Strengthening the HIV/AIDS Response at all Levels

Greg Olson

Communications Senior Associate

2015 has been a year of ambitious goal-setting for the global community. Now, on World AIDS Day, people are uniting around the world to fast-track the response to HIV/AIDS in order to end the AIDS epidemic over the next fifteen years. Health systems need to be strengthened at all levels to deliver the essential HIV/AIDS services that will end the epidemic and turn the dream of an AIDS free generation into a reality.

Graph of the global investment in HIV/AIDS response since 1990. (Credit: The Institute for Health Metrics and Evaluation)

According to the Institute for Health Metrics and Evaluation, the global funding response to HIV/AIDS grew more than 600 percent from 2000 to 2014. With the investment of around $11 billion in 2014, comes the expectation of tangible results and improvements, and that has generally been the case. For example, the number of new HIV infections per year has been decreasing and the number of people living with HIV who are receiving treatment is increasing, according to the World Health Organization.

Since 2011, the U.S. Agency for International Development (USAID)-funded Leadership, Management, and Governance (LMG) Project has strengthened health systems and the response to HIV/AIDS at all levels. Specifically, the LMG Project’s approach supports organizations, networks, and governments to provide more responsive HIV/AIDS services to more people.

Here are a few examples of how the LMG Project contributes to the HIV/AIDS response.

Organizational Development

In Uganda, the LMG Project has been providing long-term technical assistance to the Joint Clinical Research Centre (JCRC) to help the organization identify and overcome weaknesses, and to help JCRC adapt to changing needs as a leaders in the HIV/AIDS response. Over the LMG Project's last two project years, some of our achievements include improving JCRC’s financial management, information and communication technology, board governance, and human resources management.

Graphic overview of the LMG Project's support to JCRC.

Network Strengthening

Similarly, the LMG Project has supported networks that help key populations access essential HIV/AIDS services and information. The LMG Project has supported the International HIV/AIDS Alliance in the Middle East and North Africa region, where they implement a community-based program focusing on men who have sex with men and people living with HIV. Similarly, the Alliance expanded its work with the Regional Arab Network Against AIDS, including providing ICT support for HIV counseling and outreach to key populations.

Additionally, the LMG Project is designing and piloting a new program with the Malawi Network of People Living with HIV. This Network Strengthening Program is focused around six distinct challenge areas, and is customizable to the needs of networks.

Graphic overview of the Network Strengthening Program's design process.

Public Sector Health Systems Strengthening

In Honduras, the LMG Project worked closely with the Honduran Ministry of Health (MOH), via a unique direct funding mechanism from the U.S. government, to identify and qualify local NGOs that provide HIV/AIDS services. This is the only country in the region where USAID provides direct funding to local governments, for the purpose of funding local NGOs. In this supporting role, the LMG Project assists the MOH management of funding mechanisms and grants. We continue to work with the local NGOs that receive funding from the MOH, to create and support Continuous Quality Improvement Plans, and to keep the NGOs qualified to receive grants from the MOH.

Although a health systems strengthening response to HIV/AIDS is not as compelling as a story about trucking antiretroviral medications over thousands of kilometers of rough terrain, the interventions and support are just as critical. Health systems are like a three-legged stool: although one leg may be strong, if the other two are weak, the stool will collapse.

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