Third Joint Bi-Annual Review of the HIV Response in Tanzania October 2008 Assessment of Progress on Implementation of Milestones from the Second Joint Bi-Annual Review 2006 Consultant Karin Berlin Dar es Salaam, Oct 2008 HIV/AIDS BI-ANNUAL REVIEW 2008

“ Milestones ” Milestones could be activities that should be done by TACAIDS or others (variation in possibility to influence) long term expected outcomes or results short term commitment for a specific unit Additional information about who is responsible for implementation who are the partners and/or financial supporters by when has the milestone been achieved any dependencies? HIV/AIDS BI-ANNUAL REVIEW 2008

Summary of findings Private sector Optimistic targets and measurable. Not been achieved but in progress Slower process than expected Promoting bench marking and best practices Public sector Milestones achieved Slow progress in mainstreaming HIV/AIDS into MDAs Annual forum key sectors: technical level Plan for Technical Assistance Limited insight in the quarterly reporting to PMO HIV/AIDS BI-ANNUAL REVIEW 2008

Summary of findings Monitoring and Evaluation M&E system in place All three milestones achieved. Need of more training and capacity building to make the system functional District and Communities Many initiatives from TACAIDS at different levels with a variety of financial and implementing partners Almost all milestones are fulfilled HIV/AIDS BI-ANNUAL REVIEW 2008

Summary of Findings Finance Management & Funding Modalities Yes, milestones achieved except Global Fund designed to use the GBS-HIV Advocacy and Information Yes, milestones fulfilled with exception of a campaign HIV/AIDS BI-ANNUAL REVIEW 2008

Conclusions from survey of Milestones Not measurable 24 out of 31 achieved = 77% Not fulfilled in private sector (measurable) All delayed TACAIDS structure: not NMSF or AIDS policy Vague connection to MKUKUTA & PAF Low awareness Planning, planning…and then? HIV/AIDS BI-ANNUAL REVIEW 2008

Conclusions from survey of Milestones Weaker commitment at regional and district level Three Ones not implemented at all levels Lack of consistency OR harmonization and alignment? Dissemination: a problem TACAIDS horizontal structure but vertical communication? CSO umbrella, is it upside down? HIV/AIDS BI-ANNUAL REVIEW 2008

Achievements in a broader context HIV/AIDS bill GF: more health facilities providing care and treatment Integrated TB/HIV testing services established PMTCT reaching the dispensaries Improved mainstreaming at MDAs (and some externally) Regional cooperation and exchange of experiences Informal sector also part of the national response HIV/AIDS BI-ANNUAL REVIEW 2008

Achievements in a broader context Commitment from the highest political level Tanzania HIV/AIDS Indicator Survey (THIS) II carried out and showing some encouraging indications -Declining prevalence: 17 out of 21mainland regions -Tuberculosis control” continues to show strong performance Health Sector’s HIV/AIDS Strategy comprehensive strategy Interventions have been scaled up HIV/AIDS BI-ANNUAL REVIEW 2008

Recommendations ENABLING ENVIRONMENT Align with specific five operational targets in MKUKUTA NMSF coordinator at regional level Disseminate guidelines for O&OD: use local facilitators Promote Model Ward Concept Mechanism to gain insight in MDAs reporting to PMO PREVENTION Explore willingness to commit to prevention and behavioural change Choose strategic campaigns and assess impact HIV/AIDS BI-ANNUAL REVIEW 2008

Recommendations MONITORING AND EVALUATION More training, capacity building for implementers ORGANISATIONAL & INSTITUTIONAL ARRANGEMENT Analyze consultative forums with MDAs FINANCIAL, HUMAN AND TECHNICAL RESOURCES Intensify advocacy for funding through the GBS-HIV HIV/AIDS BI-ANNUAL REVIEW 2008

Recommendations FROM STRATEGY TO IMPLEMENTATION Future milestones should relate to the NMSF TACAIDS (Things are done, but delayed) Improve implementation and execution record for TACAIDS Officer “Internal Organisational & Institutional Development” Streamline and coordinate, encourage cross-learning. Plans, guidelines and policies necessary and good but create incentives for operation and implementation Create a structure and system for dissemination HIV/AIDS BI-ANNUAL REVIEW 2008

Concluding remarks Milestones set 2006: 31 Progress on Implementation: 77% are fulfilled and 3-4 more are in progress Assessment: Satisfactory and fairly good Only a snapshot of the national response HIV/AIDS BI-ANNUAL REVIEW 2008

Asanteni Sana HIV/AIDS BI-ANNUAL REVIEW 2008