1. Relationship between the World Bank, National Governments & service providers within an HIV/AIDS perspective Dr Ali Razaque Project Director Enhanced HIV/AIDS Control Programme Department of Health Government of Punjab, Pakistan

2. Enhanced HIV/AIDS Control Programmes Government of Pakistan cognizant of the growing challenge of HIV and AIDS Government of Pakistan cognizant of the growing challenge of HIV and AIDS GoP acted proactively to avail the window of opportunity GoP acted proactively to avail the window of opportunity Early 2001 National HIV/AIDS Strategic Framework developed Early 2001 National HIV/AIDS Strategic Framework developed This framework guided activities of HIV/AIDS stakeholders in Pakistan This framework guided activities of HIV/AIDS stakeholders in Pakistan

3. Enhanced HIV/AIDS Control Programmes contd. The government has negotiated with the World Bank for the implementation of “Enhanced HIV/AIDS Program” which includes: The government has negotiated with the World Bank for the implementation of “Enhanced HIV/AIDS Program” which includes: Grant of US$ 9.28 millionGrant of US$ 9.28 million Loan/Credit of US$ 27.83 millionLoan/Credit of US$ 27.83 million Other key donors include Other key donors include DFIDDFID CIDACIDA

4. Enhanced HIV/AIDS Control Programmes contd. GoP has obligated 10-15% counterpart financing GoP has obligated 10-15% counterpart financing The partnership is from 2003-08 The partnership is from 2003-08 Health a provincial subject Health a provincial subject Ensuing interventions owned at both national and provincial levels Ensuing interventions owned at both national and provincial levels Both World Bank and GoP needed to fast track procedures Both World Bank and GoP needed to fast track procedures

5. Components of Enhanced Programme Four main components 1. Expansion of Interventions Among Vulnerable Population 2. Improved HIV Prevention by the General Population 3. Prevention of HIV/STI Transmission through Blood Transfusion 4. Capacity Building and Program Management

6. Expansion of Interventions Among Vulnerable Population Through contracting NGOs to provide comprehensive service delivery packages including Through contracting NGOs to provide comprehensive service delivery packages including Behavior change communicationBehavior change communication Promotion of effective condom usePromotion of effective condom use VCT & HIV testingVCT & HIV testing STI managementSTI management Needle exchange and promotion of safe injection practicesNeedle exchange and promotion of safe injection practices Empowering vulnerable groupsEmpowering vulnerable groups

7. Improved HIV Prevention by the General Population Raising awareness and BCC aimed at general adult population Raising awareness and BCC aimed at general adult population Advocacy activities to raise awareness of decision makers and opinion leaders Advocacy activities to raise awareness of decision makers and opinion leaders Activities targeted for Activities targeted for YouthYouth Uniformed personnelUniformed personnel Formal sector workersFormal sector workers Improved STI management in public sectorImproved STI management in public sector

8. Prevention of HIV/STI Transmission through Blood Transfusion Through capacity building of provincial blood transfusion authorities Through capacity building of provincial blood transfusion authorities Implementation of quality assurance Implementation of quality assurance Expanded blood screening including Hep B and C Expanded blood screening including Hep B and C

9. Capacity Building and Programme Management Strengthening of Strengthening of NACP and PACPsNACP and PACPs NGOs capacity buildingNGOs capacity building Second generation HIV surveillance and evaluation Second generation HIV surveillance and evaluation Care for people living with HIV/AIDS Care for people living with HIV/AIDS

10. Conclusion In all provinces including AJK, NA and FATA service delivery packages are in the process of implementation In all provinces including AJK, NA and FATA service delivery packages are in the process of implementation Punjab province has been the first to engage with Civil Society to move HR agenda forward Punjab province has been the first to engage with Civil Society to move HR agenda forward Punjab experience can guide the Enhanced Programme for further HIV/AIDS prevention services with IDUs Punjab experience can guide the Enhanced Programme for further HIV/AIDS prevention services with IDUs It can also be a model for SAARC It can also be a model for SAARC

11. THANK YOU