A Presentation by Mrs NIANGADO MAH DRABO, AMICAALL MALI Coordinator

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4th Africities SummitNairobi, KenyaSeptember
20, 2006
Special Session on Localising Responses to
HIV/AIDS Achievements and Constraints

• A Presentation by Mrs NIANGADO MAH DRABO,
  AMICAALL MALI Coordinator

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Decentralisation of the response to HIV and AIDS
and efforts for scaling up the response at the
local/municipal level

• PLAN
• Introduction
• Fight against the HIV and AIDS epidemic in Mali
  weaknesses and challenges
• Recent actions
• MDG
• Implementation of the AMICAALL Approach in Mali
  (12 districts)
• Strengths, limits, and perspectives

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Introduction

• West African country
• Concentrated epidemic
• Severe consequences concerning the agricultural
  and industrial production, the business, health
  and education sectors
• Decreased standard of living

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Epidemiological Situation

• The Mali Demographic and Health Survey (EDSM III
  2001), low prevalence (1.7)
• The careful examination of this study reveals
  various characteristics

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Epidemiological Situation (continued)

• Women 2
• Men 1.3
• Teenage girls 15-19 years old 1.1
• Teenage boys 15-19 years old 0.3
• Adults 30-34 years old 3.9.

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Weaknesses and Challenges

• Infrequently integrated interventions and
  non-multisectoral approaches
• Interventions have little impact in terms of
• Ownership, risk, and vulnerability reduction
• Reduction of disease stigmatisation and
  discrimination

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Weaknesses and Challenges

• The decentralisation of national structures and
  bodies
• The coordination of actions, activities, and
  support
• The procedures and management (complex and
  non-harmonious) 
• The financial, human, technical, and material
  resources are unreliable
• The outreach and national coverage are poor

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Weaknesses and Challenges

• The provision of medical and non-medical products
  faces limitations and gaps
• The gathering, compilation, and analysis of
  strategic information (problems of monitoring and
  evaluation)
• The development of activities aiming to reduce
  the socio-cultural and economic impact of HIV and
  AIDS amongst individuals, families, and
  communities is still in its early stages.

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Weaknesses and Challenges

• The development of a lasting local response
  through decentralisation and community capacity
  building
• The democratic management of the response,
  participation, dialogue, and involvement of
  stakeholders in regards to their legal
  competence, their strengths, skills, and
  comparative advantages

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Recent Actions

• New institutional arrangements
• National political involvement in the response to
  HIV and AIDS in line with the new institutional
  approach
• 5-year sectoral action plans (2004-2008) of 11
  ministerial departments
• Strategic global action plan at national level

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HCNLS Composition Decret n04-550 /P-RM,
November 25, 2004
High National Council Against HIV/AIDS
EXECUTIVE SECRETARIAT
Public Sector 13
Private Sector 13
Civil Society 13
Partnership Development
11 Coordin. 1 association of (2 PVVIH)
10 Ministeries 3 Institutions
6 institutions 7 enterprises
7 members

• President of Republic
• Prime Minister
• 46 members

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MDGs

• Goal 6 Combat HIV and AIDS, malaria and other
  diseases
• Target 9 Between now and 2015, to stop the
  spread of HIV and AIDS and to start the reversal
  of the present situation

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AMICAALL

• The Association of Municipalities of Mali (703)
  and the District of Bamako
• Launch of the Mali Alliance Chapter on 15 March
  2002
• Official involvement of Malian mayors and local
  leaders

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AMICAALL Approach

• Setting up of municipal teams in the response to
  HIV and AIDS
• Strengthening member capacities of municipal
  teams
• Development of municipal action plans in the
  response to HIV and AIDS
• Mobilisation of funds and partners concerning the
  developed plan
• Implementation and monitoring/evaluation of
  municipal action plans in the response to HIV and
  AIDS
• Exchange of information and experiences between
  the municipalities
• Relaying of information from the local level to
  the central level so that the decisions,
  strategies and policies reflect the local
  situation.

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AMICAALL APPROACH (continued)

• Advocacy and lobbying
• Meeting of stakeholders to set up municipal AIDS
  response team to include
• Locally elected officials
• Local leaders
• PLWHA association
• Religious leaders
• NGOs
• Leaders of women and youth groups
• Administrative authorities
• Health officials
• Unions, corporations, political parties

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Goals of Municipal AIDS Response Team

• Development of local social policy (what are the
  prevention strategies? Ways to mobilise the
  population to get tested and access care centres
  for those infected and affected?
• Implementation and monitoring/evaluation of
  activities in neighbourhoods and villages

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Development of municipal action plans in the
response to HIV and AIDS

• Integration of activities prevention and care,
  support and reducing the impact of HIV and AIDS
  at all levels
• neighbourhoods, villages
• workplaces (partnership with staff associations,
  unions and corporations)
• prisons
• schools and other learning centres
• places of risky behaviour brothels and bars
• PCs

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Mobilisation of funds

• Provision of funds in the municipal budget for a
  response to HIV and AIDS column
• Access to National Advisory Council funding
  -NAP- (MAP, ADB funds)
• Access to public sector funding through sectoral
  programmes
• Access to private sector funding and
  international partners
• Mobilisation of funds through cultural and sport
  events

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Monitoring and Evaluation

• Are the accomplished activities in line with the
  established timeframe?
• Are the activities correctly realised (knowledge
  and available expertise otherwise prior capacity
  building)?
• Did people show responsible behaviour to risk?
  Stigmatisation

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Exchange of information and experiences

• Between municipalities who already applied the
  AMICAALL strategy
• Future pairing with districts not yet involved
• Publication of information bulletins, profiles

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Sharing of information

• Share mission reports (with Health Ministry,
  NAP), NGO partners
• Information bulletins
• Annual round table discussions with partners
• Participation in national and international
  meetings

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Role of elected officials in the local response

• Advocacy
• Encourage local responses (support, caregivers to
  PLWHA, orphans and women )
• Encourage civil society and private sector
  involvement
• Mobilise resources, technical, and financial
  partnerships (local, national and international).

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Strengths

• Involvement of populations in all visited
  districts Eg. Banamba
• Capacity to mobilise funds locally (cotton field
  area)
• Local care and support (in Ségou, Mopti, Sikasso
  and Banamba)
• NGO collaboration with local authorities in all
  districts where municipal AIDS response teams
  have been set up

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Limitations

• Difficulties to mobilize funds for action plans
  against HIV/AIDS in communities
• Slow implementation process
• Lack of resources to initiate monitoring and
  evaluation missions

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Perspectives

• Development of a guide on mayors and local leader
  responsibilities in the response to HIV and AIDS
• Training of trainers in 8 regions of Mali
• Pairing of pilot municipalities with neighbouring
  municipalities not yet involved
• Monitoring and evaluation (submission of reports
  on a regular basis, email exchanges )
• Site visits on a yearly, biannual, or quarterly
  basis

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Malis Vision

• Is that of an engaged, voluntary nation and
  accepting with courage its responsibility of this
  plague
• Implies that all the people accept the fact that
  HIV/AIDS affects their life and their work
• Facing this situation, what do we do?
• Reinforce the measures of prevention of
  transmission
• Reinforce the monitoring of the epidemic
• Improve the global undertaking
• Promote partnerships

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CONCLUSION

• The success of a prevention of HIV/AIDS programme
  requires full commitment of the political
  decision-makers, of the community leaders and of
  all other leaders on all levels

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CONCLUSION (continued)

• The fight against HIV/AIDS is one that affects us
  all, only adequate and concerted strategies like
  the commitment of all, make it possible to face
  the problem
• The conjugation of efforts and the combination of
  multisectoral interventions makes it possible to
  control the HIV/AIDS epidemic
• Therefore, let us strengthen the efforts to live
  in a world without AIDS by 2010.

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End

• Thank you for your attention