THE MULTISECTORAL APPROACH,
INVESTMENT THINKING AND NATIONAL
AIDS RESPONSE COORDINATION
MESFIN GETAHUN & BENJAMIN OFOSU-KORANTENG
NOVEMBER 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 levels
 Gender sensitive and human rights based approaches
 Establishment of partnerships across sectors
 Participatory approach and community mobilisation
 Institutional capacity development
 Resource mobilization
 The 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
CRITICAL
ENABLERS
Social enablers
• Political commitment &
advocacy
• Laws, policies & practices
• Community mobilization
• Stigma reduction
• Mass media
• Local responses, to
change risk environment
BASIC PROGRAMME ACTIVITIES
Key
populations
Behaviour
change
Children &
mothers
OBJECTIVES
Stopping new
infections
Condoms
Programme enablers
• Community-centered
design & delivery
• Programme communication
• Management & incentives
• Production & distribution
• Research & innovation
Care &
treatment
Male
circumcision
SYNERGIES WITH DEVELOPMENT SECTORS
Social protection; Education; Legal Reform; Gender equality; Poverty reduction; Gender-based violence;
Health systems (incl. treatment of STIs, blood safety); Community systems; Employer practices.
Keeping people
alive
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, nondiscrimination 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)