The most effective responses to the HIV/AIDS pandemic are those that are multi-faceted and multi-sectoral, and those that leverage the resources and expertise of the public and the private sectors, both for-profit and non-governmental entities. As a leading international nonprofit organization, CPSHI has been at the forefront of finding private-sector solutions to tackle this dreaded disease.
The N-MARC Project successfully implemented a "shared risk, shared investment" strategy in which donor subsidies were used to support promotional efforts, partially offsetting the risk of for-profit businesses in launching a brand new condom in the marketplace. Because Nepal has historically been highly dependent on donated condoms, increasing the availability and use of commercially affordably priced condoms is a promising trend that contributes to increased sustainability.
In a departure from previous national prevention strategies, N-MARC, and its follow-on GGMS employs our Full Market Impact™ (FMI™) model, encouraging commercial condom suppliers to increase their marketing investment in partnership with the public sector and NGOs. A number of private sector suppliers joined the project, including commercial traders and the Nepal Contraceptive Retail Sales Company, a local social marketing organization. To grow the market for commercial condoms, N-MARC supported behavior change communications targeted at most-at-risk populations (MARPS). The project also increased condom availability along major transport routes and in entertainment zones. The strategy used by AED (now FHI 360) and its partners in Nepal led to a tripling of the commercial sector's market share in just three years. Total condom market volume also grew by 32 percent over the same period. The Nepali commercial traders for their part matched N-MARC's direct investments by a 4-to-1 ratio, demonstrating the leveraging effect of a well-designed public-private partnership.
FHI 360 emphasizes the development of new, non-traditional sales outlets for condoms—even shoe peddlers. A related AED (now FHI 360) program is the mapping the availability and visibility of condoms near "hot spots" using geographic information systems (GIS) and the World Health Organization HealthMapper. "Hot spots" are locations such as bars, nightclubs, and hotels where MARPs initiate high-risk sex. GIS answers the question: are condoms available where HIV transmission is more likely to occur? These answers have helped program implementers design more targeted and efficient marketing and distribution condom interventions.
Kondom (Put It On) campaign in Tanzania urged sexually active
people to take responsibility and use condoms correctly and consistently.
The campaign was community-centered, using Tanzanian proverbs and visuals
to spark recognition of responsible sexual behavior. Vaa Kondom
reached those MARPs along transportation corridors and in workplaces
such as mines and plantations. AED's Sikia
Kengele (Ring the Bell) campaign in Tanzania encouraged
at-risk adults to be faithful to their partners. Sikia Kengele worked
through faith and community networks in high-risk areas.
In Tanzania, FHI 360, in partnership with Engender Health, is implementing the USAID-funded CHAMPION Project through which social and sexual norms are being addressed in order to reduce HIV transmission. The Vunja Ukimya (Break the Silence) campaign is part of an effort to create a national dialogue to empower women and challenge gender norms to reduce HIV transmission. Vunja Ukimya urges couples to communicate with each other and to prioritize their relationship and family. This is part of an ongoing campaign that will eventually target Gender Based Violence and other social and health issues.
In the Dominican Republic, FHI 360 is working with high-risk groups including youth, sex workers, and men who have sex with men to limit HIV infections among these vulnerable groups. The project will also conduct nationwide mass media campaigns promoting safer behaviors to the general population.
AED (now FHI 360) has been a leader in workplace HIV/AIDS programs in developing countries, beginning with Strategically Managing AIDS Responses Together in the Workplace (SMARTWork), one of the first projects to address HIV/AIDS workplace prevention and education. Through SMARTWork, AED provided technical assistance in workplace education and prevention to businesses and supported efforts to guarantee employment and human rights protection for people affected by HIV/AIDS.
Under the CHAMPION project, AED facilitated the launch of the National HIV & AIDS Code of Practice with the Ministry of Labor, Employment, and Youth Development. CHAMPION has worked extensively with the Association of Tanzania Employers to provide technical support and training to private-sector partners working in HIV prevention.
FHI 360 has worked extensively with business councils on AIDS in various countries. For example, we provide funding to support the Botswana Business Coalition on AIDS in its efforts to mobilize the private sector and foster increased understanding of HIV and AIDS issues. FHI 360 also supports the Nigerian Business Coalition Against AIDS and five participating labor unions in designing HIV/AIDS-related workplace policies.
Severely malnourished PLHIV are four times more likely to die of complications than those who receive adequate nutrition. The Kenya Nutritional and HIV Program (NHP) focuses on improving the nutritional status of patients receiving ARV treatment, orphans and vulnerable children (OVCs), and HIV-infected pregnant and postpartum women. To improve the sustainability of the program, the project also collaborates with the Ministry of Health's National AIDS/STD Control Program to include nutrition management in national health worker training curricula.
The link between HIV/AIDS and safe drinking water, sanitation, and hygiene (WASH) is well documented, as diarrheal disease is a significant contributor to morbidity, mortality, loss of functional days, and income. Diarrhea has also been shown to interfere with the absorption of ARV drugs and nutritive foods. The T-MARC Project developed WASH-related training and provider and household-level behavior change communication materials. In 2010, AED launched these materials and training, and distributed PUR® to President's Emergency Plan for AIDS Relief (PEPFAR) home-based care partners, representing more than 140,000 PLHIV throughout Tanzania. Under a two-year P&G grant, FHI 360 also provides PUR® and supportive WASH education at the household, school, and clinic-level in Tanzania's Monduli district under the Mswakini Safe Drinking Water Program.
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