THE MULTISECTORAL APPROACH, INVESTMENT THINKING AND NATIONAL AIDS RESPONSE COORDINATION

MESFIN GETAHUN & BENJAMIN OFOSU-KORANTENGNOVEMBER 2013

ADDIS ABABA

United Nations Development Programme

Background

Rationale for the multisectoral approach Need for innovative ‘solutions’ beyond the

confines of the health sector Impact of the epidemic on national

development Main aspects of the multisectoral approach

Unprecedented mobilisation of public, private and CS sectors

Inclusion of the HIV and AIDS response in development planning and implementation processes including national development plans

Impact of the multi sectoral approach

• The multi sectoral approach promoted:Political will and leadership at all levelsGender sensitive and human rights based approaches

Establishment of partnerships across sectorsParticipatory approach and community mobilisation Institutional capacity developmentResource mobilizationThe establishment of M&E and accountability systems

Decentralised structures and ensured decentralisation of services

Challenges of the multisectoral approach

Major limitations of the multi sectoral approach:Lack of focus – engaging all sectors at all levels Limited capacity building interventions for HIV and AIDS mainstreaming

Varied levels of commitment across sectors Dependence on external funding Limited cross sectoral accountability

Within the public sector Between the public sector and CS and private sectors

From multisectoral approach to investment thinking

What is the investment thinking and what is different about it:

Focus on basic programme activities proven to result in averting maximum number of infections averted and lives saved

Identify critical enablers and synergies that improve quality, efficiency and effectiveness of basic programme activities

Promotes country ownership and shared responsibility Simplifies the country strategy to get better focus –

population groups, geographic areas, etc Systematically prioritizes interventions based on country

epidemiology and context Reduces parallel interventions that spread resources

thinly across sectors

Conventional multi sectroal approach

Investment thinking

The Investment Framework

SYNERGIES WITH DEVELOPMENT SECTORSSocial protection; Education; Legal Reform; Gender equality; Poverty reduction; Gender-based violence; Health systems (incl. treatment of STIs, blood safety); Community systems; Employer practices.

CRITICAL ENABLERS

Social enablers• Political commitment &

advocacy• Laws, policies & practices• Community mobilization• Stigma reduction• Mass media• Local responses, to

change risk environment

Programme enablers• Community-centered

design & delivery• Programme communication• Management & incentives• Production & distribution• Research & innovation

Care & treatment

Male circumcision Keeping people

alive

BASIC PROGRAMME ACTIVITIES

Keypopulations

Children &mothers

Condoms

OBJECTIVES

Stopping new infections

Behaviourchange

Enablers and synergies as key aspects of the investment thinking

Why invest on enablers and synergies

Continued investment on enablers and synergies ensures: Efficacy, equity efficiency, reach and scale up of basic

programme activities Financial and programmatic sustainability of the response

through integration into broader health and non-health sectors

Non health sectors continue to implement programs that directly reduce risk to HIV

Protection and promotion of human rights and human rights principles: participation, accountability, inclusion, non-discrimination and informed consent;

AIDS response contributes to other development and health outcomes across the MDGs

Implications of the investment thinking for national coordination

Successful application of the investment thinking requires strong multisectoral coordination in order to ensure:

Strong ownership and leadership for enablers by different institutions/sectors (e.g. parliaments, justice and interior ministries, local governments)

Continued investment on enablers and synergies in the context of increased domestic financing

Strong technical guidance on national strategies and global principles

Prioritization of relevant sectors based on specific contexts (e.g. concentrated vs generalised epidemic)