Improving HIV Prevention in the Greater Mekong Subregion
- Project Name: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project
- Region/Country: Southeast Asia/Viet Nam and Lao People’s Democratic Republic
- Sector and Themes: Health
- Year: 2012-2018
- Project Leaders: Ye Xu
The project focused on regional dialogue and information exchange that can be used in the planning of HIV/AIDS services at the national and subnational levels.
Rapid economic development in the Greater Mekong Subregion has increased the movement of people and goods, resulting in greater vulnerability to HIV. There are particular challenges to addressing the HIV epidemic in the subregion. In 2011, Viet Nam was aiming for nationwide HIV prevention, treatment, and care, focusing on high-risk populations in major cities and in border districts. In the Lao People’s Democratic Republic (Lao PDR), increased mobility across border districts and the commercial sex trade created a high-risk environment. The AIDS response was inefficient due to limited staff capacity, and inadequate access to quality prevention and care services. Awareness of the risks of HIV was low among high-risk and vulnerable populations, including migrants and mobile individuals. A concerted new effort was needed to expand HIV awareness and reduce HIV prevalence.
ADB designed a loan and a project preparatory TA for the governments of Lao PDR and Viet Nam in consultation with their respective ministries of health and major stakeholder groups to strengthen awareness on HIV. The TA (funded by the Japan Fund for Poverty Reduction) and loan targeted capacity building of government departments and frontline staff through technical training programs.
The project also upgraded facilities and provided equipment for HIV programs. Behavior change communication activities spread mass awareness to target populations with increased risk. The two countries signed an MOU on a joint strategy for regional cooperation and cross-border collaboration. ADB provided block grant mechanisms, piloted in Lao PDR, for innovative HIV service delivery models targeting migrants, mobile populations, and other high-risk groups at border areas.
Knowledge products and services delivered
The TA prioritized stakeholder participation, ownership, and careful selection of project sites and scope of activities to complement the support provided by other development partners. The TA supplemented the project loan to build the capacities of the national HIV/AIDS committees, program staff, and health managers. It supported private practitioners to manage sexually transmitted infections and to provide voluntary counseling and testing services, and trained peer educators and village health workers in community-based behavior change communication activities. It developed training materials and toolkits for developing the HIV prevention and control plan, which were integrated in the annual operational plans of respective provincial health departments. The project produced seven border province profiles and five case studies capturing the practical experience and impacts of the interventions and organized regional and national learning events.
Impact and results
The project increased knowledge in HIV transmission and means of prevention. It improved coordination with the respective national HIV/AIDS prevention programs. Both countries were able to update their national guidelines and standard operating procedures for comprehensive delivery of HIV prevention services that complemented the establishment of anti-retroviral therapy centers. The project supported cross-country coordination and collaboration, focusing on strengthening cooperation and knowledge exchange on HIV response at border areas and communities.
Lessons for Replication
The project focused on regional cooperation, through dialogue and information exchange that can be localized in the national and subnational planning of HIV/AIDS services. If block grants are to be employed, the project’s institutional context and fund flow mechanisms should be considered to ensure executing agencies can engage NGOs for project interventions in hard-to-reach populations. The project also offers important lessons for communication strategies that have widespread impact on HIV prevention messaging.