POST REVIEW OF GLOBAL FUND TO FIGHT AIDS,

UNCLAS MINSK 000720 SIPDIS INFO AMEMABASSY KIEV SIPDIS DEPT FOR S/GAC: JKOLKER, NALRTUZ USAID/WASHINGTON FOR E&E/EA K.MONAGHAN, GH/ M.MILLER HHS FOR WSTEIGER USAID/KIEV FOR OHST N.GODFREY E.O. 12958: N/A TAGS: EAID KHIV SOCI TBIO BO SUBJECT: POST REVIEW OF GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA PHASE TWO GRANT RENEWAL REF: STATE 098733 ¶1. On June 27, 2006 USAID Country Representative, USAID Activity Manager and an Embassy Poloff met with UNDP HIV/AIDS Program Manager, the UNDP Resident Representative and the Belarus Global Fund Project Manager to discuss the results of Phase I of the project (which ends November 30, 2006) and possibilities for Phase II. The Phase II, three year, request for Belarus is $10.3 million. The current program is divided into several components with different risk groups and quarterly checks progress against 28 indicators. Currently 73 organizations are part of the network of partner NGOs. In the past two quarters, the Belarus Global Fund has received a rating of 4 (5 being the best). Implementers include a number of large NGOs but the largest are, Positive Movement, "Vstrecha" and UNESCO Clubs. See Para 2 below for summary of progress: 2.Grant Performance Assessment: -- Prevention of HIV-infection among Injecting Drug Users (IDUs): 55 anonymous counseling points (ACPs) have been set up to date with a total of 65 projected by the end of the grant. The main achievement is setting up a network of 73 partner organizations with the Minsk and Gomel regions having the most counseling points. By year 5 of this activity, it is expected that 60% of all IDUs will be reached (note that this is not 60% of the registered users). The current number of IDUs reached is 12,000 compared with 10,000 who are actually registered. There are 150 outreach workers and 155 specialists who have been trained in medical, psychological and social aspects of counseling for IDUs. The procurement of methadone, which was the stumbling block of the project, was given a green light by the government in late June and 51 patients are about to start receiving methadone therapy. -- Prevention of HIV infection and sexually transmitted diseases (STD) among men having sex with men (MSM): This component has made significant progress among the MSM community and is wholly run by NGOs. Free-of-charge sexually transmitted infection (STI) testing and treatment is organized in 6 cities in Belarus. A system for conducting field work among MSM in all oblast cities has been set up including Svetlogorsk (the town with the worst HIV/AIDS infection rate in the country). This component has managed to win over some governmental officials who now acknowledge its significance. -- Creating an environment that facilitates effective HIV prevention activities in the penitentiary system of Belarus: This is ONE of the best run components due to the good working relationship with prison administration and centralized decision making and implementation. Prevention activities are being implemented in 93 percent of all prisons in Belarus. Approximately, 16, 200 prisoners are reached by prevention activities through distribution of thematic materials and condoms, and by providing training. At present, about 1200 prisoners have HIV/AIDS. -- Providing access to treatment, care and support for people living with HIV/AIDS (PLHA): This component has been the most difficult to implement due to the skeptical attitude of the government officials. In spite of this, by the end of the project about 600 patients will have received antiretroviral (ARV) treatment. Eight self-support groups have been established. Average cost of ARV treatment per person is $1,000 per year. -- Setting up continuous information and educational work on HIV/AIDS prevention: This component is progressing as planned. 10,946 copies of brochures, booklets and leaflets were distributed in Quarter 5 of the project. Thematic posters are posted on 50 billboards in the larger cities of Belarus. A manual for teachers and youth trainers on HIV/AIDS prevention work among youth was developed and is now under review prior to printing. It is expected that, once approved, this manual will be distributed to 10,000 schools. The Ministries of Education, Sport and Culture participate in this component. A Resource Center has been opened and the website www.aids.by was created. -- Monitoring and Evaluation: provides for analysis of the cumulative progress of the project. The monitoring plan for 2006 was developed jointly with the HIV/AIDS Prevention Department of the Republican Center for Hygiene, and approved by the Ministry of Health. A survey titled, "Setting up HIV/AIDS Prevention Work among College and University Students" is being conducted. To date, 222 educational institutions have been surveyed. This survey will be concluded prior to the end of the grant. In addition, a manual titled, "Monitoring and Evaluation in HIV/AIDS" has been approved and will be printed and distributed by October. Finally, KMPG has given this financial management a rating of 4 out of 5 in both of the past two quarters. --Financial Status: Post is aware that initial spending was slow, mostly due to the government of Belarus bureaucracy. However, given the overall success of the activities we are not concerned about the rate of spending or the rate of implementation. ¶3. Recommendation on U.S. Vote: While the UNDP needs to staff up some, it is still doing an excellent job in coordination and management of the Global Fund project. Post recommends Phase II funding be approved. ¶4. Comment: The positive results of this activity are due to the experienced UNDP team, which overcame a difficult initial environment, addressed issues despite heavy understaffing, resolved the logistical problems concerning the procurement of drugs, equipment and other supplies and, most important, managed to reverse the initially skeptical attitude of the local officials. Based on the Grant Performance Report and the results of the meetings with the UNDP representatives the project has all chances to be implemented successfully and should receive further support. KROL