© 2005, care usa. all rights reserved. care’s experience with the president’s emergency plan...

© 2005, CARE USA. All rights reserved.

CARE’s experience with the President’s

Emergency Plan For AIDS Relief (PEPFAR)

Madhu DeshmukhDirector, HIV/AIDS Unit

CARE


CARE’s experiences with PEPFAR

Issues raised are a result of multiple conversations with CARE Country offices as they roll out PEPFAR funded activities

Issues are raised from practical experiences and need to be further explored and validated


CARE’s HIV/AIDS Capacity and Experience

CARE implements more than 120 HIV/AIDS projects in 39 countries around the world

CARE’s HIV/AIDS objectives: reduce the number of new infections

mitigate the impact of HIV/AIDS on economic development

increase access to high-quality care and support for affected families

CARE programs are comprehensive and multisectoral, working with at-risk groups


CARE’s HIV/AIDS Experience, cont’d

CARE works with governments as well as civil society including CBOs and FBOs

CARE’s HIV/AIDS responses include Hope for African Children Initiative (HACI), the CORE Initiative and the CARE-CDC Health Initiative (CCHI) in addition to the projects at the country level

CARE’s HIV/AIDS programs receive funding from a wide variety of sources


CARE’s Involvement With PEPFAR

CARE is currently implementing PEPFAR-funded programs totaling an investment of approximately $40 million

CARE has completed PEPFAR-funded programs totaling an investment of $8.6 million

CARE has a number of PEPFAR-funded programs that are about to begin and has submitted proposals for PEPFAR-funded projects in Africa, Asia and the Caribbean


Involvement With PEPFAR, cont’d

CARE’s PEPFAR-funded programs work with a variety of affected groups including OVC

These programs promote positive changes in individuals, organizations and society


Achievements Under PEPFAR

PEPFAR is an unprecedented investment and commitment by the US government.

PEPFAR has: a sense of urgency

made HIV/AIDS a less taboo subject

enabled successful efforts to be scaled up

enhanced coordination

sharpened the focus on treatment


CARE’s Achievements Under PEPFAR

Scaling up successful models

The Nkundabana Approach in Rwanda

Community-based care for child-headed households

Mobilizing and training of mentors

Children’s participation is key



Building local capacity

The CORE Initiative – Uganda

Improving government capacity (i.e. Ministry of Gender, Labor and Social Development)

Improving local organizations’ capacity



Integrating a multi-sectoral perspective into HIV/AIDS efforts Local Links (Kenya and South Africa)

Enhanced income for families

Strengthen the capacity of local organizations

Reduce stigma and discrimination

Kenya: work in 13 villages, with 13 civil society organizations, and train 415 caregivers


Challenges Under PEPFAR

The “emergency mindset” sometimes sacrifices sustainability.

Example of Rwanda: Building sustainable community capacity and responses takes time and resources.

The short RFA process is not conducive to forging strong partnerships and assembling a high-quality team.


Challenges Under PEPFAR, cont’d

Pressure to “show big numbers rapidly” creates incentives for pursuing quantity over quality.

Example of building local capacity: Capacity cannot be equated with the dollar amount of sub-grants made to local organizations

Strengthening existing capacities of local organizations takes time, commitment, resources and technical review process


Struggles Under PEPFAR, cont’d

Funds tend to be focused too narrowly

The focus on treatment is welcome and needed, but it sometimes comes at the expense of prevention, care and support.

An apparent focus on A and B over C

Programs that target non-OVC groups are not as comprehensive.


Recommendations

Questions for IOM exploration:

What kind of programs and approaches has PEPFAR funded thus far? Do they reach the most vulnerable groups? How sustainable are these efforts?

Do short funding cycles and the pressure to show quick results affect the quality and sustainability of its investments?

Is PEPFAR measuring impact as well as output? How are implementing agencies managing reporting requirements?


Information sources for IOM: PEPFAR implementers – HQ and field staff Local NGOs and CBOs – staff at all levels Groups of people living with HIV/AIDS

(PLWHA) Community and religious leaders

© 2005, care usa. all rights reserved. care’s experience with the president’s emergency plan...

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