Robert Clay, Director of the USAID Office of HIV/AIDS, Discusses What Works in Innovative Public-Private Partnerships for Reproductive Health

What is the Role of Policy? How Does Policy Pay Off?

How Has Policy Action Increased Resources for Health? The Case of Kenya

How Can Countries Improve the Flow and Use of Information for Decision-making? The Case of Peru

What Works in Innovative Public-Private Partnerships for Reproductive Health? The Case of India

Policy Pays Off Invitation

Press Release

For media inquiries, contact Becca Simon at rsimon@futuresgroup.com or +1.202.775.9680

Futures Group, an international development firm known for its evidence-based, integrated approach to complex health and development challenges, has joined the Global Business Coalition on HIV/AIDS, TB and Malaria.

Futures has been actively engaged in global health for the past 30 years. It creates innovative solutions that assist governmental and non-governmental agencies, foundations, and the private sector in designing, implementing and evaluating programs in HIV and AIDS, sexual and reproductive health, population and family planning, maternal and child health, infectious diseases, and gender.

“Effective action to improve global health and economic development demands that business and organizations from other sectors join forces to share knowledge and coordinate actions,” said John Tedstrom, GBC’s President and CEO. “By linking the work of organizations like Futures with the corporate social responsibility goals of our business members, we can identify effective ways to leverage business resources and expertise to improve the reach and results of global health action.”

“Futures Group has a unique hybrid environment that harnesses the domain-based enthusiasm of our staff around the world to the tried and tested business processes that delivers best value for money to our clients,” said Farley R. Cleghorn, Senior Vice President & Chief Technical Officer, Futures Group.

Futures Group

Established in 1971, Futures Group equips governments with data and proven tools to improve health services for the people who need it most. Futures is a services and consulting company that develops and delivers innovative, locally relevant solutions for the most vexing health problems in the developing world. Globally, Futures Group assists governmental and non-governmental agencies, foundations, and the private sector by designing, implementing and evaluating programs in HIV and AIDS, reproductive health, population and family planning, maternal and child health, infectious diseases, and gender.

The core goal of Futures Group is to improve the health of mothers, children, and families by employing deep expertise in policy and advocacy, research and strategic information, health markets and private sector engagement, modeling and economic analysis, health informatics, strategic consulting, and program management.

Over the past 38 years, Futures Group has worked closely with the United States Government to alleviate pain and suffering throughout Africa, Asia, Latin America and Eastern Europe by expanding health services throughout the developing world.

Headquartered in Washington, D.C., Futures Group has worked in more than 100 countries on more than 600 projects, and is currently running health programs in over 35 countries with over 500 staff worldwide.

For more information visit: www.futuresgroup.com.

Global Business Coalition on HIV/AIDS, TB and Malaria

The Coalition is an extraordinary alliance where business, government, and civil society join forces—a collaboration that’s closing gaps and maximizing performance in the drive to defeat disease. The Coalition’s nearly-200 member companies are at the forefront of a movement that is speeding the day when the devastation caused by HIV, TB and malaria will end.

The core idea is simple:  Apply business’ capabilities, influence, and other assets, and victory will come sooner than if the non-corporate sector is left to do the job on its own. For member companies committing assets to the fight, GBC delivers well-crafted, cost-effective ways to get focus, find partners, improve effectiveness, and boost ROI. Not every member is active on the front lines, but every member wants to help us win.

GBC represents the private sector to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Coalition has offices in New York, Paris, Johannesburg, Beijing, Nairobi and Moscow. For more information visit www.gbcimpact.org.

Futures Group, in collaboration with TDI Group, is providing leadership on an EC assignment to analyse the macroeconomic impact of the HIV and AIDS epidemic in Lesotho, and assess the fiscal impact of HIV/AIDS on government revenues, spending and on the budget balance.

Outputs

• Inception and interim reports
• Seminars with the main stakeholders to present findings
• Final report detailing the models and methodologies utilised; epidemiological and demographical analyses; estimates of the cost implications of HIV and AIDS and their likely impact on the Government budget; and recommendations at the policy and implementation levels for mitigation of the macroeconomic and fiscal impacts of HIV and AIDS

On behalf of the Joint Financing Arrangement Partners (DFID, Government of Malawi and Norway), Futures Group reviewed progress towards implementation of BLM’s Project Completion Report and achievements against targets from July 2006-June 2009. Futures Group also identified lessons learned in order to better inform Phase II of the BLM programme (July 2009-June 2015). BLM, a Malawian non-governmental organisation established in 1987, provides sexual and reproductive health and HIV and AIDS information and services nationwide.

Outputs

• DFID Project Completion Report
• General Report assessing progress and achievements, summarising lessons learned, and listing recommendations for Phase II
• Draft review of the new JFA document for Phase II and debriefing session with all JFA partners

Futures Group is part of a consortium led by GFA Consulting Group that is providing state-of-the-art support on HIV prevention and control measures to the Programme Executing Agencies at the Health and Finance Bureaus in Henan and Yunnan Provinces. Futures Group provides specific input on planning and scheduling; human resources; training; information; education and behaviour change communication measures; harm reduction; and reporting between the provincial health bureaus, the national government and KfW.

Outputs

• Ongoing reporting on HIV prevention and control at the provincial level
• Strengthened harm reduction interventions
• Strengthened HIV prevention measures for commercial sex workers, males who have sex with males, floating populations and other high-risk groups
• More effective mass media campaigns developed and implemented at the provincial level
• The establishment and utilisation of a common M&E strategy and framework

Futures Group is leading a support team that is providing technical assistance (TA) and management support to the National AIDS Control Organisation (NACO) and State AIDS Prevention and Control Societies (SACS) in India. The TA focuses on strengthening capacity of NACO and SACSs, facilitating policy formulation, and guiding implementation in three core areas: harm reduction and opioid substitution therapy (OST) for injecting drug users (IDUs); males who have sex with males and transgender interventions; and research capacity. This support is enabling an effective decentralised response to HIV and AIDS that is focused on vulnerable groups and context-specific needs.

Outputs

• Mid-term evaluation and development of reports
• Scale-up of harm reduction and OST interventions for IDU
• Scale-up of interventions for males who have sex with males and transgenders
• Flexible funding mechanisms implemented
• Research capacity of NACO strengthened
• Overall institutional capacity of NACO strengthened

In concert with our colleagues and friends around the world, Futures Group recognizes World AIDS Day on December 1, 2009.  UNAIDS estimates there are now 33.4 million people living with HIV around the world.  In 2008, 2.8 million people became infected with the virus, and 2 million people died from AIDS.  Futures Group aims to increase access for all to prevention, treatment, care, and support because we believe this access is a fundamental human right.  In support of the theme Universal Access & Human Rights, read highlights from a few of our projects around the world and how we are helping to make this a reality.

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Futures Group Europe: Support for Collaboration Between Government and Civil Society: The Twin Track Approach to Strengthening the National Response to HIV and AIDS in Kenya

As part of our continuing series of Briefing Papers on the work we do for DFID and the EC we presented a summary of our best practice approach of capacity building at both the national government level and the community level.  Only by bringing these two elements together (along with the private sector) can meaningful progress be made in evidence-based policies and programs to slow the spread and impact of HIV and AIDS.

Click here for the full report.

For more information: info@futuresgroup.com

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Communications for Behavior Change: Expanding Access to Private Sector Products and Services in Afghanistan (COMPRI-A)

Futures Group’s commitment to universal access to HIV services is evident in our work in Afghanistan.  The COMPRI-A project is working closely with the National AIDS Control Program in Afghanistan to produce World AIDS Day events aimed at raising awareness and reducing stigma at both the national and provincial levels.  At these events, IEC and BCC materials will be distributed to key HIV stakeholders and the media in seven provinces, and the Minister of Public Health will deliver a speech at the main event in Kabul.  In addition, a series of television clips on HIV has been developed and will be nationally broadcast.  These clips will feature national figures, such as the Minister of Public Health and the Minister of Women’s Affairs, stating that fighting HIV is a national responsibility.  Under the COMPRI-A project, Futures Group is also establishing male health clinics in Kabul and Mazar-I-Sharif that will offer a range of STI and HIV services and health information, with the ultimate goal of improving access for the men who have sex with men (MSM) population.

For more information: info@futuresgroup.com

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Health Policy Initiative: Workshop for Healthcare Providers in the Middle East and North Africa Region on HIV-Related Stigma and Discrimination

In the Middle East and North Africa (MENA) region, HIV remains a neglected and complex challenge. This is partially due to the lack of proper monitoring and evaluation practices in the region. For example, available regional data show a wide range of prevalence estimates (see Box 1).

High-risk factors, including conflict, gender disparity, poverty, mobility, weak governance, and a dearth of information, education, and communication about HIV, have created an environment where HIV is increasing both rapidly and silently among the many “loud emergencies” in the region.

However, progress is being made to engage people living with HIV (PLHIV) in the HIV response—and not just as beneficiaries of services or sources of testimonials to break the silence surrounding HIV. USAID’s Asia and Middle East (AME) Bureau, through the POLICY Project, established a MENA Leadership Initiative, which continues to be successful in engaging PLHIV as leaders. The USAID | Health Policy Initiative now implements the leadership initiative with partial support from USAID core funding and in collaboration with UNDP’s HIV/AIDS Regional Program in the Arab States (UNDP/HARPAS), UNAIDS, the Global Network of People Living with HIV and AIDS (GNP+), the International Community of Women Living with HIV and AIDS (ICW), Association Tunisienne de Lutte Contre les Maladies Sexuellement Transmissibles et le SIDA (ATL), and Freedom Center, Egypt/MENA.

Furthermore, a lack of awareness and accurate, high-quality information on HIV has led to myths and misinformation that create high levels of stigma and discrimination, even among healthcare providers. In order to address these concerns and create awareness, the Health Policy Initiative will partner with the Association Marocaine de Solidarité et Développement (AMSED) to implement a five-day workshop that focuses on the various forms of stigma and discrimination in healthcare settings.  The workshop will include activities and presentations based on participant feedback including: drivers of stigma and discrimination; stigma and discrimination in the healthcare setting; the impact of HIV and stigma in personal and professional lives; counseling and testing; ethical issues related to stigma and discrimination; clinical discussions related to HIV including current trends and question/answer sessions; and next steps and action plans to create change among peers.

The overall goal of the workshop is to empower a cadre of trained healthcare providers and PLHIV to reduce HIV-related stigma and discrimination among their peers.  Specific objectives of the workshop include:

• To raise awareness about stigma and discrimination within the healthcare sector;
• To provide an opportunity for PLHIV leaders and healthcare providers to learn and work together to reduce stigma and discrimination in their countries and region;
• To provide an opportunity for healthcare providers from the MENA region to learn about the latest clinical advances in HIV related to treatment, PMTCT, co-infection, and other context-specific information based on participant feedback; and
• To develop a stigma and discrimination curriculum for healthcare settings, specific to the needs and issues in the MENA region.

The workshop will take place December 7^th-11^th, 2009. The participants will consist of 15 PLHIV and 15 physicians from the MENA region.

For more information: info@futuresgroup.com

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Establishing Technical Support Units for HIV Prevention and Care programs in China – including an MSM Framework and Shenzhen Risk Analysis

In support of China’s national medium-to-long-term HIV and AIDS Plan, with funding from DFID, Futures Group has established a technical support unit (TSU) in collaboration with Family Health International and the British Council. The overall objective of the TSU is to develop China’s capacity to provide effective technical assistance (TA) to HIV prevention and care programs, and particularly, the Global Fund program. Specifically, Futures Group is providing strategic information training and TA to enhance the quality and reach of the government’s response to HIV/AIDS; improving the quality of interventions for drug users, sex workers, clients of sex workers, and men who have sex with men; and providing targeted TA to the State Council AIDS Working Committee to improve its support for national and provincial M&E, policy development, planning, and coordination.

For a related report click here.

For more information: info@futuresgroup.com

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MEASURE Evaluation:  MSM Risk Assessment in Rwanda

Under the MEASURE Evaluation project, Futures Group carried out a behavioral surveillance study (BSS) of MSM in Kigali in 2008–09, in collaboration with the Rwandan Ministry of Health and UNAIDS.

Rwanda has responded strongly to HIV, but prevention among MSM has not yet been addressed due to a strong cultural resistance to homosexuality, and a lack of data showing the public health value of attending to the sexual health needs of this group. Futures Group conducted an exploratory study on HIV risk among MSM in Kigali using snowball sampling involving peer leaders. The aim of this study was to describe the population of MSM in Kigali and explore the nature of sexual activity between MSM. The 98 respondents were demographically, socially, and sexually diverse. Respondents reported relatively high numbers of both male and female partners, and considerable HIV risk behaviors, including commercial sex with men and women, low condom use during both anal and vaginal sex, high mobility, and considerable alcohol use. Many respondents reported verbal and/or physical abuse due to their sexuality. Although findings portray a concerning picture of HIV risk, this study is a first step to shaping the HIV response for MSM in Kigali.

The full study report is available here.

For more information: info@futuresgroup.com

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MEASURE Evaluation: HIV Impact Analyses in Nigeria

Under the USAID-funded DATE project, Futures Group is conducting an impact assessment of HIV sexual prevention programming in Nigeria using data triangulation methodology. Project objectives include:

• To synthesize and triangulate data to inform recommendations for Nigeria’s HIV sexual transmission prevention priorities and, particularly, the PEPFAR program areas related to Abstinence & Be Faithful and Condoms & Other Prevention;
• To better understand unmet need and under-served populations, as well as data gaps related to sexual prevention programming; and
• To build capacity in triangulation and data use among key stakeholders, including the Government of Nigeria.

DATE (Data Analysis and Triangulation for Evaluation) is a one year USAID funded project under the USAID/SEARCH IQC (Supporting Evaluation and Research to Combat HIV/AIDS).

DATE is led by Futures Group, in partnership with the Nigerian Association for Reproductive and Family Health (ARFH) and University of California, San Francisco. More information about this project is available on the SEARCH IQC webpage: http://www.projectsearchiqc.com/

For more information: info@futuresgroup.com

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Health Policy Initiative: The GOALS Model

Background:  Models for Strategic Planning

Futures Group has created several models that help program planners and policymakers estimate the resources needed to achieve their goals. The models can help answer key questions, including:

• How much funding is required to achieve the goals stated in a strategic plan?
• What goals can be achieved with the resources currently available?
• How would various resource allocation patterns affect the achievement of program goals?

Using the Goals Model to Enhance National HIV Responses

The Goals Model is a powerful tool that helps strengthen national HIV responses by showing how the amount and allocation of funding is related to the achievement of national goals, such as the reduction of HIV prevalence and expansion of treatment, care, and support. Goals brings together information on costs and program impacts and relates it to overall trends in countries’ HIV epidemics. The Goals Model is composed of the Resource Needs and Capacity Modules, which are used to estimate the resources required to implement specific interventions and the associated human resources and training costs.

The Goals Model has the greatest impact when it is used at key points in the strategic planning process, such as during the drafting or revision of National HIV/AIDS Strategic Plans. It can help policymakers make better choices about how to balance prevention, care and treatment, and impact mitigation needs. This is particularly important given the global economic downturn, which can be expected to increase competition for resources in coming years.

While models do not provide all the answers, by helping policymakers and advocates understand the program impact of different funding levels and allocation patterns, they can help promote more effective, evidence-based responses to the HIV epidemic.

The Goals Model software and user manual can be downloaded here.

To find out more about how the Goals Model has been used to support countries’ HIV responses, see the links below:

In Ghana, the Goals Model was applied to help set priorities for high-risk populations and for the development of the annual program of work over the life span of the National Strategic Framework 2006-2010 (NSF-II).

In Namibia, the Goals Model was used to provide a detailed costing of the National Strategic Plan on HIV/AIDS (2004-2009): Third Medium-Term Plan, (MTP III) and to outline different resource allocation scenarios to help policymakers make strategic planning decisions.

Futures used the Goal Model to help Kenya cost its National Health Sector Strategic Plan (2005-2010).

In partnership with ASEAN (Association of Southeast Asian Nations), the Resource Needs Module was used to develop detailed assessments of the potential impacts of the HIV epidemic in seven ASEAN countries—Cambodia, Lao PDR, Indonesia, Malaysia, Philippines, Thailand, and Vietnam—as well as the resources required to ramp up these countries’ HIV responses. The resulting documents have been used as advocacy tools to foster dialogue and political leadership to strengthen the HIV response in Southeast Asia. Socioeconomic Impacts of and Resource Requirements for HIV and AIDS (Full Report) (Brief)

In Vietnam, the Goals Model was used to assess the likely future course of the HIV epidemic and the cost effectiveness and implications of four different intervention scenarios. Combining Epidemiology and Economic Analysis to Inform the Response to the HIV Epidemic in Ho Chi Minh City (Full Report); The HIV Epidemic in Ho Chi Minh City: Costs of Things to Come (Brief)

For more information: info@futuresgroup.com

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Health Policy Initiative: Integrating Reproductive and Child Health (RCH) and HIV in Northern India

India has the third largest number of PLHIV and one of the highest fertility rates in the world. In keeping with the global shift toward a health systems approach to address HIV, India has taken initial steps for RCH/HIV integration. Toward this end, pilot projects have been undertaken in the country. However, no efforts have, thus far, been made in the North Indian states where institutional deliveries are very low and the HIV epidemic is growing. Contributing toward the achievement of the integration goal of the National AIDS Control Program (NACP) III, the USAID | Health Policy Initiative is working with the Uttar Pradesh State AIDS Control Society (UPSACS) to develop a suitable model for integrating HIV and RCH services for the state, the first time ever in a Northern state in the country. The state has a low HIV prevalence rate, but is highly vulnerable to the further spread of HIV. It is expected that the integration would help in optimal utilization of resources and provision of seamless services to the end users. It will also help ensure long-term sustainability of HIV interventions within the framework of the National Rural Health Mission (NRHM), a government of India program for strengthening health systems and services.

Currently, the USAID | Health Policy Initiative is undertaking an extensive literature review of the best practices on integration internationally and nationally to bring research findings to the discussion table. It is documenting the national best practice model in Karnataka, which has achieved significant results in terms of increase in pregnant women registering at antenatal clinics, pre- and post-test counseling, spouse testing, and mother-baby pairs on Nevirapine. The documentation brings understanding and clarity on the key process and systems involved. In addition, a Task Force for integration is being set up in Uttar Pradesh that will use the learning from Karnataka and other best practices compiled by the project to prepare a model and operational guidelines for RCH/HIV integration in the state.  The RCH/HIV integration model, once developed and operationalized, will contribute toward prevention of parent-to-child transmission of HIV; increase in uptake of counseling and testing services which will lead to increase in pre-ART registration; reduction in loss to follow-up cases; and improved coverage of pregnant mothers for counseling and testing.

For more information: info@futuresgroup.com

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Health Policy Initiative: Citizen Monitoring in Vietnam and Mali

Futures Group, through its work on the USAID | Health Policy Initiative, has been active in developing a model of citizen monitoring of health services. In Vietnam and in Mali, the project has been working with the national networks of PLHIV to develop a means of collecting and analyzing data from the consumers’ point of view.  In both cases, the work has focused on quality of health services for PLHIV along with analysis of the role of PLHIV in policy dialogue and decisionmaking.

This work is part of the development of good governance structures and is a vital link to better accountability in HIV services. It provides a missing link in the communication of services via an appreciation of the recipient’s perspective in national and local policy dialogue. It also provides an opportunity for the development of capacities so that representatives of PLHIV organizations build their advocacy and negotiation platforms based on evidence.

For more information: info@futuresgroup.com

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Health Policy Initiative: PLHIV Networking and Positive Prevention

Two crucial aspects of improving HIV prevention efforts in a move toward more coherent combined interventions are the development of social capital of PLHIV and facilitation of a process for PLHIV organizations to work much more closely with service providers in education outreach, adherence support, service referrals, peer support, and policy dialogue. Futures Group, through its work on the USAID | Health Policy Initiative, has provided technical assistance to PLHIV networks to strengthen their organizational development and build skills of members in order to enhance their “social capital” (defined as involvement in social dialogue and decisionmaking and gaining stronger influence in decisions affecting their lives).

Part of this work has been facilitating discussions within international networks of PLHIV concerning the development of a theoretical framework of “positive prevention” from the point of view of PLHIV. Positive prevention is a term that is used by many persons to mean many things. PLHIV organizations, however, use the term to refer to issues of quality of life through the development of quality of care and improved self-worth. By addressing quality of life issues from a broader perspective, a more sustained response to prevention of illness and of transmission of HIV can be accomplished.

For more information: info@futuresgroup.com

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Health Policy Initiative: Supporting UNAIDS in Addressing Structural Issues

Futures Group has been collaborating with UNAIDS and its cosponsors in the development of improved responses to structural issues related to most-at-risk populations. In southern and eastern Africa, the USAID | Health Policy Initiative has collaborated closely with the Technical Support Facilities (TSF) of UNAIDS to build capacities related to costing – a vital factor in improved national responses.

In the Latin America and Caribbean region, Futures Group has supported UNAIDS and UNDP in the development of a strategic framework for improved national responses to gay men, other MSM, and transgenders in concentrated epidemics. Through its work in Health Policy Initiative, Futures Group has collaborated with UNAIDS and the National Institute of Public Health of Mexico to build capacities of health professionals and representatives of civil society from throughout the region.

For more information: info@futuresgroup.com

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Futures Group embraces the global struggle against HIV and AIDS and opportunities to work with individuals, coalitions and partner organizations to raise awareness and set high, achievable goals for the international development community.  In recognition of World AIDS Day 2009, Futures Group is proud to support the World AIDS Day Community Statement and the World AIDS Day Communiqué on HIV/AIDS Sector Capacity Building.

For more information on how Futures Group is helping to increase access to HIV prevention, treatment, care, and support, go to www.futuresgroup.com or email info@futuresgroup.com.

Futures Group FP Conference Sessions.

Sex and sexuality in the Shenzhen tongzhi circle: HIV risk context and migrant men who have sex with men in China