements; and • An External Audit Agent (EAA) being selected through an international competitive recruitment process to provide an independent professional opinion on

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the financial statements produced for the project. The EAA will undertake audits as per international standards of auditing. Project Accounting Policies MDTF resources will be accounted for by the Project on a cash basis. This will be augmented with appropriate records and procedures to track commitments and to safeguard assets. Accounting records will be maintained in US$. The PAA will use chart of accounts that will facilitate the preparation of relevant monthly, quarterly and annual financial Statements, including information on the following:

• Total project expenditures • Total financial contribution from each financier • Total expenditure on each project component/activity, and • Analysis of that total expenditure into civil works, various categories of goods,

training, consultants and other procurement and disbursement categories. Planning and Budgeting Cash budget preparation will follow the procedures outlined in the PIM. Additionally, financial projections or forecasts for the life of the project (analyzed by year and quarterly basis) will be prepared. On an annual basis, the PAA will support the implementing agencies to prepare their cash budget for the coming period based on the work program. The cash budget should include the figures for the year, analyzed by quarter. The cash budget for each quarter will reflect the detailed work plans and project activities, schedules (including procurement plan), and expected expenditure on project activities scheduled respectively for the quarter. The annual cash budget will be sent to the Task Team Leader at least two months before the beginning of the project fiscal year Internal Audit The Internal audit function is not properly developed in Southern Sudan. The PAA will be required to perform adequate fiduciary check prior to disbursement of funds under the project. Fixed Assets and Contracts Registers The PAA will prepare and regularly update a Fixed Assets Register. A copy of the register would be given to the implementing agency. Any changes to the register, in additions and disposals should be communicated to the PAA and the information used to update the register. A Contracts Register would also be maintained in respect of all contracts with consultants and suppliers. The PAA will prepare Contract Status Reports on quarterly basis to help SSAC monitor its expenditures and avoid over commitment of project funds. Control procedures over fixed assets and contracts with Consultants and suppliers/vendors will be documented in the PIM.

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Flow of funds and Banking Arrangements Under the MDTF arrangements funds management are for most projects are centralized within the MOFEP, where the PAA provides the day to day oversight for flow of funds. In this project due to its varying decentralized implementation, there will be different players involved in the flow of funds. This will require that the respective roles and accountability requirements are well defined and people involved are trained prior to the release of any funds. The PAA will be responsible for preparing and submitting to the World Bank consolidated applications for withdrawal, as appropriate. Appropriate procedures and controls will be instituted and documented in the Project Implementation Manual (PIM) to be issued by the PAA. This manual will be used by the PAA for project implementation, to ensure that disbursements and fund flows are carried out in an efficient and effective manner. The PAA will maintain a cumulative record of draw-downs from the MDTF grant that will be reconciled monthly with the Disbursement Summary provided by the Bank. Detailed banking arrangements, including control procedures over all bank transactions (e.g. cheque signatories, transfers, etc.), ill be documented in the PIM. All significant payments for works, good and services under the project will be effected by the PAA after the approval by the SSAC (include the title or Project Team Leader). The PAA will process payments and effect payment directly to the beneficiary through bank transfers. Payments to NGOs and UN agencies will be paid by the PAA in accordance with the terms of their agreements. Flow of Funds to States It is expected that States may receive funds to implement their agreed program of activities. The eligible activities to be implemented at the State level will be part of the project implementation manual. The detailed flow of funds arrangements would be included in the implementation manual they would follow the procedures outlined below;

i) At the beginning of each year, the SSAC would request all States to submit proposals for their HIV/AIDs activities to be funded under the project;

ii) These proposals would be reviewed and based on approved amounts, incorporated in the projects work plan and budget for the year;

iii) The State work plan and budget would be divided into phases or quarters (which ever is applicable), supported by an implementation plan or program which links phase or quarter amounts with activities to be completed within that phase or quarter;

iv) The State shall request for their initial (phase or quarter) amount, supported by approved work plan and budget and their bank account into which the funds are to be paid;

v) Subsequent releases will be based on evidence that funds have been used for agreed activities and evidence that phased activities have been completed. The MA or an independent agency will also certify compliance funds utilization;

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Flow of Funds Arrangements for sub-grants In addition to significant payments made at the center, the project will transfer funds to implementing beneficiaries at decentralized locations to enable them implement their approved or agreed activities. It has been agreed that a Regional Facilitating Agent (RFA) would be hired to manage the grant approval process for activities at the decentralized location. The RFA would be responsible for reviewing, supervising, and evaluating grant proposals, then making recommendations to SSAC. This would include working with States to review proposals, verifying eligibility of proposal recipients, and monitoring performance. The detailed approval processes, including eligibility will be documented in the operations manual, however the key flow of funds steps will include the following:

i) At the beginning of each funding cycle, adverts would be placed in local news papers, community notice boards and other media inviting recognised bodies (eligibility and qualifying bodies to be included in manual);

ii) Request received by the RFA would be assessed in accordance with the approved manual and approved those grant proposals that meet the criteria;

iii) The assessment would include agreeing the payment schedule to support the planned activities;

iv) The SSAC would then sign a funding sub-grant agreement with the grant recipient. The signed grant agreement would include a payment schedule, that will be the basis of payments, the bank accounts of the recipient, implementation plan and physical reporting formats and their key personnel;

v) On the basis of the approved grants, the SSAC (with the guidance and recommendation of the RFA) would request for the release of funds from the PAA;

vi) Funds would be released in phases and amount to be released must be linked to the completion of specific activities in the proposal;

vii) The request which shall be a statement listing the name and address of grant recipient, duly supported by the signed sub-grant agreements and details of recipients bank accounts;

viii) Subsequent releases for on going activities will be based on the submission of agreed physical reports that certify the completion of agreed phased activities for which the funds were released;

ix) The RFA, together with SSAC, would be required to carry our independent reviews to certify that planned activities were carried out;

x) Any grant recipient found to have misused funds would be required to refund the funds;

The MDTF Monitoring Agent would monitor and report on the utilization of funds in the pooled account funds, released to the States and beneficiaries in States and Counties, including the fiduciary standards complied with and the reliability of the FM systems.

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Auditing Arrangements The Project's financial statements will be audited in accordance with internationally recognized auditing standards by independent auditors. As part of the fiduciary arrangements an External Audit Agent will be appointed through international competitive selection process to be responsible for the audit of the all MDTF funded projects in Southern Sudan including this project. The audited financial statements for each year will be submitted to the Bank within 6 months of the end of the fiscal year to which it relates. In addition to the audit report, the external auditors will be expected to prepare Management Letters giving observations and comments, and providing recommendations for improvements in accountability weaknesses identified during their audit and also confirm if the project has complied with financial covenants in the MDTF Grant agreement. GoSS is responsible for: (i) having the Project's financial statements audited annually, and (ii) submitting to the Bank the copies of the audited statements together with management letters on the due dates. Disbursement Arrangements Disbursements from the MDTF would be through Report Based Procedures. In addition some direct payments, including special commitments will be made from the MDTF account to UN agencies and large contractors. PAA shall submit payment requests to the Bank based on Interim Un-audited Financial Reports (IFRs). Documentation supporting all expenditures claimed will be retained by the PAA, and will be available for review when requested by the MA, Bank supervision missions and the project’s external auditors. All disbursements are subject to the conditions of the MDTF Grant Agreement and the procedures defined in the Disbursement Letter. The Project Account will be replenished through the submission of Withdrawal Applications supported with quarterly IFRs and copies of relevant bank statements. The withdrawal application shall include an amount required to finance Eligible Expenditures during the six-month period following end of the quarter for which the IFR was prepared. Detailed disbursement procedures will be documented in the PIM. As capacity at central, states and county level is developed, project funds will be disbursed through the Ministries, states and counties to pay for eligible expenditures especially for recurrent expenditures. Prior to funds being disbursed to the Ministries, states and counties, a capacity assessment exercise would be carried out by the PAA and to establish the readiness of these levels to receive and account for project funds. Minimum access criteria will be developed by PAA in consultation and relied on by the PAA and the PCU to ensure that funds are not disbursed through the Ministry, states and counties mechanisms without the minimum expected accounting capacity to manage funds entrusted with them. The minimum access criterion need to be acceptable to MDTF and specified in the financial management procedures manual.

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Disbursement Table

Category Amount of the Grant Allocated (in US Dollars)

% of total Expenditures to be Financed by the Grant

(1) Works, Goods, Consultants’ Services, including Training, Operating Costs

30,750,000 86%

(2) Unallocated

1,000,000

Total 31,750,000

Designated Account There will be One Designated Pooled Account under this project. This Pooled account which will be maintained in US$ and opened in a commercial bank acceptable to World Bank as Administrator of the MDTF will received both the MDTF funds from the World Bank and the GoSS counterpart funds in the agreed disbursement percentages. In addition the project will operate State level bank accounts in relevant currencies for the benefit of paying for activities at the State and County level in accordance with the agreed flow of funds arrangements. This project will not fund salaries of GOSS staff and Commission staff. Financial Reporting and Monitoring Monthly, quarterly and annual reports will be prepared for the purpose of monitoring project implementation. The reports will be submitted to the MA, the SSAC, MOFEP and the World Bank. Detailed reporting procedures and the format, contents and frequency of reports will be fully documented in the PIM. Monthly: On a monthly basis, the PAA will prepare and submit the following reports to GoSS, MA and the Bank:

• Bank Reconciliation Statement for each bank account; • Monthly Statement of cash position for project funds from all sources, taking

into consideration significant reconciling items; • Monthly Statement of Expenditure classified by project components,

disbursement categories, and comparison with budgets, or a variance analysis; and

• Statement of Sources and Uses of funds (by Major Category/ Activity); Quarterly: The quarterly reports or the financial monitoring reports will be prepared by the PAA on a quarterly basis and submitted to GoSS, MA and the Bank:

• Financial Reports which constitute the Interim Un-audited Financial Reports (IFRs)include a Statement showing for the period and cumulatively (project life or year to date) inflows by sources and outflows by main expenditure classifications; beginning and ending cash balances of the project; and supporting schedules comparing actual and planned expenditures. The reports

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will also include cash forecast for the next two quarters. • Physical Progress Reports which include narrative information and output

indicators (agreed with SSAC) linking financial information with physical progress, and highlighting issues that require attention.

• Procurement Reports, which provide information on the procurement of goods, work, and related services, and the selection of Consultants, and on compliance with agreed procurement methods. The reports will compare procurement performance against the plan agreed at negotiations or subsequently updated, and highlight key procurement issues such as staffing and building Borrower capacity.

• SOE Withdrawal Schedule listing individual withdrawal applications relating to disbursements by SOE based method, by reference number, date and amount.

Annually: The annual project financial Statements, which will be prepared by the PAA will include the following:

• Statement of Sources and Uses of funds (by major Category/ Activity); • Statement of Cash Position for Project Funds from all sources; • Statements reconciling the balances on the various bank accounts (including

the Project Account) to the bank balances shown on the Statement of Sources and Uses of funds;

• SOE Withdrawal Schedules listing individual withdrawal applications relating to disbursements by the SOE based method, by reference number, date and amount;

• Notes to the Financial Statements. Indicative formats for the reports are outlined in the Bank's: (a) Financial Monitoring Reports: Guidelines to Borrowers, and (b) Annex to the Master Implementation Manual. The actual format will be fully documented in the PIM. Supervision Plan As this is a high risk project, it will be supervised on a quarterly basis by the Country based Financial Management Specialist. Supervision activities will include review of quarterly IFRs; review of annual audited financial statements and management letter as well as timely follow-up of issues arising; annual review; participation in project supervision missions as appropriate; and updating the FM rating in the Implementation Status Report (ISR) and PRIMA.

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Annex 5. Economic and Financial Analysis

Economic analysis: The detailed economic analysis on HIV/AIDS has been carried out under the umbrella project (See Annex 5 of the Project Appraisal Document for the Multi-Country HIV/AIDS Program for the Africa Region-Report No. 20727 AFR, paragraphs 76-78). The analysis includes an overall assessment of the impact of HIV/AIDS on economic development and poverty, and shows that a reduction in AIDS-related deaths would increase growth of GDP. This analysis was done before the extensive reduction in the cost of antiretroviral drugs which has further increased the life expectancy and quality of life of people living with HIV/AIDS. Financial analysis: Financial analysis for total health expenditure and per capita health spending has been carried out as part of the preparation for the MDTF for the South Sudan Umbrella Program for Health System Development. The analysis concluded that total health expenditures from international sources and MDTF/GoSS-financed projects were projected to reach around US$130 million in 2006. This amount did not take into account the amount of direct GoSS spending on the health system. Per capita expenditure on health services was estimated at US$13, with requirements of per capita expenditures of US$14. Per capita health expenditure in Southern Sudan is estimated to rise to US$17, by 2010.

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Annex 6: Social and Environmental Safeguards Policies The MDTF HIV/AIDS Project involves the renovation of old and the construction of new buildings, such as office buildings, VCT rooms, and STI Clinics, which triggers both the Environmental Assessment (OP4.01) and Involuntary Resettlement (OP4.12) Safeguards Policies. As part of the preparation for the South Sudan Umbrella Program for Health System Development, an Environmental and Social Management Framework (ESMF) and a Resettlement Policy Framework (RPF) were developed as mitigation instruments as the sites and locations of sub-projects were not yet fully known. This project will abide by the above frameworks. OP4.01 also requires a Medical Waste Management Plan (MWMP) to ensure the effective collection and disposal of hazardous medical waste. This project will also follow the MWMP that was developed for the South Sudan Umbrella Program for Health System Development. These safeguards instruments will be implemented by a Safeguards Officer in the MoH with support from the Ministry of Environment, Wildlife Conservation and Tourism (MoEWCT), and a long-term technical advisor for ongoing capacity building and monitoring of safeguards implementation. Potential environmental impacts from buildings (e.g. safe water supply, sanitation, waste disposal) are expected to be entirely avoided or mitigated through the application of common-sense environmental site selection, design and construction guidelines. Land acquisition for new buildings will be subject to the provisions of the RPF to ensure that land is either government land free of claims or donated voluntarily, or acquired through adequate compensation of existing land owners/users. Before any construction begins, safeguards clearances will be required from both the MoH Safeguards Officer and the MDTF Administrator. In order to ensure transparency and equity, for each construction site, a Land Acquisition Assessment (LAA) will be conducted by the contractor, prior to any construction work. The LAA is a screening tool that will help determine whether further mitigation instruments are needed during implementation. The Safeguards Officer and other designated participants are trained on how an LAA is prepared and used. The MoEWCT coordinates a MDTF Safeguards Management Committee, comprised of Safeguards Officers from each ministry benefiting from the MDTF. The MoEWCT will not have subproject approval authority. However, each Safeguards Officer will have the authority to determine, in consultation with the coordinator, whether the site is free of safeguards issues and whether additional mitigation measures are needed. The Committee has training and technical assistance for ongoing capacity building and monitoring of safeguards implementation. This arrangement will support not only continuous performance improvement for the Safeguards Officers and implementation of the ESMF, RPF and MWMP, but also policy, regulatory and institutional strengthening for the MoEWCT to support environmentally sustainable growth and resource management in South Sudan. The expected roles and duties of the members of MDTF Safeguards Management Committee (SMC) are summarized as follows:

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• Coordinator: He/she will liaise between the Safeguard Officers and other parties, will call and organize meetings as needed, and will provide technical assistance to the members of the Committee as needed. He/she will not, however, have administrative authority over the members of the Committee;

• Safeguard Officers: Each officer will (i) ensure proper implementation of

safeguard procedures in his/her own area; (ii) review, approve or reject the screening results for subprojects; and (iii) report quarterly to his/her ministry and to the MDTF Administrator.

The SMC will be supported by a regionally recruited advisor specialized in World Bank Safeguards over the project period (five years). The advisor will monitor the implementation of the safeguard procedures, provide training and advice to the SMC as needed, and will report to the benefiting ministries and to the MTDF Administrator. Training for the SMC is anticipated to include training in Bank safeguards, the MDTF ESMF/RPF, and the MWMP, plus a study tour to learn how these instruments are implemented, e.g. study tour to Kenya or Tanzania. Trainees would be the Safeguards Officers, 1-2 others per ministry, and the Coordinator. The training would take place during the study tour, and the training costs would be shared by the participating MDTF projects/ministries.

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Annex 7: Civil Society Organizations (CSOs) Definition of Civil Society Organizations The term “Civil Society Organizations” covers Non-Governmental Organizations (NGOs), faith-based organizations (FBOs), community-based organizations (CBOs), various ‘community’ associations such as people living with HIV/AIDS (PLWHA) and, an entity in the private sector or a local organization. Eligibility Criteria To be eligible for participation a Civil Society Organization should:

• be an established group (either local and/ or international) that is registered through a relevant Government agency, or have international recognition or have a demonstrated history of community work;

• have experience in community work and be endorsed by community leaders or

parish councils; and

• have a verifiable management and accounting structure or make arrangements with another entity which can provide these services.

Through an official in the SSAC, responsible for liaising with the CSOs, the SSAC would check the evidence of eligibility of an interested CSO and inform the CSO (or request additional information). The SSAC may, in some cases, help attain eligibility or recommend twinning and/or mentoring arrangements with an eligible group. This would facilitate the broadest possible participation of civil society in the HIV/AIDS prevention and control campaign. Eligible Activities The project will provide funding for HIV/AIDS-related interventions that support the objectives of the project. These may be new activities that CSOs wish to undertake or scaling up of existing activities. Eligible activities will be subject to periodic review by the SSAC and will include but are not limited to the following: (a) HIV/AIDS IEC/BCC activities

• Drama • Concerts • Competitions • Use of the mass media • Seminars and talks on HIV/AIDS prevention and treatment • Condom distribution including social marketing • Actions for reduction of discrimination and stigma • Voluntary Counseling and Testing (VCT) • Activities related to preventing mother to child transmission of HIV • Community mobilization to increase uptake of HIV/AIDS services

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(b) Community targeted activities for HIV/AIDS Vulnerable Groups

• Sex workers • Prisoners • Truck drivers, Bus drivers, and taxi-drivers • Young women • Youth (including establishment of youth-friendly health services) community

centers that include dissemination of HIV/AIDS prevention messages and counselling

• Training and support for Peer Educators • Extension workers (Agric, Vet, Roads) • Traders

(c) Provision of Care and Support for PLWHA and those affected by HIV/AIDS

• Provision of home-based care kits • Guidance to care-givers • Education, psychosocial and material support to orphans • Training for income generation activities for PLWHA, orphans,

widows/widowers or those caring for PLWHAs • Provision of seed/start-up money for income generation activities • Guidance on treatment for STIs, opportunistic infections and ARVs • Support will be provided for community-based care activities provided

through e.g. churches, local associations, private health facilities and others. (d) Capacity Building Activities: These would include training of civil society organizations on HIV/AIDS knowledge and communication. Requirements for Funding (a) Grant Proposals must have the following regardless of funding threshold:

• Justification for the intervention including its consistency with the National HIV/AIDS Strategy

• Identified beneficiaries • Cost breakdown • Implementation plan and schedule (if indicated) • Organization structure • Fiduciary capacity • Indicators for measuring effects of the proposal activities

Procedures and Processes for Solicitation, Review and Selection of CSO Proposals The participation of CSOs in the project would occur through any one of the following three (3) methods: (1) General Call for Proposals

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(a) The SSAC would launch a formal Call for Proposals in the local media. This would be done at least once a year. (b) CSOs would prepare proposals according to guidelines provided by the SSAC (c) The SSAC (directly or through contracting arrangements with a well established and experienced NGO) would provide technical assistance to CSOs in proposal preparation. (d) CSO proposals would be sent to the SSAC. (e) The SSAC would establish a public record of the transaction by recording the date of receipt and checking for the following information:

• Title of proposed project • Contact details (name, position, address/telephone number) • Brief description of the project • Location of the project • Main objectives • Implementation schedule • Measurable benefits • How project will be monitored and evaluated • Resources requested

An indication of whether the group has applied for/ and or received funding from other funding agencies (f) The CSO that submitted the proposal would receive a written acknowledgement from the SSAC within one (1) week of receiving the proposal. (g) The SSAC would then refer proposals to a SSAC CSO Proposal Evaluation Committee (h) If any member(s) of the Evaluation Committee is/are also a member/s of a CSO that has a proposal being reviewed by the Evaluation Committee, then the member(s) will be replaced by a suitable alternate from or approved by the SSAC. (i) Evaluation of program relevance and capacity of the CSO: The criteria to be used by the Evaluation Committee to assess CSO proposals would include the following:

• Relevance to the National HIV/AIDS Strategy • Target group(s) • Benefits • Technical soundness • Clarity of results • Measurability • Monitoring and Evaluation component • Management and Operational structure of CSO • Skills • Capacity building • Implementation schedule • Budget • Similar projects previously implemented

(j) The Committee may secure the advice of other experts, as necessary, in order to assist in making a decision. Its decision-making process shall be transparent. (k) The Evaluation Committee shall evaluate the project and make the necessary recommendations including the proposed amount of the award, if approved. (l) The SSAC shall notify the proponent and invite the representative of the CSO to conclude a contract, if recommended.

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(m) Once approved, proposals shall be sent to the fiduciary Officers in the MoFEP for processing. (2) Solicitation by SSAC or Line Ministries

SSAC may identify individual CSOs that have specific knowledge and/or capacities that are necessary to support the HV/AIDS Prevention and Control Program. In such cases, it shall make the request publicly, and allow a period for receiving comments before awarding contracts for the services. CSOs may also be invited by the MoH or non-health ministries to perform specific functions such as IEC/BCC activities or support formulating and/or implementing work programs of line ministries. Depending on their comparative advantages, they may serve the needs of specific target groups at risk or in need of care and support. (3) Solicitation by CSOs Any CSO may make a proposal to contribute to the HIV/AIDS Prevention, treatment, care and support agenda. It shall provide evidence of its “eligibility” and present a brief description of its concept including:

• area of SSAC ’s work to which it is addressing its proposal, • the targeted beneficiary(ies) of the action, • the action/s to be undertaken, • the measurable benefit to be expected, and • the required resource envelope.

The SSAC shall make a preliminary evaluation of its interest, and if favorable, convene a discussion of the concept with the CSO. An agreement shall be reached on whether a full proposal was warranted or whether additional strengthening would be helpful. Implementation of CSO Projects The SSAC shall provide guidance and training for the implementation of the projects and also monitor their implementation. For all projects, CSOs shall submit a mid-term report. For financial documentation and reporting, the CSO shall designate an individual to be responsible for ensuring that reports and accompanying documentation are in order. The SSAC shall have oversight for financial management and procurement issues and be responsible for ensuring that appropriate reports are submitted. Performance and completion evaluation At the completion of the services, the proponent shall submit a self -evaluation of the services according to the proposal. This shall be validated by the SSAC and the result shall become a public record.

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Annex 8: Project Proposal Budget

2008 2009 2010 2011 2012 No Components Activities MDTF GoSS/Other MDTF GoSS/Other MDTF GoSS/Other MDTF GoSS/Other MDTF GoSS/Other Total

Institutional and capacity Building of SSAC at all

levels

1.1 Human Resources Development: Support institutional and technical capacity building of SSAC at all levels 200,000.00 50,000.00 200,000.00 200,000.00 100,000.00 100,000.00 200,000.00 100,000.00 250,000.00 50,000.00 1,450,000.00

1.2 Policy & Planning:Develop policy HIV/AIDS multisectoral framework and M&E framework, BCC and BCT guidelines 100,000.00 50,000.00 100,000.00 50,000.00 200,000.00 100,000.00 150,000.00 50,000.00 150,500.00 50,000.00 1,000,500.00

uct

1.3 Infrastructural Development: Construct offices spaces and provide equipment, vehicles, bicycles and motorcycles, including communication equipment at all levels. 1,500,000.00 150,000.00 1,099,500.00 150,000.00 300,000.00 300,000.00 100,000.00 200,000.00 200,000.00 300,000.00 4,299,500.00

1.4 Monitoring and evaluation: harmonization of the M&E framework, and traning of M&E staff, reporting and dissermination of HIV/AIDS data to relevant stakeholders. 100,000.00 100,000.00 150,000.00 0.00 150,000.00 50,000.00 50,000.00 50,000.00 87,500.00 100,000.00 837,500.00

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1.5 Procurement and Financial Management: Training of staff on World Bank and GoSS procurement and financial Management guidelines and Procedures. 500,000.00 100,000.00 300,000.00 0.00 200,000.00 0.00 200,000.00 50,000.00 50,000.00 0.00 1,400,000.00

2 Subtotal 2,400,000 350,000 3,750,000 400,000 950,000 550,000 700,000 450,000 738,000 500,000 8,987,500

Line Ministries Response

2.1 Provide technical and financial support to mainstream HIV/AIDS into the relevant ministries, develop workplans with detailed budgets of the strategic sector ministries at all levels. 500,000 100,000 375,000 50,000 350,000 100,000 350,000 150,000 400,000 100,000 2,475,000

2.2 Establish HIV/AIDS focal points in line ministries. 300,000 100,000 200,000 100,000 200,000 50,000 150,000 50,000.00 150,000 100,000 1,400,000

3 Subtotal 800,000 200,000 575,000 150,000 550,000 150,000 500,000 200,000 550,000 200,000 3,875,000

Civil Society Response

3.1 Promote and support the existing civil soceity organizations (CSOs) and develop new partnerships between government institutions and civil the society. 250,000 200,000 2,000,000 175,000 2,000,000 50,000 1,000,000 0 500,000 0.00 6,175,000

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3.2 Build an improved infrastructure capacity and service delivery of CSO. 1,000,000 100,000 1,000,000 125,000 2,000,000 0 1,500,000 0 1,500,000 0 7,225,000

3.3 Increase participation of local communities and community leaders respose to HIV/AIDS. 1,500,000 100,000 1,500,000 0 650,000 100,000 400,000 200,000 375,000 150,000 4,975,000

Subtotal 2,750,000 400,000 4,500,000 300,000 4,650,000 150,000 2,900,000 200,000 2,375,000 150,000 18,375,000

Health Sector Response

4.1 Strengthen the MOH capacity to deliver HIV/AIDS services at all levels and improve HIV/AIDS prevention, treatment, care and impact mitigation for general population and the most at risk group. 750,000 100,000 800,000 50,000 900,000 50,000 900,000 100,000 500,000 100,000 4,250,000

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4.2 Develop policies, prgrams guidelines for HIV/AIDS prevention atreatment and care services 100,000 100,000 200,000 100,000 200,000 100,000 100,000 100,000 212,500 50,000 1,262,500

Subtotal 850,000 200,000 1,000,000 150,000 1,100,000 150,000 1,000,000 150,000 712,500 150,000 5,512,500

Grand Total 6,800,000 1,000,000 9,825,000 1,000,000 7,250,000 1,000,000 5,100,000 1,000,000 4,375,500 1,000,000 36,750,000 Total Budget 2008 - 2013 36,750,000 MDTF 31,750,000

GoSS 5,000,000

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