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PEPFAR-funded Programs

Evaluate gaps in HIV programming for refugees and propose strategies for improvement. Explore challenges faced and future prospects to align programs with PEPFAR goals.

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PEPFAR-funded Programs

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  1. PEPFAR-funded Programs Susan Purdin, RN, MPH Senior Technical Advisor, Reproductive Health Fourth Meeting of the IOM Committee for the Evaluation of PEPFAR September 15, 2005

  2. The International Rescue Committee • Provides programming from the acute emergency to the post-conflict phase for persons affected by armed conflict, including refugee resettlement in the USA • Beneficiary populations include: • Refugees • Internally Displaced Persons • Returnees • Communities hosting refugees and IDPs • Returnee communities

  3. IRC’s international programming • Social • Schools • Health • Water & sanitation • Gender-based violence • Economic • Livelihoods • Governance & Rights • Protection • Civil society development

  4. Lack of attention to HIV for refugees • 29 countries in Africa host more than 10,000 refugees • UNHCR reviewed 22 national AIDS plans, only 10 include refugees in their program activities. • In 23 states with approved GFATM proposals only 5 programs have included activities for refugees. • Only 8 of 15 approved World Bank MAP projects have refugee-specific components

  5. Forced migration in conflict

  6. HIV vulnerability in conflict

  7. IRC implements primary health care programs in 20 countries • All with some aspects of HIV programming • Prevention • Behavior change • Blood safety & universal precautions • Care & support • Prevention & treatment of opportunistic infections • Home-based care • ART

  8. IRC’s HIV activities have been funded by • CDC – Kenya – CDC/PEPFAR • CIDA • SV • DFID • EC • ECHO • Packard Foundation • USAID – Uganda – USAID/PEPFAR • USBPRM – Ethiopia, Uganda – BPRM/PEPFAR • USOFDA • UNFPA • UNHCR

  9. Ethiopia – Sherkole Refugee Camp

  10. Kenya

  11. Uganda

  12. Challenges identified • Pressure to increase targets – and it seems that all they care about are the numbers – no interest in constraints, local community participation, etc – if your numbers are on target you are OK, if not, do not expect any additional funding (Ethiopia) • Short notice from prime agency (PRM, AID) for PEPFAR reports (Kenya) – and – dual reporting to PEPFAR and prime agency (all) • Interpersonal relationships between IRC and granting agency are key – in securing funds and in negotiating implementation and reporting requirements. • Collecting data from sub-grantees on activities according to PEPFAR’ s reporting format (Uganda) • Proportional allocation of funds is pre-established per program area. For example, 66% of Prevention funding must go to AB, which means that in Uganda condoms are almost completely cut from budgets and 10% of overall funding should go to OVCs, which means that these activities will have to be expanded at the expense of other program areas such as building institutional capacity and rehabilitation of facilities (Uganda)

  13. Future prospects • BPRM representative based in Uganda is advocating for PEPFAR allocations for refugees in his countries: • Cote d’Ivoire • Kenya • Rwanda • Tanzania • Uganda

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