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# **Comments on Questions posed for the Town Hall Meeting on the President's Emergency Plan for AIDS Relief, December 18, 2003**

Submitted by: Pact Inc.'s Community REACH HIV/AIDS Grants Program,
Georgia Beans, Grants Manager, <gbeans@pacthq.org> Telephone: (202)
466-5666

# Submitted to: Acting Executive Director of PACHA, Josephine Bias Robinson

# **What lessons can you provide/share regarding planning, implementation, and out-come measurement strategies that have worked best; what did not work and why?**

Clear goals, objectives, and targets are critical in planning a program
so that organization that apply to implement that program are clear from
the beginning what a donor is trying to achieve and how they will be
required to demonstrate/measure program success. It is very difficult to
adapt an on-going program to revised reporting requirements.

Overly onerous, prescriptive, or complex reporting requirements are not
readily understood and are not always easily adapted to innovative
programs. It is not enough to provide organizations with indicators, an
understanding of the impact desired can be measured in a number of ways.
Better to provide the outcomes and let organizations develop appropriate
indicators commensurate with their programs that are easily understood,
captured, and reported.

# 

# **What are the vital aspects of effective partnerships and with whom?**

**With whom?**

Community REACH strives to partner with community based local
organizations (CBOs) on the frontlines of the AIDS epidemic. Local
organizations are sensitized to the needs of the community and
understand the cultural, environmental, political, and social norms that
will ensure program success. Pact believes in peer partnerships between
the international community and individuals, organizations and networks
acting locally to address the pressing human needs created by HIV/AIDS.

Pact's program encourages funding partnerships between international
NGOs and CBOs with the international organization acting in a mentoring
role for provision of direct technical assistance to strengthen local
managerial capacity of local organizations to receive and manage
international funds. Pact also provides technical assistance directly to
organizations to ensure strong accountability and an ability to
demonstrate positive program results.

**What are the vital aspects of effective partnerships?**

-   Trust in local partner organizations to effectively plan
    interventions and target beneficiaries in their own local
    communities is key.

-   The ability and willingness of an international NGO or government
    agency to partner with local NGO organizations as colleagues and
    peers providing advice and assistance in managing US government
    grant funding rather than simply "managing" the local NGO is key to
    an effective partnership.

-   Pact's successful strategy is to work with grantees and local
    partners through peer partnerships. We work as one team in
    implementing the HIV/AIDS programs.

How have you been able to effectively involve people living with
HIV/AIDS in your work?

The Pact Community REACH team has PLWAs on its program advisory
committee providing input to our strategy and annual work plans. We also
solicit the input of PLWAs as technical reviewers of grant applications
received for funding.

Pact additionally requires Greater Involvement of People Living with
AIDS (GIPA) principles to be applied in grant applications for as part
of its evaluation criteria for selecting successful applicants.

The most recent Community REACH grants awarded in April 2003 are using
innovative approaches to reduce stigma and discrimination [while
actively incorporating and advocating the principles of Greater
Involvement of People Living with HIV/AIDS (GIPA). An overview of that
program is attached.]{.underline}

**GOAL \-- Uganda**: The project is addressing stigma and discrimination
at individual, community and institutional levels in the Bugiri
District, integrating information-based approaches, coping skills
acquisition, advocacy and policy dialogue in order to maximize impact.
This integrated strategy will enable PLWHA to develop their coping
abilities and play a leading role in addressing the causes of stigma and
discrimination, creating an enabling environment in which PLWHA can
advocate for greater respect for their rights and achieve a reduction in
institutionalized stigma and discrimination. Local Partners: Bugiri
Network of AIDS Service Organizations (BUNASO), National Community of
Women Living with HIV/AIDS (NACWOLA)

**Journalists Against AIDS (JAAIDS) \--Nigeria:** JAAIDS is working to
equip gatekeepers in the media with accurate, up-to-date information in
order to ensure reliable reporting on issues, challenges and solutions
around HIV/AIDS stigma and discrimination. The project will provide
platforms for informed public discussion and debate on stigma and
discrimination and build capacity among leaders of the Nigerian media in
Lagos, Abuja, Ekiti, Enugu and Kano so that they will, on their own,
become advocates for change---in terms of communicating behavior change
to reduce stigma and mobilizing policy change.

**Kimara Peer Educators and Health Promoters Trust Fund \--Tanzania:**
This project will ensure that all Kimara staff, volunteers, and an
initial core of ten-cell leaders have the skills necessary to recognize,
challenge, and carry out a program to reduce stigma and discrimination
in Kinondoni District. It will further empower PLWHA and their families
to overcome internal (felt) stigma, challenge stigma and discrimination,
and be actively involved in reducing stigma and discrimination in their
community.

**Medical Care Development International (MCDI) -- South Africa:** This
two-year project is building NAPWA's capacity to utilize multiple
approaches for community mobilization and to improve legal protection
for PLWHA in Ndwedwe District. The project is based on the principles of
a rights-based approach (*e.g.,* universality, gender equality,
accountability of duty-holders, participation) and principles of GIPA to
effectively address internal and external stigma and discrimination.
Local Partner: National Association of People Living with HIV/AIDS
(NAPWA) -- South Africa

**Mildmay\--Kenya:** This program addresses the need to sensitize the
wider community and address the need for regular psychosocial activities
to support those infected and affected by HIV/AIDS. Mildmay will utilize
existing relationships with selected health professionals in eight
districts in Nyanza province to scale up 16 community-based initiatives
in partnership with the Kenya Ministry of Health. Local Partners: 16
Community-Based Organizations (CBOs)

**Kara - Zambia:** The purpose of the Kara Counseling and Training Trust
program is to raise awareness and create the safe spaces needed to allow
communities to begin the process of creating a social movement to reduce
the impact of HIV and TB-related stigma by using the ICRW *Understanding
and Challenging HIV/AIDS Stigma: A Toolkit for Action* in a series of
workshops with key community players. Kara is facilitating and
supporting community initiatives that develop anti-stigma activities and
address knowledge gaps, in order to reduce fears around HIV/AIDS.

**Adventist Development and Relief Agency (ADRA) --Cambodia:** ADRA and
its local partners are empowering and mobilizing stakeholders, such as
trained Buddhist leaders, local authorities and PLWHA to help reduce
internal and external stigma and discrimination and facilitate
widespread and enduring changes in social attitudes in Sampov Meas
District. These stakeholders are mobilized to disseminate accurate
information about and dispel myths surrounding HIV/AIDS and PLWHA,
promote a compassionate community and individual response to PLWHA, and
inform people about locally-available voluntary counseling and testing
(VCT) and support services. Local Partners: Rural Association for the
Development of the Economy (RADE), Cambodia Organization for Human
Rights and Development (COHRD)

**CARE-Cambodia**: The purpose of the CARE Cambodia program is to
increase level of involvement of religious figures in stigma and
discrimination work, and community mobilization by training and
mobilizing 200 religious leaders in CARE's five project areas. CARE
Cambodia also plans to facilitate the involvement of over 200 people
living with HIV/AIDS (PLWHA) in provincial government AIDS program
coordinating committees, VCT services, self-help groups, community
outreach and PLWHA advocacy.

**Les Promoteurs de l\'Objectif Zerosida (POZ) \-- Haiti**: POZ is
creating and strengthening self-help support groups in four geographical
areas of Haiti: the west, northeast and southeast and the north
districts. The self-help groups will learn to identify initiatives that
contribute to improving conditions of sero-positive individuals, their
families, and their communities. The project will increase PLWHA groups'
advocacy skills and empower them to take a more active role in reducing
the rate of spread of HIV/AIDS and stigma and discrimination

# **About Community REACH**

Pact's Community REACH program is funded through USAID's Global Bureau
for Health's Office of HIV/AIDS and designed to facilitate the efficient
flow of grant funds to organizations playing valuable roles in the
struggle against HIV/AIDS. It does this by promoting both scaling-up of
successful programs and start-up of new programs with potential for
demonstrable impact in primary prevention and education, voluntary
counseling and testing, and care for those living with HIV and AIDS.

**Vision and mission**

Community REACH envisions communities united by courage and hope,
equipped with strengthened capacity, and energized by ownership to lead
an expanded fight against HIV/AIDS. This fight will result in decreasing
transmission of HIV, better care for those living with HIV/AIDS,
especially among the most vulnerable and a safer, more interconnected
world.

The mission of Community REACH is to rapidly make support available to
community-based HIV/AIDS programs reaching the most vulnerable groups
that are unserved or underserved with the most needed services.

**Community REACH results as of October 2003**

After two years of activity, Pact's Community REACH project funds 29
organizations with 34 local NGO subgrant partners for a total of \$6
million dollars. Together 63 NGOs are implementing projects in 75
communities in nineteen countries in Africa, Asia, Latin America and the
Caribbean, and Eurasia.

Community REACH programs are mainly competitively awarded through
requests for applications (RFAs) for work in USAID's expanded response,
rapid scale-up and intensive focus countries in the following focus
areas:

-   Care and support-community/home-based networks

-   Youth VCT linkages and referrals

-   Community-based interventions that target stigma and discrimination

-   Services for street children

-   Support to people living with HIV and AIDS networks

# In just over a year of activities, Community REACH grantees have provided care and support services to more than 20,000 OVC and PLWA and reached more than 28,000 people with prevention messages. Grantees are also currently establishing nine youth-focused VCT sites with many more in the planning stages. In just six months of VCT grant programs some 1,500 youth received VCT services from Community-REACH supported centers.