ដឹកនាំការឆ្លើយតបនឹងជាំងឺឆេដស៏ឆៅប្បឆេសកម្ពុជា
Managing HIV and AIDS Response in Cambodia
National AIDS Authority, 26 December 2013
Dr Phalla Tia , Vice Chair of NAA
ចំណុចគន្លឹះននបទបង្ហាញ
1
Introduction
2
Result Based Management (RBM)
3
Update HIV and AIDS Response in Cambodia
4
5
Global, regional and country commitments for HIV and AIDS
response
Lessons learned from the HIV and AIDS Response in 2012-2013
6
Managing HIV and AIDS response in 2014-2015
7
Conclusions
Suggestions for recommendations
Introduction
What is the value added of the
National AIDS Authority ?
សារគ្នលេះឹ ៩​
9 Key messages of
Leadership Forum
បុស្នតគ្រួ ឆោយឆសាក​​
សាត យមានគានឆយើង
ម្ួយចាំននួ ានសាំោនតលង់លក់ឆៅឆលើចងកូត
But unfortunately, some
of us have fallen asleep at
the wheel
Khun Mechai Viravaidya
President of PDA
1.
ពប្ងឹងម្គ្គឆុ េេសភាពនិងការប្គ្ប់ប្គ្ង (Leadership and Management)
2.
វិនិឆោគ្ឆោយភាពវវឆ្លលត (SMART Investment ( low cost , high impact ))
3.
េិនននយ័ គ្ឺជាេាំណាច ( Data is power)
4.
រូបេនកឆនេះឆ យើ គ្ឺជាេនកដឹកនាំ ( You are the leader)
5.
6.
សូម្េុកស គ្ម្ន៏ជាសនលូ វនការឆ្លយើ តប ( Community as the center of the response)
ឈប់ឆ្វដើ ចូ ពីម្នុ ឆេៀត។​ប្តវូ ឆ្វតាើ ម្របកគ្ាំឆ ើញថ្មIី nnovations ( Not business as usual ; Move
with the innovation)
7.
8.
ជាំរុញការស្សវងរកករណីថ្បមី ឆងកនើ ចាំននួ េនកឆប្បប្ើ ាស់ឧសថ្ប្បឆ្លាំងឆម្ឆោគ្​​ឆេដស៏នងិ ឆ្វឆើ ោយគាត់បនតការពាាលជាប់ជាប្បចាំ (
Accelerating case detection, maximizing ARV using , retain ARV
users)
ឆតត តឆលើប្បជាជនចាំណុចនិងេីតាាំងយុេសា
ធ ប្សត ( Be focus on KAPs and geographic area
9.
លុបបាំាត់ការឆរើសឆេើងនិងមាក់ងាយ (E liminate S&D )
Are we on the right track?
If yes how ? Is a dashboard necessary?
Introduction
II- Management
I- Financial
III- Program
WHO ( WHAT GROUP) IS
MAKING DECISION?
Doing the right thing : Leadership
Doing thing right : Management
Key Phases of RBM
Strategic
Planning
Performance
Measurement
Performance
Management
UNICEF
• Formulating SMART results
• Setting targets
• Selecting indicators
• Monitoring performance data
• Reviewing & reporting performance
• Evaluation and Lessons
• Using performance information for
managing
Definitions
Impact
Positive and negative, primary and secondary
long-term effects produced by a
development intervention, directly or indirectly,
intended or unintended.
Outcome
The likely or achieved short-term and
medium-term effects of an intervention’s
outputs.
Output
The products and services which result from the
completion of activities within a development
intervention.
Types of Change
Impact
Changes in the lives of people
Outcome
Institutional Change: values, ethic, rules, laws –
associated with to institutional performance, access..
Behavioural change: knowledge, skills, practices
(individual level)
Output
Operational Change: provision of goods and services
Definitions
Impact:
Human Change
Outcome:
Institutional &
Behavioural Change
Outputs:
Products & Services
Skills & Abilities
Positive and negative, primary and secondary
long-term effects produced by a
HIV infections
reduced
development
intervention,
directly or indirectly,
intended or unintended.
The likely or achieved short-term and
medium-term
effects ofresponse
an intervention’s
An effective national
is delivered
outputs.
The products and services which result from the
National AIDS Commission has the capacity to operate
completion of activities within a development
effectively and guide the national response
intervention.
Results-Chain
Inputs
Activities
Outputs
Outcomes
Indicators
Assumptions/Risks
Impact
A Typology for RBM
Results
Like…
Focus
Impact
HIV incidence
reduced
Human!
Outcome
Response
brought to scale
Institutional/
Outcome
Leadership
empowered
Output
Skills of NAC
strengthened
Activity
Train 250
district AIDS
officers
Behavioural
Institutional/
Behavioural
Operational/
skills, abilities,
products &
services
@
Timeframe
5-10 yrs
5 yrs
5 yrs
<3 yrs
<1 yr
Why RBM?
It provides a coherent framework for
strategic planning and management
based on
learning and accountability.
បចចុបបននភាពវនការោលោលជាំងឺឆេដស៏ឆៅកម្ពុជា
ចាំនួនេនកផ្េុកឆម្ឆោគ្ឆេដស៏
76,000នក់
ចាំនួនប្សតីផ្េុកឆម្ឆោគ្ឆេដស៏
39,000នក់
ករណី្លងឆម្ឆោគ្ឆេដស៏ថ្មី
1,400នក់
ចាំនួនប្សតីមានវផ្េឆ េះេេួលការពាាលឆដើម្បីបងាករការចាំឡងឆម្ឆោគ្ឆេ
ដស៏ឆៅកូន
1,058នក់
េនកជាំងឺឆេដស៏ោយុឆលើស១៥ឆ្លនាំស្ដលប្តូវេេួលថ្នាំARV
54,000នក់
េនកជាំងឺឆេដស៏ោយុឆលើស១៥ឆ្លនាំស្ដលានេេួលថ្នាំARV
44,318នក់
ប្គ្ួសារស្ដលរងឆបេះ ល់ឆោយជាំងឺឆេដស៏ស្ដលេេួលឆសបៀង
ករណីសាលប់ឆោយជាំងឺឆេដស៏
0?ប្គ្ួសារ
2,700នក់
កុមារកាំប្ ឆោយឆម្ឆោគ្ឆេដស៏ 28,500
បចចុបបននភាពវនការោលោលជាំងឺឆេដស៏ឆៅកម្ពុជា
ចាំនួនេនកផ្េុកឆម្ឆោគ្ឆេដស៏
76,000នក់
ចាំនួនប្សតីផ្េុកឆម្ឆោគ្ឆេដស៏
39,000នក់
ករណី្លងឆម្ឆោគ្ឆេដស៏ថ្មី
0នក់
ចាំនួនប្សតីមានវផ្េឆ េះេេួលការពាាលឆដើម្បីបងាករការចាំឡងឆម្ឆោគ្ឆេ
ដស៏ឆៅកូន
1,104នក់
េនកជាំងឺឆេដស៏ោយុឆលើស១៥ឆ្លនាំស្ដលប្តូវេេួលថ្នាំARV
54,000នក់
េនកជាំងឺឆេដស៏ោយុឆលើស១៥ឆ្លនាំស្ដលានេេួលថ្នាំARV
44,318នក់
ប្គ្ួសារស្ដលរងឆបេះ ល់ឆោយជាំងឺឆេដស៏ស្ដលេេួលឆសបៀង
ករណីសាលប់ឆោយជាំងឺឆេដស៏
20,000ប្គ្ួសារ
0នក់
Cambodian migrants
working in Thailand
Total
registration of
Cambodian
Migrants to
Thailand :
235,521+
112,275
(2011, MOPH
Thailand )
HIV
prevalence:
2.15% ( 2010
MOPH
Thailand)
ឆសចកតីឆបតជាាចិតតថ្នក់ពិភពឆោកនិងថ្នក់តាំបន់
កនុងការឆ្លើយតបនឹងឆម្ឆោគ្ឆេដស៏/ជាំងឺឆេដស៏
Global and Regional Commitments on HIV and AIDS
វថ្ងផ្ុតកាំណត់សាំោប់
ឆសចកតីសាំឆរចឆលខ៦៦/១០របស់ប្កុម្ប្បឹកាឆសដឋកិចចជនិងសងគម្វនេងគការស
ប្បជាជាតិកនុងតាំបន់ោសុីនិងាសុី វីកវន​(ESCAP)
ឆគាលឆៅស សវតសរបស់េងគការស ប្បជាជាតិ
ឆគាលឆៅស សវតសេី៦បញ្ឈប់ការោលោលជម្ងឹឆេ
ដស៏ឆៅឆ្លនាំ២០១៥និងឆផ្តើម្ឆ្វើឆោយជាំងឹឆេដស៏ថ្យ
ចុេះ
២០០១ការប្បកាសឆសចកតីសាំឆរចចិតតរបស់េងគការ
ស ប្បជាជាតិឆលើការងារឆេដស៏: វិបតតិសកលសកម្មភាពសកល
ឆសចកតីសាំឆរចឆលខ៦៧/៩របស់(UNESCAP)
២០០៦ការប្បកាសឆសចកតីសាំឆរច
ឆគាលនឆោាយរបស់េងគការស
ប្បជាជាតិ
២០១១ឆសចកតីប្បកាសឆគាលនឆោាយវនេងគការស
ប្បជាជាតិឆលើការងារឆេដស៏:បឆងកើនកមាលាំងឆយើងឆដើម្បីលុប
បាំាត់ឆម្ឆោគ្ឆេដស៏និងជាំងឹឆេដស៏
២០១១ឆសចកតីឆគាលនឆោាយវនASEAN:ឆ្វឆើ ោយ
០ការ្លងឆម្ឆោគ្ឆេដស៏ថ្មី០ការឆរើសឆេើងនិង០សាល ប់ស្ដលប
ណាតលពីជាំងឹឆេដស៏
ឆគាលឆៅស សវតសរបស់េងគការស
ប្បជាជាតិ
ឆគាលឆៅនិងការឆបតជាាចិតតលុបបាំាត់វន
ឆសចកតីឆគាលនឆោាយវនេងគការស
ប្បជាជាតិ
សាំឆរចឆគាលឆៅបីសូនយ
០្លងថ្ម​ី ០សាល ប់​០ឆរើសឆេើង
ដល់ឆ្លនាំ២០១៥/២០២០
2011 United Nations General Assembly Political Declaration on HIV/AIDS:
Targets and elimination commitments
សាំឆរចឆគាលឆៅបីសូនយ
០្លងថ្ម​ី ០សាល ប់​០ឆរើសឆេើង
ដល់ឆ្លនាំ២០១៥/២០២០
2011 United Nations General Assembly Political Declaration on HIV/AIDS:
Targets and elimination commitments
Lessons learned from HIV and AIDS
Response in 2012-2013
Cambodian Context for HIV and AIDS Response
70
1.8
1.7 1.7
1.6
60
1.6
1.5
55 54
1.5
1.4
1.3
50
HIV
epidemic
and Funding
1.3
46
1.2
58
1.6
55
1.4
48 47
1.2
40
1
1
1
35
0.9 0.9
30
0.8
26
0.6
20
19
0.3
10
0.3 0.5
0.1 0.1
1
3
3.5
5
5
5
6
7
8
8
500 MUSD
0.8
0.7
0.6
0.4
8.5 10
0.2
0
0
1
2
3
4
Decades 1991-2000
Strategic
Plan
STP
MTP
NSP0
9
10 11 12 13 14 15 16 17 18 19 20 21
Funding in MUSD
NSPI
Decades 2010-2020
Decades 2000-2010
HIV prevalence among adult
NSPIII
NSPII
05-06
NASAI
Costing
modalities
1. Results?
1.1 1.1
Resource Need
Model(RNM)
07-08 09-10
11-12
NASAII
NASAIV
NASAIII
Long Run Cost
(LRC)
NSPIV
Cambodian Context for HIV and AIDS Response
Paris Declaration on Aid effectiveness ឆសចកតីប្បកាសេីប្កុងារើសសតីពីប្បសិេធភាពជាំនួយ
Accra Agenda for Action
Busan HL Forum on aid effectiveness
GDJ TWG/JMI
Partnership
& country
ownership
PBA
70
1.8
1.7 1.7
1.6
60
1.6
1.5
55 54
1.5
1.4
1.3
50
HIV
epidemic
and Funding
1.3
46
1.2
58
1.6
55
1.4
48 47
1.2
40
1
1
1
35
0.9 0.9
30
0.8
26
0.6
20
19
0.3
10
0.3 0.5
0.1 0.1
1
3
3.5
5
5
5
6
7
8
8
500 MUSD
0.8
0.7
0.6
0.2
0
1
2
3
4
Decades 1991-2000
STP
MTP
NSP0
9
10 11 12 13 14 15 16 17 18 19 20 21
Funding in MUSD
NSPI
Decades 2010-2020
Decades 2000-2010
HIV prevalence among adult
NSPIII
NSPII
05-06
NASAI
Costing
modalities
Results?
Effectiveness?
Efficiency?
Sustainability ?
0.4
8.5 10
0
Strategic
Plan
1.
2.
3.
4.
1.1 1.1
Resource Need
Model(RNM)
07-08 09-10
11-12
NASAII
NASAIV
NASAIII
Long Run Cost
(LRC)
NSPIV
Investment
Framework
(IF)
េភិប្កម្ប្គ្ប់ប្គ្ងេូទាំងកម្មវ្ិ ី
Program Based Approach
១កម្ម វត្ថុន ៃះភិក្កម្ក្រប់ក្រង
ទូ ទង
ាំ កម្ម វ ិធី
1Consensus ​on objectives of
PBA
៨ការសិកា ិងសាំរបសាំរ ួល
8 Learning and adaptation
២ក្កបខណ្ឌគោល គោបាយ
ទូ លាំទូលាយ
2 Comprehensive Policy
Framework
៧ការគលើកកាំពស់សម្ថ ភាពប
គចច កគទស
7 Capacity Development
component
៣គោលគៅរ ួម្ោា
3 Common Goals
៦ការឯកភាពគលើរចនាសម្ព ័
ិងការបបងបចកភារកិចជ 6
Agreed institutional
arragements and
responsibilities
Source : www.cdc-crdb.gov.kh
៤ក្កបខណ្ឌគរៀបចាំការគក្បើ
ក្បាសថវ ិកាទូ លាំទូលាយ
4 Comprehensive Resource
Framework
៥ភាពជានៃរូ ិងរចនាសម្ព ័ ធ
សាំរាប់គធវ ើការស ទ នា
5 Partnership and dialogue
structures
JMI- Joint Monitoring Indicators 2012-2013) of
GDJ TWG on HIV and AIDS
Cambodia’s 2015 HIV Prevention, Treatment and Impact Mitigation Targets are
achieved through cost effective and efficient programme-based approaches
Key Events in 2013
•
United Nations
–
–
•
•
•
•
GFATM
•
•
•
•
•
•
National Stakeholder Consultation for
the Mid-term Review of the Progress
towards the Targets of the 2011 UN
Political Declaration on HIV/AIDS​​ June
2013 ( HLM) 10 Indicators for Three
Zero
GARPR : UNGASS
NSP III ( Review ) ….NSPIV
GDJ TWG on HIV and AIDS
– ( 2012 -2013 JMI )
– Partnership Development
Strategies (GDJ TWG Retreat in
Siem Reap) 12-13 Nov 2013
– National HIV Health Sector
Program Review in Cambodia 29
April – 10 May 2013
HIV-Sensitive Social Protection for Impact
Mitigation in Asia and the Pacific
ICAAP11 ( 16-22 November 2013)
•
SSF Reprogramming August 2013
Gender Review
OIG Report / Recovery
NFM Application for 2016-2018
New Term of CCM
GFATM SSF Phase 2 ( signing in 2Jan
2014)
Incentives Scheme and Proposed
Incentives ( December 2013 )
NAA
•
•
•
•
Investment framework for effective
response to HIV and AIDS
New Structure of the National AIDS
Authority ( 27September and 18
November 2013)
Policy Board Meeting ( 28 November
2013)
7 Points policy directives ( 17 December
2013)
How these activities are initiated ? How those activities are coordinated?
Domestic vs. External Sources (millions of USD)
• Spending from external sources was reduced by 20% from 2010 to 2012
• NASA III didn’t include 2.5m$ p.a. of salaries paid by RGC
HIV/AIDS Spending by Financing Sources, (millions of
USD)
HIV/AIDS Spending by Financing Sources, (% of
total)
HIV/AIDS Spending by ASC (millions of USD) and
Number of ART Patients
Budget allocation
WHO ( WHAT GROUP) IS
MAKING DECISION?
Proposal Development Committee
( Round Based Application)
Budget allocation
Monitoring HIV and AIDS Response
CCC
LFA
CCC Oversight
PR ( SR, SSR)
GDJTWG on
HIV and AIDS
URC
Monitoring Flagship Program
យនតការប្គ្ប់ប្គ្ងម្ូលនិ្សិ កល
GF Board
GFATM Management
GF Secretariat
1.
2.
OIG
Audit
Investigation
Portfolio Manager
Guiding documents
1. Governance Manual
2. PD Manual
3. Conflict of interest
Policy
CCC
CCC Ex Com
CCC OC
GDJTWG on
HIV and AIDS
LFA
WG
AIDS
PR
WG
TB
PR
PDC
WG
Ma
WG
HSS
PR
PR
Guiding documents
1.
2.
3.
4.
5.
6.
Program Grant Agreement
HR Manual
Finance Manual
Procurement Guidelines
SR Management Guidelines
M&E Guidelines
PR Coordinating Group
SR
SR
SR
SR
SSR
SSR
SSR
SSR
GDJTWG on
Health
MOH
ការប្បៀបប ៀបមួយ
A dashboard is needed
1. Financial
2. Management
3. Program
បុគ្គលិករដឋេះ២០០០នក់
បុគ្គលិកសងគម្សុីវិលេះ៤០០០នក់
ប្បជាជនឆគាលឆៅេះ១០០០០០នក់
II- Management
I- Financial
III- Program
WHO ( WHAT GROUP) IS
MAKING DECISION?
Grant Dashboard (GFATM)
II- Management
1. Where are the drugs?
2. Are sub-recipients receiving
resources and technical
assistance as schedule?
I- Financial
Where is the money?
Recommendations
Actions
III- Program
1. Are activities implemented
as planned ?
2. Do the results match the
performance goals ?
Injecting plus sex work
Sharper
Boosted
epidemiologic COPCT
al targeting: Response
reaching
those at
highest risk
Injecting DUs
Male/TG sex workers
MSM ‘pleasure
circuit’
Non injecting DU EW
‘Massage’
KTV
Beer promoters
...
Casino workers
Current Trends in Health Financing
Health Financing Indicators
In 2008
Total Health expenditure (THE) ( US$ M)
564
General government Health expenditure ( GGHE) ( US$ M)
105
External expenditure on health ( US$ M)
111
Total health expenditure per capita
41
Total health expenditure as % of GDP
5.5
General government Health expenditure ( GGHE) as % of
THE
19
External expenditure on health as % of THE
19.7
Out of pocket expenditure on health as of % of THE
Total HIV and AIDS expenditure ( US$M)
Total HIV and AIDS expenditure as % of THE
Government HIV and AIDS expenditure as % of GGHE
Source : Health Financing report 2012, MoH , NASA IV, 2013
in 2012
763
187
117
52
5.4
24.5
15.3
61.5
51.8
9.2
60.2
50.9
6.7
5
3
Health Sector Review
• Urgent need to prepare a resource needs and mobilisation plan for
sustained funding for essential HIV and AIDS services until 2020
– Sustain donor funding at adequate levels , increase domestic funding
through diverse mechanisms as part of gradual integration of the HIV
Program in broader Health system
– In the shift towards more domestic funding, continuum of key
prevention,care and treatment program needs to be mainted
– Increase value for money to allocate resources to the most effective
programs and improve service delivery and management efficiencies
• Agreement on mechanism to increase domestic funding as a
contribution of supply ( e.g. ARVs, Condoms) and demand side (
e.g. inclusions of ART, STI services in socal health protection
schemes) financing under the new health financing policy
Next steps in the coming two years
• Expand and use evidence at central and provincial levels for priority
settings and to inform the multi-year plan, systematically evaltuate
program
– Ongoing/ complete NASA IV, budgeting for GF HIV/SSF grant phase 2 costing
,Cambodia 3.0
– To be developed effectiveness and efficiency assessment , unit costs and
resources need estimates
• Develop a multi-Year resources needs and mobliisation plan
to advocate and work with development partners, MOH,
MOEF, other non health Ministreis, and other programs
• Engage with MOH to contribute to the development and
implmentation of Cambodia Healht strategic Plan from 2016
onwards and Cambodia Health Financing Policy
Are we on a secure road “Getting to Zero ?”
AIDS Spending Category
Asia and Pacific and Cambodia
100%
90%
8%
7%
26%
32%
11%
80%
12%
70%
10%
9%
60%
50%
24%
7%
30%
28%
27%
27%
Cambodia 2011
Cambodia 2012
40%
30%
20%
43%
10%
0%
Asia and Pacific (2007)
Policy and enabling Environment
Program Management and Administration
Orphans and Vulnerable Children
Care and Treatment
Prevention
Managing HIV and AIDS Response in
2014-2015
Is there any innovative structure to replace it ?
Cambodia’s 2015 HIV Prevention, Treatment and Impact Mitigation Targets are
achieved through cost effective and efficient programme-based approaches
CAM-H-NCHADS Phase 2
2014
2015
YEAR 1
YEAR 2
Summary budget by cost category
Human Resources
Technical and Management Assistance
Training
Health Products and Health Equipment
Pharmaceutical Products (Medicines)
Procurement and Supply Management
Costs (PSM)
Infrastructure and Other Equipment
Communication Materials
Monitoring and Evaluation (M&E)
Living Support to Clients/Target
Population
Planning and Administration
Overheads
Other
TOTAL
TOTAL
%
21%
3%
6%
11%
23%
5,534,823
6,312,397
11,847,220
788,125
725,718
1,513,843
1,696,646
1,784,304
3,480,950
3,294,693
3,253,082
6,547,775
6,508,240
6,511,840
13,020,081
1,262,288
1,370,572
2,632,860
458,145
293,733
751,878
254,666
152,626
407,293
2,346,086
2,774,916
5,121,002
3,606,408
4,170,604
7,777,011
1,201,376
1,081,246
2,282,622
1,028,943
1,233,256
2,262,199
-
27,980,441
-
-
23,578,249 57,644,735
5%
1%
1%
9%
13%
4%
4%
0%
CAM- HIV- SSF Phase II
CHEC
0%
CPN+ CRS
2% 2% FI HACC
0% 1%
AHF
3%
KHANA
19%
NCHADS
58%
NAA
7%
NMHCH
3%
NPH
RHAC 0%
2%
WOMEN
2%
SHCHC
1%
Estimated Resources for 2014
100%
90%
80%
1
3
1
4
Private ( Nat/ Intl)
70%
Intl NGO
60%
50%
31
UN
40%
GFATM
30%
20%
10%
0%
Multi (-GF/Uns)
Bilateral
6
6
1
RGC
Cambodia : Keys actions on GA Resolution 65/277
Key actions
Target 1
Target 2
Target 3
Target 4
Target 5
Target 6
Target 7
Target 8
Target 10
Responsible
Coordination: NCHADS
Contributors: key NGOs, UNICEF, WHO, UNAIDS, US-CDC, MARPs.
Coordination: NCHADS
Contributors: key NGOs, UNICEF, WHO, UNAIDS, CDC, MARPs.
Coordination: NAA/MoI
Revise PCPI training and monitoring tools to ensure effective implementation and monitoring of the initiative.
Contributors: KHANA, FHI360, HACC, UNAIDS.
Review the Boosted CoPCT SOP and adapt its services to the immediate and evolving needs of MARPs, especially Coordination: NCHADS
those who face multiple risks.
Contributors: key NGOs, UNICEF, WHO, UNAIDS, US-CDC, MARPs.
Finalize and approve the NSP policy and SOP reflecting clear institutional leadership in overseeing and managing Coordination: National Mental Health Programme (Ministry of Health)/NACD
the NSP and related programmes.
Contributors: NACD, WHO, UNAIDS, HAARP, KHANA, Mith Samlanh, Korsang, FHI360.
Coordination: National Mental Health Programme (Ministry of Health)
Accelerate transition of the NSP licensing authority from NACD to the Ministry of Health.
Contributors: NACD, WHO, UNAIDS, HAARP, KHANA, Mith Samlanh, Korsang, FHI360.
Coordination: NCHADS
Implement CPITC initiatives among PWUD and PWID.
Contributors: WHO, UNAIDS, KHANA, Mith Samlanh, Korsang, FHI360.
Advocate for better cross border coordination between Thailand and Cambodia on the issue of CoPTC for Migrant Coordination: NCHADS /NAA
Workers
Contributors : ASEAN ATFOA, JUNIMA/ UNDP
Operationalize the recommendations of the recent Health Sector HIV Programme Review and conduct necessary Coordination: NMCHC
and consistent follow-up.
Contributors: NCHADS, key implementing NGOs, WHO/JUTH, CDC, CHAI
Coordination: NMCHC
Conduct implementation research for new services and approaches to test for efficiency and effectiveness,
prioritizing the most important target groups.
Contributors: NCHADS, key implementing NGOs, UNICEF
Integrate PMTCT into national health system and funding mechanisms to ensure the sustainability of PMTCT (see Coordination: MOH
Target 10).
Contributors: NCHADS, NMCHC, key implementing NGOs, UNICEF/JUTH
Operationalize the recommendations of the recent Health Sector HIV Programme Review and conduct necessary Coordination: NMCHC
and consistent follow-up.
Contributors: NCHADS, key implementing NGOs, WHO/JUTH, CDC, CHAI
Coordination: NMCHC
Conduct implementation research for new services and approaches to test for efficiency and effectiveness,
prioritizing the most important target groups.
Contributors: NCHADS, key implementing NGOs, UNICEF
Integrate PMTCT into national health system and funding mechanisms to ensure the sustainability of PMTCT (see Coordination: MOH
Target 10).
Contributors: NCHADS, NMCHC, key implementing NGOs, UNICEF/JUTH
Operationalize the recommendations of the recent Health Sector HIV Programme Review and conduct necessary Coordination: NCHADS
and consistent follow-up.
Contributors: CENAT, NMCHC, key implementing NGOs, WHO/JUTH, US-CDC, CHAI.
Coordination: NCHADS
Conduct implementation research for new services and approaches to test for efficiency and effectiveness,
prioritizing the most important target groups.
Contributors: NCHADS, key implementing NGOs, UNICEF
Integrate care and treatment into national health system and funding mechanisms to ensure the sustainability of Coordination: MOH
these services (see Target 10).
Contributors: NCHADS, key implementing NGOs, WHO/JUTH, CHAI
Coordination: NAA
Identification and costing of key program interventions of NSP III/IV by using the Investment Framework
Contributors: key ministries, implementing NGOs, UNs and Development Partners
Coordination: NAA
Develop a five year resource mobilisation plan to guide funding applications with the RGC as well as external
donors.
Contributors: key ministries, implementing NGOs, UNs and Development Partners
Coordination: NAA, as part of the NSP III mid-term review (MRT)
Assessment of current HIV funding governance mechanisms and recommendations for gradual
harmonisation/integration within national systems
Contributors: NCHADS, relevant departments in MoH, MoP, MEF and other ministries, UNAIDS, WHO, US-CDC, GiZ
Coordinator: NAA
Use the governance and accountability structure to mobilize resource from funding agencies including GFATM
Contributors: NCHADS (Costed health sector response to HIV/AIDS, key implementing NGOs, UN and other
development partners
Comprehensive HIV-related gender (including GBV) review of national response to HIV
Coordination: NAA in collaboration with MOWA, UN agencies and CSOs
Develop clear strategy and indicators on GBV and HIV
Coordination: NAA in collaboration with MoWA, UN agencies and CSOs
Development of an evidence informed Action Plan on GBV and HIV (consistent with NSP III mid-term review
Lead: MoWA in collaboration with NAA, NCHADS, with inputs from development partners and CSOs
(MRT)recommendations and NAPVAW)
Coordination: NAA
National review of Law and Policy barrier for the AIDS response (as per Cambodia’s commitment to the ESCAP)
Contribution: key ministries, civil society, UNAIDS/UNDP
Coordination for Law enforcement bodies: NAA in collaboration with MOI and relevant development partners and
communities
Legal literacy among Law enforcement bodies and the PLHIV and MARPs communities
Coordination for communities: CPN+ in collaboration with networks of MARPs with support from NGOs working
on Legal and human rights, government and relevant development partners and UN agencies
Coordination: NAA and MOI
Implementation of action on PCPI with a clear monitoring system established
Contribution: UNAIDS/ relevant development partners and NGOs
Conduct MTR of NSP III (including the issues on governance and accountability framework for country response to Coordination: NAA
HIV and AIDS).
Contributors: UNs/Development partners, CRDB/CDC, MARPs Network, CSOs and key ministries
Review and update when needed recommendations of the ‘Review of SP for Incorporating HIV Sensitivity’ report Coordination: NAA
and identify key actions to implement them
Contributors: CARD, key ministries, implementing NGOs, UNDP/JUTH
Coordination: NAA, possibly as part of the NSP III mid-term review
Address remaining information gaps on HIV specific SP services e.g. service coverage and gaps, unit and total costs
Contributors: CARD, key non-health ministries, implementing NGOs, UNAIDS/JUTH
Raise the understanding and share experience on the Boosted CoPCT SOP for MARPs at the national and subnational levels.
Conduct mapping exercise to identify and locate MARPs at higher risk and services delivery points for a better
planning and delivery of services.
Coordination: NAA
Ensure planning and resource mobilization for continued essential SP services for HIV affected households while
pursuing opportunities for gradual integration of management and service delivery mechanisms
Contributors: CARD, key non-health ministries, implementing NGOs, UNAIDS/JUTH
Timeline
Q4 2013
Q3 2013
Q3 2013
Q3 2014
Ongoing process
Q3 2013
Q3 2013
Q1 2014
Starting Q3 2013
Starting Q3 2013
On-going process
Starting Q3 2013
Starting Q3 2013
On-going process
Starting Q3 2013
Starting Q3 2013
On-going process
Q3-4 2013
Q1 2014
Q3-4 2013
Starting Q1 2014
Q3-4 2013
Q2 2014
Q1 2014
Q3-4 2013
Q4 2013
Q3-4 2013
Q2-Q3 2013
Q2 2013
Q3-4 2014
Q3-4 2013 for HIV/SSF
grant
Annual RGC budgeting
periods
2015 for new GF grant
GDJTWG on
HIV and AIDS
What is the line
of accountability?
GDJTWG on
Health
100%
GFATM
90%
1
3
1
4
Technical
Advisory Board
80%
Private (
Nat/ Intl)
70%
Intl NGO
60%
50%
31
Multi (GF/Uns)
UN
GFATM
40%
FLAGSHIP
Bilateral
30%
RGC
20%
6
10%
6
United Nations
0%
1
GDJTWG on
HIV and AIDS
100%
90%
1
3
1
4
80%
70%
Intl
NGO
60%
50%
31
Multi
(GF/Un
s)
40%
30%
20%
10%
Privat
e(
Nat/
Intl)
6
6
0%
1
UN
Continuum of
Prevention ,
Care
treatment
and support
Impact
Mitigation
Enabling
Environment
and HR
Leadership
and
Development
synergies
GDJTWG on HIV and AIDS
Continuum of
Prevention ,
Care
treatment
and support
Impact
Mitigation
Enabling
Environment
and HR
Leadership
and
Development
synergies
Conclusions and
Recommendations
Strengthening coordinating structure
100%
90%
1
3
1
4
80%
Private (
Nat/
Intl)
Intl NGO
70%
60%
50%
31
UN
40%
30%
20%
Multi (GF/Uns)
GFATM
6
10%
6
Bilateral
សាំឆរចឆគាលឆៅបីសូនយ
០្លងថ្មី​០សាល ប់​០ឆរើសឆេើង
GDJTWG on
HIV and AIDS
Continuum of
Prevention , Care
treatment and
support
Impact Mitigation
Enabling
Environment and
HR
Leadership and
Development
synergies
0%
1
I- Financial
II- Management
III- Program
យនតការប្គ្ប់ប្គ្ងម្ូលនិ្សិ កល
GF Board
GFATM Management
GF Secretariat
1.
2.
OIG
Audit
Investigation
Portfolio Manager
Guiding documents
1. Governance Manual
2. PD Manual
3. Conflict of interest
Policy
CCC
CCC Ex Com
CCC OC
GDJTWG on
HIV and AIDS
LFA
WG
AIDS
WG
TB
PR
PR
PDC
WG
Ma
WG
HSS
PR
PR
Guiding documents
1.
2.
3.
4.
5.
6.
Program Grant Agreement
HR Manual
Finance Manual
Procurement Guidelines
SR Management Guidelines
M&E Guidelines
PR Coordinating Group
SR
SR
SR
SR
SSR
SSR
SSR
SSR
GDJTWG on
Health
MOH
7 Point Policy Directives
• 1. The National AIDS Authority should continue coordination with relevant
ministries and institutions as well as with development partners and civil
society organizations to promote and encourage the 100% use of condom
for the sake of safe sex, a mean of preventing the transmission of sexual
disease and HIV virus.
•
• 2. Incorporate the fight against AIDS and mother health-care as additional
points in the Village-Commune Safety policy of the Ministry of Interior.
•
• 3. The National AIDS Authority, the Ministry of Health, along with relevant
ministries and institutions, the development partners, and the civil society
organizations should coordinate in mapping out localities identifying the
number of PLHIV and MARPs --including entertainment workers, men
having sex with men, orphans and vulnerable children, and PLHIV who
migrate-as well as the number and locations of establishments providing
continuum of prevention and HIV and AIDS treatment and related
services.
7 Point Policy Directives
•
•
•
•
•
•
4. The National AIDS Authority should take measures to reactivate AIDS-fighting Committees
at capital, provincial, districts, communes, and sangkats. The Ministry of Health should advice
Provincial Health Department to closely coordinate with Provincial AIDS Committee/
Secretariat for HIV and AIDS response. Every Provincial AIDS Committee/ Secretariat should
strengthen partnership with civil society organizations operating in respective province to
enhance effectiveness of the response.
5. The National AIDS Authority, the National Authority for Combating Drugs, the Ministry of
Interior, the Ministry of Health, and relevant ministries and institutions should coordinate for
creating an enabling environment for MARPs, including entertainment service girls, men
having sex with men, and injecting drug users, to have access to comprehensive HIV and AIDS
treatment services.
6. The National AIDS Authority should coordinate with the Ministry of Education, Youths, and
Sports, youth organizations, and relevant institutions to broaden education for male and
female young people to equip them with an accurate understanding of the danger of HIV and
AIDS and to inform them on comprehensive preventive options.
7 Point Policy Directives
• 7. The National AIDS Authority has leading roles in coordinating and
monitoring the implementation of the work on HIV/AIDS as
mentioned in the National Strategic Development Plan 2014-2018
in conformity with the guidance provided by the Royal Government
of Cambodia through the Cambodia Rehabilitation and
Development Committee of the Cambodia Development Council.
The National AIDS Authority has leading roles on aid effectiveness
and bears the responsibility for a nationwide HIV and AIDS
response. Relevant ministries, Phnom Penh and Provincial AIDS
Committees should coordinate to develop respective HIV and AIDS
action plan for optimizing the use of funding received from all
sources in order to achieve tangible, effective, and efficient results
and move forward in ensuring sustainability of the response.
Mobilizing resources for 2016-2018
1. Use existing guiding principles , SOP and
guidelines/directives , commitments (
PBA, RBF, ..)
2. NSPIV Development
3. Application of NFM
NSPIII Review
NSPIV
Submission for
GFATM by using NFM
2016-2018
Investment Framework in Cambodia
ប្ាសាេភិមានោកាស
1
2
3
4
ប្គ្ប់ប្គ្ងឆដើម្បីលេធផ្ល
(Managing for results)
ភាពឆ្វើជាមាចស់
Ownership ( Partner countries )
វដគ្ូឆរៀបចាំ រឆបៀបវារ:ការងារ
(Partners set
agenda)
តាំរឹម្រឆបៀបវារ:
ការងាររួម្គាន
ជាម្ួយ
វដគ្ូ
Alignment ( Donors-Partners) (Aligning with partners’
agenda)
ភាពតាំរឹម្
សុខុដុម្នីយកម្ម
Harmonization
( Donors-Donors)
Phimeanakas
ឆរៀបចាំឆោយមាន
ការឯកភាពរួម្គាន
( Establishing common
arrangements)
ឆប្បើប្ាស់ប្បព័នធរបស់វដគ្ូ( Using
partners’ system
សាំរួលបេោឋ នឆោយងាយ
( Simplifying
procedures)
ស្ចកចយព័ត៌មាន
( Sharing
information
Robust country dialogue is the
foundation​(NFM)
HIV, TB and malaria
programs incl.
health staff and
Health system
planners
People living with
HIV, TB patients,
people who have
had malaria
Country Dialogue with
diverse group of
stakeholders to identify
priorities to put in the
Concept Note
Women's
organizations
Domestic
human rights
experts
Men who have sex
with men (MSM) and
transgender people
Migrants, refugees,
internally displaced
people, ethnic
minorities, forest
fringe workers
People who
inject drugs
Key Affected
Populations:
national
networks
Sex
workers
Youth
GDJTWG on HIV and AIDS
function regularly
100%
Continuum of
Prevention ,
Care
treatment
and support
90%
1
3
1
4
80%
Intl NGO
70%
60%
Impact
Mitigation
50%
31
Enabling
Environment
and HR
30%
20%
GFATM
6
10%
6
0%
Sub-TWG on HIV and AIDS
function regularly
Multi (GF/Uns)
UN
40%
Leadership
and
Development
synergies
Private (
Nat/
Intl)
1
Bilateral
Key Events in 2014-2015
•
United Nations
–
–
•
•
•
GFATM
•
•
•
•
•
•
National Stakeholder Consultation for
Continuum
of of the Progress
the
Mid-term Review
towards
the Targets
Prevention
, of the 2011 UN
Political Declaration on HIV/AIDS​​ June
Care
2013 ( HLM) 10 Indicators for Three
treatment
Zero
and support
GARPR
: UNGASS
NSP III ( Review ) ….NSPIV
GDJ TWG on HIV and AIDS
– ( 2012 -2013 JMI )
– Partnership Development
Strategies (GDJ TWG Retreat in
Enabling
Siem
Reap) 12-13 Nov 2013
Environment
– National
HIV Health Sector
and HRReview in Cambodia 29
Program
April – 10 May 2013
HIV-Sensitive Social Protection for Impact
Mitigation in Asia and the Pacific
•
SSF Reprogramming August 2013
ImpactReview
Gender
OIG
Report / Recovery
Mitigation
NFM Application for 2016-2018
New Term of CCM
GFATM SSF Phase 2 ( signing in 2Jan
2014)
Incentives Scheme and Proposed
Incentives ( December 2013 )
NAA
•
•
•
•
Investment framework for effective
response
to HIV and AIDS
Leadership
New Structure of the National AIDS
and
Authority ( 27September and 18
Development
November
2013)
synergies
Policy
Board Meeting ( 28 November
2013)
7 Points policy directives ( 17 December
2013)
NCHADS