I have been incredibly busy in the two weeks following on from World AIDS Day. My DFID colleague Katie Bigmore and I and Mauricio Cysne from UNAIDS joined a team from the World Bank who were reviewing Mozambique’s World Bank MAP programme (Multi-country HIV/AIDS Programme for Africa).
The MAP programme provides grant financing rather than the Bank’s more usual IDA (International Development Association) credit funding to more than 30 countries tackling the HIV/AIDS epidemic. It has committed more than $1.6 billion to fight AIDS since its inception. Mozambique secured MAP funds in 2004, and has been using those funds to coordinate the national response to HIV/AIDS through the countries National AIDS Committee.
The National AIDS Committee has a board, which is chaired by Mozambique’s Prime Minister, Luisa Dias Diogo, and operates through a secretariat, chaired by Joanna Mangueira. The National AIDS Committee is well known throughout the country, it has established a network which supports a multisectoral response and reaches down from the central to the provincial and district levels. One of the particular challenges that it has faced is how to channel funds to civil society, and this challenge has been hampering the effective use the available funding, particularly the resources intended to work through civil society.
In Mozambique, Non Government Organisations are often seen, primarily, as service providers, but many NGOs and civil society organisations here have an equally important function of advocacy and can be an important force for strengthening accountability for an effective national response to the epidemic. The review of the MAP programme has allowed thought to be given to how the remaining funds of the MAP programme can be spent effectively before the end of the current programme in 2009, to make sure that Mozambique is eligible for a second MAP programme.
The highlight of the mission was a meeting last week with the Prime Minister of Mozambique, Luisa Dias Diogo. We shook hands, sat down and after a brief welcome from the Prime Minister, Susan Hulme from the World Bank set out some of the issues facing the MAP programme.
Prime Minister Diogo - Mozambique’s first woman Prime Minister and ranked 89th on the 2007 Forbes World’s 100 most powerful women list (in large part for her anti-poverty work) - then gave us her considered opinion. The Prime Minister was an inspiring person to meet, she has a clear grasp of the HIV/AIDS situation in Mozambique and recognises the main challenges to an effective national response.
She is justifiably proud of the national prevention strategy that Mozambique launched on World AIDS day, and also understands the importance of effectively engaging civil society in the national response. HIV prevalence in Mozambique has remained at 16% of the sexually active population in the two most recent surveys, the last being in 2007, but some provinces have seen prevalence rates rise to over 23%.
A renewed effort is needed to tackle this huge threat to the nation's further development and the national prevention strategy hopefully marks the beginning of these renewed efforts to turn around the epidemic. The Prime Minister is a champion of women’s empowerment, and recognises that any success in tackling the epidemic must come from active support and full engagement of women in the national response.
A recent review of the key drivers of the HIV epidemic in Mozambique has highlighted the problem of multiple concurrent partnerships, with many men having more than one sexual partner at a time. An important part of the future response needs to focus on reducing the number of multiple concurrent partnerships and ensuring that people are aware of the need to have safe sex and have access to and use condoms.
I believe that an effective and well coordinated national communication response will be key and that a clear vision for that communication needs to emerge over the coming months. Effective engagement and support of civil society participation, giving people a stronger voice in the national response will also be critically important.
I am convinced that under Prime Minister Diogo’s leadership, with new ways of engaging and financing civil society participation being developed, Mozambique’s MAP programme will deliver effective support over the coming year, increasing the possibility of Mozambique securing a second phase of funding and building a solid foundation for more effective engagement of civil society in future.