Acronyms List AIDS CCM GFATM/GF HIV HR HSS IP M&E MDG MoH NGO PLHIV/PLH PR SR TA UN UNAIDS UNDP UNESCO UNFPA UNICEF WG WHO NSP NPA MEC Acquired immunodeficiency syndrome Country Coordinating Mechanism, or the MEC in Uzbekistan context Global Fund to Fight AIDS, Tuberculosis and Malaria Human immunodeficiency virus Human resources Health system strengthening Implementing partner Monitoring and evaluation Millennium Development Goal Ministry of Health Non-government Oarganization People living with HIV Principal recipient Sub-recipient Technical assistance United Nations Joint United Nations Programme on HIV/AIDS United Nations Development Programme United Nations Educational Scientific and Cultural Organization United Nations Fund for Population Activities United Nations Children's Fund Work group World Health Organization National Strategic Programme National Plan of Actions Multi sector Expert Council 2
TABLE OF CONTENTS UNDP PROJECT DOCUMENT. 1 ACRONYMS... 2 I. SITUATION ANALYSIS. 4 II. STRATEGY. 6 III. RESULT AND RESOURCES FRAMEWORK 9 IV. MANAGEMENT ARRANGEMENTS. 17 V. MONITORING FRAMEWORK AND EVALUATION 21 VI. LECAL CONTEXT... 25 VII. ANNEXES... 26 3
I. SITUATION ANALYSIS UNDP works on the ground in 177 countries, in order to build national capacities and to assist countries in addressing development challenges. The capacity of local institutions to implement and manage the systems developed to address the issues of HIV/AIDS, Tuberculosis and Malaria in Uzbekistan, particularly at a governmental level, is as equally important as the availability of policies and response mechanisms. UNDP will, through this project, contribute to strengthening existing national structures in order to halt the spread of three diseases including AIDS, Tuberculosis and Malaria. In many countries worldwide, UNDP has been chosen to fulfill the Principal Recipient role of the grants awarded by the Global Fund. In Uzbekistan, starting from 2011, UNDP has undertaken this role for the HIV grant awarded to the country by the Global Fund Executive Board. UNDP in Uzbekistan has also become a Recipient of the operational funding for the Secretariat of the Country Coordination Mechanism (hereinafter the Multi-sectorial Expert Council (the MEC) within the Uzbekistan context), which has been stipulated in the Funding Agreement with the Global Fund (Annexe 1) signed on the 12 th of July 2012, and effective until the end of 2013. In accordance with the Presidential Resolution on Additional Measures to Increase the Efficiency of HIV response in the Republic of Uzbekistan, as dated on the 26 th of December, 2008, the Republican Coordinating Commission on preventive measures against the spread of HIV infection has been established. The Multi-sectorial Expert Council has been established under this Commission. Under the chairmanship of the Deputy Prime Minister, the MEC has been established in order to ensure that the following principles set by the Global Fund policies are adopted: The promotion of national ownership; The fostering of innovative partnerships to fight the three diseases (AIDS, Tuberculosis and Malaria); The encouragement of country program formulation and implementation; The development of national policies, priorities and partnerships; The promotion of accountability and transparency. The following gaps within the capacities of the MEC have been identified for further improvement, within the framework of this project: The major issue that prevents the Secretariat from obtaining up-to-date information from the regions is the low quality of data collected at a local level. There are no fully-functioning mechanisms established for quality data collection, analysis and disaggregation, at either the local or the central level of the MEC. The application of a multi-sectorial approach to fighting HIV, Tuberculosis and Malaria, allowing for the efficient engagement of all line ministries, local administrations and members of civil society. The lack of cross-sectorial work also means that there is no clear vision regarding the role of the MEC in the country, among both government officials and the civil society. The MEC does not have a clearly articulated communications strategy that would allow it to deliver key messages to both the public and decision-makers. MEC meetings are currently irregular. In 2012 there have been three MEC meetings, while in previous years MEC meetings occurred at a rate of less than once a year. Communication occurs spontaneously, particularly in cases when issues or problems arise that require immediate reaction or follow-up.
There is a growing number of HIV infection among women, and there is a need to raise understanding of the importance of gender mainstreaming in public health institutions. Another issue is the absence of a resource mobilization strategy for the MEC, to provide a clear analysis of all the available resources in the country, as well as potential sources of funding needed to pursue public health programmes. It is important to mention that the MEC requires a mechanism to ensure that there is no duplication of activities undertaken by the various parties that implement public health programmes regarding HIV, TB and Malaria in Uzbekistan. These parties include but are not limited to international organizations. With a growing number of people contracting HIV in Uzbekistan, there is a need to establish a HIV hot line for the general population. This may be seen as an effective prevention tool that can be piloted within the current project, based on the successful experience of other countries such as the Russian Federation. In addition, according to an analytical report regarding the needs assessment for the technical assistance of national counterparts working in area of HIV/AIDS, as prepared by the Central Asian AIDS Control Project in Uzbekistan (2010), the following issues have been outlined: There are no experts in the area of planning and HIV/AIDS programme management; There is a lack of skills among specialists, particular a lack of knowledge regarding procedures of data collection, analysis and feedback collection from beneficiaries; There is limited access to scientific and methodological literature on HIV/AIDS. These areas have been chosen by this project for further intervention, in order to build the capacities of national counterparts working in the area of public health. Based on the experience of the implementation of HIV grants, there is always a possibility for unpredicted changes in the context in which public health programmes are implemented. An example is the recent urgent need for additional financial resources for ARV drugs, due to both the increasingly growing number of people who are in need of treatment, and the adoption of the new WHO protocol. The MEC s role in this regard is crucial in addressing the concerns of all parties involved, while bringing them to the attention of high level officials. II. STRATEGY Outcome 4 of the UN Development Assistance Framework is Effectiveness, inclusiveness and accountability of governance at the central and local levels enhanced. This outcome envisages that effective governance principles should be in place for the efficient execution of public health programmes in Uzbekistan. 5
The following activities are envisaged in the current project: 1. The strengthening of the capacities of public health institutions in data collection and analysis In order to ensure clear linkage and consistency between Global Fund grant and National Strategic Programmes, including those regarding HIV/AIDS, the MEC needs a strengthened information sharing system. The Secretariat of the MEC should become a source of latest updates from the Global Fund, and a reliable channel of information from both internal and external parties. In order to strengthen the capacities of the technical level of MEC specialists in quality data collection and data analysis, the project will conduct the analysis of current gaps in data collection and develop clear reporting recommendations for establishing mechanisms for quality data collection (standard operating procedures). This will enable better coordination, monitoring and reporting from Principal Recipients and Regional MECs, and will facilitate data collection from the regions for effective and timely decision-making processes. The analysis and replication of best examples of MECs operating in the regions will ensure the sharing of knowledge and experience among regional MECs. In order to implement this process, a short assessment will be conducted together with the MEC Secretariat to identify the two to three best regional MECs that will become role models for other regions. These MECs will share their best techniques and methodologies, and replicate their approach to work in other regions. The effectiveness of a MEC depends to a large extent on the quality and timeliness of the Principal Recipients of the grants, regarding information sharing on the three diseases, and reporting to the MEC. Relevant needs assessment will support the further establishment of effective information sharing, and the provision of timely reports to the MEC in order to promote informed decision-making processes. UNDP will be supporting the Secretariat in developing and sharing MEC key documents among key interested parties and decision-makers, particularly those documents which are instrumental for the provision of rationale for the future levels of interventions and sources of funding. Examples of such documents include those related to HIV programs, including state budget allocations. 2. The raising awareness of the best approaches in fighting the three diseases among government officials UNDP will facilitate the increased participation of non-state actors in the MEC, with the support from the Secretariat of the MEC. The meaningful participation and representation of People Living with HIV will be facilitated by the project. The above activities will further contribute to the building of capacities for an effective multisectoral approach. Sharing best practices is an important component that will enable the MEC to incorporate some best international practices and tools. In order to further streamline current efforts made by the UNDP in the country towards gender equality, a separate series of trainings on gender and public health issues will be conducted for both high level MEC members and non-mec government officials. A bulletin on gender and public health will be developed and shared with a wide spectrum of government officials, who would incorporate recommendations for the mainstreaming of gender equality in the health sector with a focus on the social aspects of the three diseases. In order to address recent challenges related to the shortage of financial resources needed for the ARVT, the project will contribute to the development of a complex resource mobilization strategy for the MEC. 6
One of the important aspects of effective MEC functioning is ensuring an understanding of the role of the MEC by local NGOs and government institutions. A series of presentations on the role of the MEC and the Global Fund are planned to be delivered, in order to increase knowledge and build stronger partnerships with local NGOs, line ministries and other government bodies. The project will further facilitate the effective oversight of Global Fund's grants through the provision of UNDP s best practice methodology in monitoring and evaluating MEC members, and facilitating knowledge sharing among MEC members and external partners involved in implementing the Global Fund grants. 3. The greater involvement of non-state stakeholders (NGOs, PLHIV) in decision-making processes regarding public health issues The MEC has a monitoring role of the program including the Principal Recipient(s), whilst strengthening the PR and SR systems for M&E, there will be opportunities to strengthen the monitoring systems of the MEC through joint monitoring visits organised on a regular basis. In order to strengthen the MEC to better address emerging country needs in its work to halt the three diseases, all actors should be aware of the MEC s role in coordinating efforts. In addition, the principle of a multi-sectorial approach within the MEC should be in place for the more effective use of existing resources in the public sector, as well as in the civil society. Raising awareness about the MEC is an important initiative to be supported by UNDP through regular meetings and consultations held with national institutions and local NGOs that are part of the grants implementation, as well as those that could become partners within the area of halting the spread of the three diseases. These could include the Ministry of Higher and Secondary Education, the Ministry of Justice, the Ministry of Finance and others. In strengthening the positioning of the MEC in country by delivering presentations and engaging a wider spectrum of partners into the dialogue and decision-making process, the regularity of MEC meetings is a key factor for the effective coordination of efforts in combating the three diseases. UNDP in its part will actively support the arrangement of MEC meetings on regular basis, in order to discuss plans, share information and continue the implementation of National Strategic Programmes and projects that are funded by the Global Fund. In partnership with the MEC Secretariat, UNDP will identify the information flows and reporting schemes required by the MEC to be effective. Within the framework of this activity, and with the support from the MEC, UNDP will pilot a HIV hotline in Tashkent. A number of activities are planned to be carried out in this regard, including cost estimation, the analysis of current capacities available at the city AIDS Center, and the needs assessment for future capacity strengthening. It is planned that a pilot will be launched, and its results and recommendations for scale up will be presented at a MEC meeting by the end of 2013. In addition, through this component, the project will identify gaps in the operational environment for NGOs that will hamper the effective execution of the HIV component, while providing the MEC with the recommendation and solutions that can address these gaps. UNDP will also promote the main programming principles to be part of the MEC activities. These principles will include results-based management, a human rights-based approach, gender equality (through promoting the equal participation of women and men at meetings and events), environmental sustainability and capacity building. 7
III. RESULTS AND RESOURCES FRAMEWORK Intended Outcome as stated in the Country Programme Results and Resource Framework: Strengthened public administration at all levels that exercises efficient, accountable and inclusive governance Outcome indicators as stated in the Country Programme Results and Resources Framework, including baseline and targets: Indicator: Progress in civil service reform. Baseline: Neither comprehensive civil service reform, nor law on public administration adopted. Target: Comprehensive strategy in place for civil service reform and shift towards Results-Based Management. Applicable Key Result Area (from 2008-13 Strategic Plan): Fostering Democratic Governance: Strengthening accountable and responsive governing institutions Partnership Strategy: Ministry of Health, UNDP, Republican Centre to fight AIDS, Multisectoral Expert Council and its Secretariat, UNAIDS, WHO, Ministry of Higher and Secondary Education, Ministry of Justice, Ministry of Finance and others. Project title and ID (ATLAS Award ID): Strengthening national capacities to address emerging challenges in fighting the spread of three diseases (AIDS, Tuberculosis and Malaria) INTENDED OUTPUT Output: National capacities to address emerging challenges in fighting the spread of three diseases (AIDS, Tuberculosis and Malaria) strengthened Baseline 1.1 Low capacities of MEC technical staff in data collection and analysis Baseline 1.2 Lack of mechanisms for data collection and OUTPUT INDICATORS Indicator 1.1 # of MEC technical staff who have skills to collect, analyse and disaggregate data (including by gender) Indicator 1.2: Availability of mechanisms for data collection and analysis in place 2013 OUTPUT TARGETS FOR YEARS Target 1.1 14 MEC technical staff who have skills to collect, analyse and disaggregate data (including by gender) Target 1.2 Operation procedures for data collection for the MEC is developed and adopted INDICATIVE ACTIVITIES Activity Result 1: The strengthening of the capacities of public health institutions in data collection and analysis Actions: To conduct trainings on data collection, analysis and disaggregation (including by gender) for technical level MEC members in all 14 regions short assessment of best regional MECs to develop recommendations on replication of experience to other regions in quality data collection and operation overall development of the operations procedures for data collection, analysis and RESP.PARTI ES Activity 1 UNAIDS UNDP WHO MEC INPUTS Activity Result 1 TRAC: 2012: 884 USD 2013: 102200 Global Fund: 2012: 83 878 USD
analysis desegregation for the oblast level MEC Baseline 2.1 Low awareness of government officials on application of multisectoral approach to fight HIV, TB and Malaria Baseline 2.2 Low awareness on gender and public health issues among government officials Baseline 2.3 Absence of comprehensive resource mobilisation strategy for MEC Baseline 2.4 Absence of comprehensive communications strategy Indicator 2.1 # of government officials that are able to apply multisectoral approach to fight HIV, TB and Malaria Indicator 2.2 Gender and HIV bulletin for decision makers is published Indicator 2.3 Availability of resource mobilisation strategy for MEC Indicator 2.4 Availability of comprehensive communications strategy 2013 Target 2.1 30 government officials are able to apply multisectoral approach to fight HIV, TB and Malaria Target 2.2 Gender and HIV bulletin is approved and formally presented at MEC meeting Target 2.3 Resource mobilization strategy is adopted and implemented by MEC Target 2.4 Communication strategy is adopted and implemented Activity Result 2: The raising awareness of the best approaches in fighting the three diseases among government officials Actions: to organize a study tour on multisectoral approach for two government members of MEC, two NGO members of MEC, one member of MEC Secretariat, two representatives of MoH and MoF non members of MEC, with further learning follow up round tables conducted for at least 30 MEC members and key line ministries representatives to conduct training for 30 government officials including MEC members (+ 14 oblast level MEC) on gender and public health is organized at three stages introducing basics of how certain health problems affect women and men, girls and boys differently, gender based health planning, policy making and service delivery, introduction to gender analysis methods for public health Activity 2 UNDP MEC Secretariat Activity Result2: TRAC 2013: 5700 USD publication and dissemination of the Gender and HIV bulletin development of communication 9
strategy for MEC development of the complex resources mobilization strategy Baseline 3.1 There is no HIV hotline established in the country Baseline 3.2 No joint monitoring visits conducted with wider spectrum of partners Baseline 3.3 No high level events conducted with participation of NGOs, International organizations with government authorities on public health issues Indicator 3.1 HIV hot line launched and started its effective work by the end of 2013 in Tashkent city Indicator 3.2 # of joint monitoring visits with participation of Principal Recipients, Government Officials non MEC members and NGOs (at least 40% of women to be part of monitoring group) Indicator 3.3 # of round table discussions conducted with participation of NGO, international community and wide range of government counterparts to raise challenges and serve as a basis for further 2013 Target 3.1 HIV hot line is piloted in Tashkent by the end of 2013 (2012) 2013 Target 3.2 Joint monitoring visits with participation of Principal Recipients, Government Officials non MEC members and NGOs conducted at least 2 times a year (at least 40% of women to be part of monitoring group) Target 3.3 At least 2 round table discussions conducted per year with participation of NGO, international community and wide range of government counterparts Activity Result 3: The greater involvement of non-state stakeholders (NGOs, PLHIV) in decision-making processes regarding public health issues Actions: to conduct rapid assessment and based on the results pilot HIV hot line in Tashkent city. To present the results of the pilot and recommendations for scaling up during MEC meeting close monitoring and work with the Ministry of Justice on enabling environment for NGO operation in the country to organize joint monitoring visits with the Principal Recipients, government counterparts and NGOs (twice a year), reports of those visits to be presented during quarterly round tables presentations on the role of MEC and the Global Fund its policies, new developments on quarterly basis (round tables) regular round tables and consultations to be held with national institutions and local NGOs on progress towards combating the three diseases UNAIDS UNDP WHO MEC MoJ Activity Result3: TRAC: 2013: 42100 USD Global Fund: 2013:93 239 USD 10
MEC meetings facilitation and support of regular MEC meetings (that are held twice a year) 11
IV. MANAGEMENT ARRANGEMENTS Project Organisation Structure Project Board Senior Beneficiary MEC members, MEC Secretariat Executive UNDP Senior Supplier Global Fund, UNDP Project Assurance Good Governance Unit Resource Management Unit Project Manager NPO on Public Health Project Support UNDP Business Center MEC Secretariat staff The Project Board consists of 3 parties: (i) Senior Supplier UNDP and the Global Fund - that will ensure that necessary inputs are provided for the achievement of project s deliverables. These inputs may consist of programming and technical expertise, knowledge, planning and monitoring support, financial resources, logistic arrangements and other support; (ii) Executive UNDP. The role of the Executive is representing the project ownership; (iii) Senior Beneficiary MEC, MEC Secretariat - representing the interests of those who will ultimately benefit from the project. The Senior Beneficiary s primary function within the Board is to ensure targeted delivery of project s outputs from the perspective of project beneficiaries. The Project Support provides project with administrative and clerical support as required by the needs of the project implementation team. It may include documentation, filing, logistics and other support in facilitating financial, HR and procurement related operations. The management arrangement follows the UNDP s POPP. UNDP s Direct Implementing Modality (DIM) will be used in executing the project. DIM authorization (dated 18.12.2012) was granted to UNDP Country Office in Uzbekistan to implement this project on behalf of UNDP during 2012-2013. The UNDP country office may provide support services for assistance with reporting requirements and direct payment. When providing the above support services, the UNDP Country Office will recover the costs for providing Implementation Support Services on the basis of actual costs and transaction fee based on the Universal Price List (see Annex1 attached). According to the corporate guidelines, these costs are an integral part of project delivery and, hence, will be charged to the same budget line (account in AWP) as the project input itself. 12
The procurement of goods and services and the recruitment of project personnel by the UNDP country office shall be in accordance with the UNDP regulations, rules, policies and procedures. The relevant provisions of the Standard Basic Assistance Agreement (SBAA) between the Government of Uzbekistan and the UNDP, signed by Parties on 10th June 1993, including the provisions on liability and privileges and immunities, shall apply to the provision of such support services. V. MONITORING The monitoring of the Project will be carried out in line with the UNDP instructions on monitoring and evaluation. Quarterly action plans will be prepared as a tool for planning, coordination and monitoring. The monitoring of the Project progress will be carried out through the delivery of milestones and upon the UNDP management s request. Regular meeting with Head of Good Governance Unit will be conducted and a Progress Report will be prepared at the end of the Initiation Plan, using the standard format available in the Executive Snapshot. The report will cover technical, financial and other administrative aspects with an aim of monitoring the achievements of the projects goals effectively and efficiently. In accordance with the programming policies and procedures outlined in the UNDP User Guide, the project will be monitored through the following: Within the annual cycle On a quarterly basis, a quality assessment shall record progress towards the completion of key results, based on quality criteria and methods captured in the Quality Management table below; An Issue Log shall be activated in Atlas and updated by the Project Manager to facilitate tracking and resolution of potential problems or requests for change; Based on the initial risk analysis submitted (see annex 1), a risk log shall be activated in Atlas and regularly updated by reviewing the external environment that may affect the project implementation; Based on the above information recorded in Atlas, a Quarterly Progress Reports (QPR) shall be submitted by the Project Manager to the Project Board through Project Assurance, using the standard report format available in the Executive Snapshot; a project Lesson-learned log shall be activated and regularly updated to ensure on-going learning and adaptation within the organization, and to facilitate the preparation of the Lessons-learned Report at the end of the project; a Monitoring Schedule Plan shall be activated in Atlas and updated to track key management actions/events. Annually Annual Review Report. An Annual Review Report shall be prepared by the Project Manager and shared with the Project Board and the Outcome Board. As minimum requirement, the Annual Review Report shall consist of the Atlas standard format for the QPR covering the whole year with updated information for each above element of the QPR as well as a summary of results achieved against pre-defined annual targets at the output level; Annual Project Review. Based on the above report, an annual project review shall be conducted during the fourth quarter of the year or soon after, to assess the performance of the project and appraise the Annual Work Plan (AWP) for the following year. In the last year, this review will be 13
a final assessment. This review is driven by the Project Board and may involve other stakeholders as required. It shall focus on the extent to which progress is being made towards outputs, and that these remain aligned to appropriate outcomes. In addition to the abovementioned, the following reporting scheme will be used under Activity # 2 of this document as per Funding Agreement signed with the Global Fund: As a CCM Funding Recipient, UNDP Uzbekistan is accountable for the use of CCM funding and the management of funds. According to the Global Fund Regulations even when CCM proposes a Recipient Entity to receive the funds on its behalf, the CCM is directly responsible for the disbursement and activity reports. During implementation, and no later than one month after completion of Quarter 3 (month 10) of the funding period, the CCM will submit a Progress Update and Disbursement Request from which includes as per the requirements of the Global Fund and as stipulated in the Agreement signed. Field trips to regions as well as spot checks will be used as an instrument to monitor quality of project implementation. Quality Management for Project Activity Results (to be elaborated in the course of project implementation) VI. LEGAL CONTEXT This document together with the CPAP (2010-2015) signed by the Government and UNDP which is incorporated by reference constitute together a Project Document as referred to in the SBAA and all CPAP provisions apply to this document. Consistent with the Article III of the Standard Basic Assistance Agreement, the responsibility for the safety and security of the implementing partner and its personnel and property, and of UNDP s property in the implementing partner s custody, rests with the implementing partner. The implementing partner shall: put in place an appropriate security plan and maintain the security plan, taking into account the security situation in the country where the project is being carried; assume all risks and liabilities related to the implementing partner s security, and the full implementation of the security plan. UNDP reserves the right to verify whether such a plan is in place, and to suggest modifications to the plan when necessary. Failure to maintain and implement an appropriate security plan as required hereunder shall be deemed a breach of this agreement. The implementing partner agrees to undertake all reasonable efforts to ensure that none of the UNDP funds received pursuant to the Project Document are used to provide support to individuals or entities associated with terrorism and that the recipients of any amounts provided by UNDP hereunder do not appear on the list maintained by the Security Council Committee established pursuant to resolution 1267 (1999). The list can be accessed via http://www.un.org/docs/sc/committees/1267/1267listeng.htm. This provision will be included in all sub-contracts or sub-agreements entered into under this Project Document. 14
VII. RISK LOG Description Category Impact/ probability Countermeasures/Mngt response Owner Government commitment and rather fragmented involvement in coordination of the GF grants implementation Strategic Probability: Medium Impact: High Encouraging the MEC meetings, promoting ownership, day to day work raising awareness on the issue MEC, UN agencies, MoH Limited number of international partners as well as civil society organizations in the country predetermines the scope of the MEC composition Strategic Probability: Medium Impact: High Convincing the engagement of the existing partners into coordination of the effort in implementing the GF Projects. MEC, GF Secretariat, UNDP, UNAIDS MEC members high turnover, unsustainable capacity strengthening effort Strategic Probability: high Impact: High Incorporate introductory information arrangement for MEC members-new comers to ensure that some basic information is available right after new appointment. MEC, GF Secretariat, UNDP, UNAIDS 15
VIII. ANNEXES Annex 1. Global Fund CCM Funding Agreement and Performance Framework Annex 2. Terms of Reference for Project Board 16