69627 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment Usha Vatsia World Bank, HNP Unit, Human Development Network July 8, 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 2 Contents 1. Introduction .............................................................................................................................. 3 Rapid literature search ........................................................................................................ 3 Interviews with Bank staff .................................................................................................. 3 Meetings with Interagency Partners ................................................................................. 3 2. The State of SRH and HIV Linkages ................................................................................... 4 International Commitment & Action ......................................................................................... 4 Global Funding ........................................................................................................................... 5 Bank Efforts to Date .................................................................................................................... 6 3. Potential opportunities to engage ........................................................................................ 7 External to the Bank ................................................................................................................... 7 Global Leadership................................................................................................................ 7 Interagency Working Group .............................................................................................. 7 Within the World Bank ............................................................................................................... 8 HNP ....................................................................................................................................... 8 Global HIV/AIDS Program................................................................................................. 8 The Regions .......................................................................................................................... 9 Annex 1. Rapid Literature Search ........................................................................................... 10 Annex 2. Bank SRH-HIV/AIDS Linkages Experience Matrix .......................................... 17 Annex 3. Major Organizations Working on SRH-HIV Linkages ..................................... 22 Annex 4. FP-HIV Integration Interagency Working Group: Organizations and Experts ....................................................................................................................................................... 23 Annex 5. Family Planning/HIV Interagency Working Group, October 2008 Meeting 28 World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 3 1. Introduction This World Bank commissioned report (June 2008) is an assessment of the state of SRH and HIV/AIDS linkages with the objective of providing preliminary information and recommendations on which to base future Hub efforts on this initiative. Derived from a brief review of recently published and gray literature, key Bank staff interviews, and meetings with interagency partners between May 15 and June 25, 2008, this report summarizes the major findings and potential opportunities for the HNP Unit to strengthen and promote synergies between SRH and HIV/AIDS. Rapid literature search A rapid search of literature was conducted using Google Scholar and specific websites, i.e., www.HIVandSRH.org, WHO, for articles published since the 2006 international conference in Addis Ababa, Ethiopia, and documents shared by Bank staff. 60 documents were gathered through this search. Over a third of the documents relate to health systems strengthening and financing, and policy or advocacy, and almost a third relate to meeting the needs of specific demographic groups, i.e., youth, orphans and vulnerable children (OVC), and people living with HIV/AIDS (PLWHA). Thirteen of these documents relate to service integration, and three provide guidance or recommendations to specific organizations on integration. The needs of women and girls were noted to be a cross-cutting theme in many of these documents. The bulk of literature provided by Bank staff relate to HIV/AIDS program experience, two address SRH and HIV integration in strategy documents (HNP and ActAfrica), two are external interagency documents for activities which Bank staff provided technical input, and one report documents SRH/HIV linkages in three countries. The complete list of literature from this search can be found in Annex 1. Interviews with Bank staff Background meetings and interviews were conducted with available Bank staff in the Hub, the Global HIV/AIDS Program, and the Regions to gather relevant information for this assignment. Given the brevity of time and staff travel schedules, the interviews conducted in this short period were fewer than ideal. Nevertheless, the interviews conducted were informative. Some of the meetings yielded additional documents for review and are included in Annex 1, though most were not found to relate directly to SRH and HIV linkages. Annex 2 contains a matrix of the Bank’s experience captured in these interviews. Meetings with Interagency Partners Meetings were held with partners working on the Family Planning and HIV/AIDS Integration Interagency Working Group (IWG) to gather information on the group’s current agenda, World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 4 primarily with USAID’s focal points and FHI. These meetings have been vital in gaining access to important information, such as the ongoing Cochrane review on SRH and HIV/AIDS linkages. The scope of the Hub’s rapid literature search, discussed earlier, was adapted as a result of this new information. In addition, HNP became a part of the IWG’s preparatory panels to review current evidence on which it will base its technical recommendations in an upcoming workshop in October described in detail in the next chapter. 2. The State of SRH and HIV Linkages International Commitment & Action The international community has evolved in its understanding of SRH and HIV linkages since the 1994 International Conference on Population and Development (ICPD), and in the last two years made a clear statement as the relevance and importance of linking HIV and SRH: for the good of the individuals most impacted—women, girls, and PLWHAS; and for the cost- effectiveness of programs. In September 1994, the ICPD established that the effective prevention and treatment of sexually transmitted diseases, including HIV, is an integral part of reproductive health services. 1 Almost ten years later, the Glion Call to Action in May 3-5, 20042, and the New York Call to Commitment on June 4, 20043 issued policy statements confirming the international community’s commitment to intensifying the linkages between SRH and HIV/AIDS. In 2005, UNAIDS put forth a policy position paper, “Intensifying HIV Prevention� 4 , which highlighted the urgency to scale up efforts to prevent HIV in order to reverse the epidemic by forging links with other programs and services including SRH since the majority of HIV infections are sexually transmitted or are associated with pregnancy, childbirth, and breastfeeding.5 Furthermore, the paper identifies some of the same common root causes, i.e., 1WHO/HIV/2005.05: WHO/UNFPA/UNAIDS/IPPF. Sexual and Reproductive Health and HIV/AIDS: A Framework for Priority Linkages, October 2005. Available at: http://www.who.int/hiv/pub/prev_care/A%20Framework%20for%20Priority%20Linkages%20FINAL.pdf 2WHO, The Glion Call to Action on Family Planning and HIV/AIDS in Women and Children, May 3-5, 2004. Available at: http://www.who.int/reproductive-health/stis/docs/glion_cal_to_action.pdf 3UNFPA, The New York Call to Commitment: Linking HIV/AIDS and Sexual and Reproductive Health, June 4, 2004 Meeting, Rockefeller Foundation, New York, NY, 2004. Available at: http://www.unfpa.org/upload/lib_pub_file/321_filename_New%20York%20Call%20to%20Commitment.pdf 4UNAIDS, Intensifying HIV Prevention: A UNAIDS Position Paper, 2005. Available at: http://data.unaids.org/publications/irc-pub06/jc1165-intensif_hiv-newstyle_en.pdf 5 WHO/HIV/2005.05, October 2005. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 5 gender inequity, poverty, and social marginalization of the most vulnerable populations and groups. By strengthening links between HIV and SRH programs and services, and by putting special effort into reaching people excluded from access to health and other services, the paper asserts that the result would be more relevant, cost-effective, and impactful programs. Since 2006, there have been two major international consultations to share the evidence on linking SRH and HIV to inform program and policy development in Africa and South Asia. There was also a landmark global consultation on SRH and Rights of PLWHA held in Amsterdam in December 2007 sponsored by EngenderHealth, IPPF, UNAIDS, UNFPA, and WHO. During this meeting, an international group of 65 HIV-positive women, men, young people, and transgender individuals articulated a vision statement to guide advocacy, policy, programs, and funding priorities that respect their basic SRH rights and wishes, emphasizing the need for health systems to do the same. 6 In 2008, a Family Planning/HIV Interagency Working Group (IWG) has been actively working on building this evidence on integrating three specific service areas with family planning: counseling and testing, preventing mother to child transmission (PMTCT), and, care and treatment. This IWG will convene a workshop this coming October, to be chaired by WHO, where 50 FP and HIV technical experts from donors, NGOs, local governments, and PLWHAs will review what is known about FP/HIV integration, and develop technical recommendations for field programs integrating FP and HIV. To prepare for this meeting, technical expert panels have been formed to review the literature for each of the three intervention areas. The panels will draft technical recommendations to be considered, amended, and finalized at the October meeting. Annex 5 contains more information about this workshop and the literature reviews being conducted by the panels. The upcoming August 2008 International AIDS Conference in Mexico City has included sessions and workshops which link SRH and HIV, such as addressing challenges for girls and women, in relation to SRH rights, PLWHAs, fertility, and Global Fund proposals, to name a few examples. Global Funding The current global health funding climate has led to heightened concerns that HIV/AIDS, and other disease-focused funding is eclipsing funding for other areas of health, including for sexual and reproductive health. As a major donor of HIV/AIDS programs, the USG’s funding limitations, ideologically rather than evidence-based, has crippled the ability of organizations to develop effective and appropriate responses to the epidemic on the ground. These funding patterns have weakened healthcare infrastructure as a whole, as influenced by the movement of workers to better-resourced programs. 6 WHO, Landmark Global Consultation on Sexual and Reproductive Health and Rights of People Living with HIV, 2007. Available at: http://www.who.int/reproductive-health/hiv/jointannouncment_srh_plhiv.pdf World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 6 At the writing of this report, the proposed US budget is still expansive for HIV/AIDS and malaria initiatives. Counter to that expansion, the US commitment to core programs and services focused on women and children continue to lag without legitimate justification. 7 Uncertainty in the global health funding environment remains, particularly in light of the upcoming US elections, the war-on-terror related commitments, and the troubled US economy. The one bright light in this scenario appears to be the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) which recently accepted proposals that contain sexual and reproductive health and HIV/AIDS integration services. Bank Efforts to Date Efforts to integrate SRH and HIV/AIDS on Bank projects have been limited to date. In the past year, Africa is the only region (Act Africa) that has been consciously building linkages experience, i.e., in Ethiopia, which it is in the process of finalizing its documentation of lessons learned. Several regions were not interviewed during this brief period (ECA, LAC, SAR), which might have missed integration related activities in those regions. HNP recently completed documenting three country case studies from Malawi, Niger, and India. In May 2008, HNP joined the Family Planning (FP)/HIV Interagency Working Group (IWG) that is working on building the technical aspects of FP/HIV integration, and is serving on a counseling and testing technical panel which will be used in the October 2008 workshop mentioned earlier in this section. 7Global Health Council, Analysis of the President’s FY09 Budget Request for Global Health, Public Policy Update, Global Health Link, April 2008 Issue #148. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 7 3. Potential opportunities to engage External to the Bank Global Leadership Given the growth in momentum and international consensus to link SRH and HIV/AIDS, the current funding environment and related complications of current USG policies, this is a critical time for the World Bank to take on a larger leadership role in filling the gaps that emerged in this analysis. In particular, it should consider focusing its efforts on promoting and building the evidence-base for:  the prevention agenda;  SRH rights of PLWHA, women, and girls8;  health systems strengthening for SRH-HIV integration (from policy level to community level service delivery) In order to be effective in this global technical leadership role, the Hub would also need to galvanize colleagues in GHAP, including GAMET and ASAP, and in the Regions to develop and contribute to a common agenda to share its experience with the international community. Interagency Working Group There are several meetings in the next several months where HNP could continue making a significant contribution to the FP/HIV IWG, including: panels activities to review the literature and draft technical recommendations on FP and counseling and testing integration from July to September in Washington, DC and Mexico City during the International AIDS Conference (IAC); finalizing technical recommendations in October 21-22 workshop; and a follow-on donor’s meeting on October 23, the latter two of which will be held in Washington, DC. HNP might consider continuing to contribute to the IWG in the future to share Bank experience with international partners working on this critical area. A complete list of people and organizations involved in the Family Planning/HIV IWG is contained in Annex 4. 8 Pursuing the needs of women and girls is not meant to imply that men and boys should be ignored as effective male engagement and participation is now recognized to be an essential strategy for empowering women and girls in improving their sexual and reproductive health. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 8 Within the World Bank HNP HNP may consider actively engaging all relevant teams within the Hub to ensure that the SRH- HIV/AIDS Linkages initiative is appropriately incorporated into current and future Hub activities, such as the health systems strengthening study. By the same token, it may explore how the initiative might be added into other PopRH projects to maximize the results of each work program. Hub colleagues could be invited to attend presentations SRH and HIV integration, such as the August 20, 2008 meeting planned with FHI, to gain a better understanding of the importance of this area to the Hub’s work and to the progress made in international commitments in the HIV and SRH community. Global HIV/AIDS Program Before starting any integration work together, HNP might need to orient GHAP colleagues on SRH and its relationship to HIV/AIDS, and GHAP might be asked to brief the Hub on current related issues from its perspective. Doing so will help both teams better understand the rationale and benefits of integration. As mentioned in the last Chapter, there is no apparent conscious effort to integrate SRH into HIV/AIDS programs. Nonetheless, when presented with the opportunity, there was expressed interest in GHAP in collaborating on cost-effectiveness studies and in developing practical tools. Another potential area to partner is with the Global AIDS Monitoring and Evaluation Team (GAMET), which works closely with UNAIDS and other global partners such as other UN agencies, bilateral donors, and the Global Fund to Fight AIDS, Tuberculosis and Malaria, is the identification, development, and testing of integration measures or indicators. To facilitate related knowledge sharing and product development in the Bank, the Hub could form an Intraagency (World Bank) SRH/HIV/AIDS Linkages Working Group that could be formed as a sub-group of the PRH Thematic Group, to engage and build awareness on the importance of integrating SRH and HIV with GHAP and the Regions. This IWG could be initiated in partnership with GHAP to create a technical balance to the proposed working group. The SRH and HIV focal points could be invited to participate in this IWG and plan joint activities based on shared goals. HNP might facilitate GHAP’s invitation to the FP/HIV/AIDS Integration Interagency Working Group (IWG) based on its expressed interest in joining this activity. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 9 The Regions All but one of the regions interviewed report having no experience with integrated programs in their countries. Africa is the only region (Act Africa) that has linkages experience, i.e., in Ethiopia, which it is in the process of finalizing its lessons learned; HNP could follow up to request a copy of this report and attend briefings on it, if any are planned. Although there was no need for technical assistance expressed at the time, the region might be asked if they have any needs that became more apparent as a result of their lessons learned from Ethiopia. ActAfrica is likely to develop knowledge products in the coming year, which might be an area for collaboration. It also plans to start attending the interagency working groups on integration, which it attended in the past. HNP is already collaborating with ActAfrica in inviting FHI to share lessons learned from its recently conducted five-country assessment in a meeting planned for August 20th this year. East Asia and Pacific (EASHD) region assisted in developing a small communications piece for a SRH and HIV education project for the transport sector in China, and conducted a biobehavioral study in Papua, Indonesia. They have plans to conduct a behavioral survey in PNG. Although the region did not have any current technical assistance needs, it may in a couple of years to follow up to the work in Papua. Middle East & North Africa (MENA) region has a possibility to develop an integrated health and HIV/AIDS program in Djibouti where there might be an opportunity to provide technical assistance. This region has no other current needs, but is more open to SRH than HIV due to the conservative nature of the societies in the countries in works with. Most regions seemed not to completely understand SRH and how it might be integrated into HIV/AIDS. The Regions could be invited to join the PRH Thematic Group, which will be re- activated, to develop a common agenda on integration, i.e., building the technical knowledge within the Bank, share experience, and create practical tools. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 10 Annex 1. Rapid Literature Search 1. Adair, T, Desire for Children and Unmet Need for Contraception among HIV-Positive Women in Lesotho, DHS Working Papers, Macro International, Inc., March 2007. 2. Askew, I, Berer, M, The Contribution of Sexual and Reproductive Health Services to the Fight against HIV/AIDS: A Review, Reproductive Health Matters 2003; 11 (22):51-73. http://www.jstor.org/stable/pdfplus/3776046.pdf 3. Bates, N, Policy Updates: Significant Changes Expected for Global Health Programs Funding in FY 2007, Global Health Link, August-September 2006 Issue 140. 4. Bearinger, LH, Sieving, RE, Ferguson, J, Sharma, V. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential, The Lancet, Vol. 369, April 7, 2007. http://conf2007.womendeliver.org/youth/pdf/9_global_Perspectives.pdf 5. Bell, E, Mthembu, P, O’Sullivan, S, Moody, K. Sexual and Reproductive Health Services and HIV Testing: Perspectives and Experiences of Women and Men Living with HIV and AIDS, Reproductive Health Matters, 2007. http://www.who.int/reproductive- health/hiv/rhmarticles/perspectives.pdf 6. Bell E; Perchal P, Sexual and reproductive health for HIV-positive women and adolescent girls: manual for trainers and programme managers, New York, New York, EngenderHealth, 2006. [235] p. http://www.engenderhealth.org/files/pubs/hiv-aids- stis/SRH_for_HIV_Positive_Women_English.pdf 7. Daly, M. F. Schechtman, L, SHADOW REPORT Review of Country Coordinating Mechanism Proposals with SRH-HIV/AIDS Integration Submitted to the Global Fund Round 7, Global AIDS Alliance, 24 August 2007. 8. Daulaire, N, Funding Must be Equitable, Letter from the President, Global Health Link, February-March 2007 Issue #143. 9. de Bruyn, M. 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UNICEF/WHO, PMTCT High-Level Global Partners Forum Meeting Report, November 6-27, 2007. 47. USAID, Family Planning/HIV Integration: Technical Guidance for USAID-Supported Field Programs, 2003 http://www.usaid.gov/our_work/global_health/pop/publications/docs/fphiv.pdf 48. USAID, Meeting Agenda, Interagency Youth Working Group, December 6, 2007. http://www.infoforhealth.org/youthwg/iywg/6Dec07.shtml 49. WHO, The Glion Call to Action on Family Planning and HIV/AIDS in Women and Children, May 3-5, 2004. Available at: http://www.who.int/reproductive- health/stis/docs/glion_cal_to_action.pdf 50. WHO/HIV/2005.05: WHO/UNFPA/UNAIDS/IPPF. Sexual and Reproductive Health and HIV/AIDS: A Framework for Priority Linkages, October 2005. Available at: http://www.who.int/hiv/pub/prev_care/A%20Framework%20for%20Priority%20Linkage s%20FINAL.pdf 51. WHO, Guidance On Global Scale-Up Of The Prevention Of Mother To Child Transmission of HIV: Towards Universal Access For Women, Infants and Young Children and Eliminating HIV and AIDS Among Children, Inter-Agency Task Team on Prevention of HIV Infection in Pregnant Women, Mothers and Their Children, 2007. 52. WHO, Landmark Global Consultation on Sexual and Reproductive Health and Rights of People Living with HIV, 2007. Available at: http://www.who.int/reproductive- health/hiv/jointannouncment_srh_plhiv.pdf 53. WHO, Asia-Pacific Operational Framework for Linking HIV/STI Services with Reproductive, Adolescent, Maternal, Newborn and Child Health Services, March 2008. http://www.wpro.who.int/NR/rdonlyres/DB0EB0E3-3AB5-4667-ACD9- E8C5DAEA53FC/0/HSI_LinkingHIVServices_March2008_FINAL.pdf 54. Wittenberg J; Munthali A; Moore A; Zulu E; Madise N, Protecting the next generation in Malawi: new evidence on adolescent sexual and reproductive health needs, New York, New York, Guttmacher Institute, 2007. 48 p. http://www.guttmacher.org/pubs/2007/12/10/PNG_Malawi.pdf 55. World Bank, Health Development: The World Bank Strategy for Health, Nutrition, & Population Results, 2007. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 16 http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources /281627-1154048816360/HNPStrategyFinalTextAnnexes.pdf 56. World Bank, Getting Results, Combating HIV in the East Asia and Pacific Region Transport Sector: Success on the Road in China East Asia and Pacific Region Transport Sector and Human Development, Global HIV/AIDS Program, November 2007. 57. World Bank, Getting Results, Risk Behavior and HIV Prevalence in Tanah Papua, Indonesia, Results of Integrated Biological and Behavioral Surveillance Among the General Population in Tanah Papua, Global HIV/AIDS Program, November 2007. 58. World Bank, HIV/AIDS Brief, East Asia and Pacific Region, Gray literature, World February 2008. 59. World Bank, The World Bank’s Commitment to HIV/AIDS in Africa: Our Agenda for Action, 2007-2011, March 2008. http://siteresources.worldbank.org/INTAFRREGTOPHIVAIDS/Resources/WB_HIV- AIDS-AFA_2007-2011_Advance_Copy.pdf 60. World Bank/HNP, HIV/AIDS and Sexual Reproductive Health Linkages: Case studies in Niger, Malawi, and one Indian State – Rajasthan, 2008. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 17 Annex 2. Bank SRH-HIV/AIDS Linkages Experience Matrix Unit Experience/Plans Cost-effectiveness Technical Assistance Shared documents Other studies Needs Identified GHAP –  GHAP serves on an No  Private sector 2 documents shared:  GHAP is interested Robert Oelrichs Interagency Task involvement in STI 1)PMTCT High-Level in working on the Team (IATT) for treatment Global Partners Forum FP-HIV Integration PMTCT. (Cambodia) Meeting Report, Nov. IWG and the  GHAP has 2007, and 2) WHO, Cochrane Review. conducted a Guidance on global  GHAP is also technical review scale-up of the interested in mission in prevention of mother to collaborating on Cambodia with this child transmission of conducting studies group. HIV: towards universal or in developing  No experience with access for women, toolkits for this on Bank infants and young integration. projects. children and eliminating HIV and AIDS among children / Inter-Agency Task Team on Prevention of HIV Infection in Pregnant Women, Mothers and their Children, 2007. GHAP – No experience with this ------ ------ None Asked if IPPF and Janet Leno, ASAP area on Bank projects. UNFPA is involved in the IWG GHAP – GAMET, Overall comment based They are looking at cost- Yes definitely so. She Marelize Görgens- Marelize Gorgens- on experience with non- effectiveness in China recommended the Albino ... [et al.], The Albino Bank work: (David Wilson in GHAP following three areas for Africa Multi-country There’s definitely is working on that). technical assistance: AIDS Program, 2000– recognition of the need 2006 : results of the World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 18 Unit Experience/Plans Cost-effectiveness Technical Assistance Shared documents Other studies Needs Identified to integrate. Maybe 1. When we arrive at a World Bank’s response even go back to PHC policy, we must to a development crisis , approach instead of relate it to the other 2007. treating HIV as a policies and not just separate disease. In the leave it on its own. national response, there are some indicators for 2. There’s a need to SRH as well as other link HIV and SRH areas on health. information, not just the policies. In the Bank’s work: For too long, HIV Might need to look at has been on its own. country specific documents to tease out 3. At the field level, this information. what’s needed is For instance, in Rwanda, good practical MAP funds logistics, advice. A which supports the publication series, sector as a whole, not not another set of just HIV. None of the guidelines, because MAP countries seem to there are too many have specific SRH already. Perhaps a programs. set of case studies so there is knowledge sharing between countries and situations. ActAfrica, Africa In FY09, ActAfrica will ----- --------- -------- (AFTHV) – Sangeeta likely take on the Raja following integration activities:  Compendium of World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 19 Unit Experience/Plans Cost-effectiveness Technical Assistance Shared documents Other studies Needs Identified background resources, based on the paper Elizabeth wrote when she was in HNP  Knowledge management (based on FHI's work).  Participation in the Interagency group.  Other activities based on their lessons learned from Ethiopia. East Asia and Pacific HIV TTLs were ------ ------ 4 documents shared: (EASHD) – Reem Hafez canvassed to find none WB docs - Regional HIV currently working no brief, getting results SRH and HIV docs on China and integration. An internal Papua, and Papua regional brief on HIV biobehavioural survey was shared. The region’s primary focus on is on policy analysis/AAA and select lending. The follow-up to the biobehavioral survey done in Papua, Indonesia, may lead to future work in this area but for now there is World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 20 Unit Experience/Plans Cost-effectiveness Technical Assistance Shared documents Other studies Needs Identified nothing planned. The region developed a small journalistic piece (media) on SRH and HIV education in transport sector for China with Fei Deng. There are plans for a behavioral study and lending in PNG in a couple of years. Middle East & North HIV is not a priority for ------- Not right now, perhaps She sent a draft of the Africa (MNSHD) the region. by the end of the chapter on STI Francisca Ayodeji calendar year after the biomarkers they are Akala, Currently, it has one HIV synthesis is using as proxies in this HIV project in Djibouti, completed. study (not for and one study to gather circulation). information on prevalence rates on Lebanon amongst key groups through an IDF grant. Both projects will come to an end soon. In Yemen, there’s a health sector reform project that includes SRH. In addition to the HIV World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 21 Unit Experience/Plans Cost-effectiveness Technical Assistance Shared documents Other studies Needs Identified project, there’s a health project in Djibouti, which is also coming to an end. There’s a possibility that the next health project will be proposed as a single project to include both health and HIV, which may lead be a potential opportunity to integrate HIV and SRH. The region is conducting an HIV synthesis (through a consultant), who is exploring the use of biomarkers for other STIs as proxies, i.e., Herpes Simplex Virus Type 2, HPV and cervical cancer levels, with the hope that the biomarkers will yield useful data for talking to policymakers in the region. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 22 Annex 3. Major Organizations Working on SRH-HIV Linkages The major organizations working on SRH and HIV Linkages include:  Centers for Disease Control (CDC)  Elizabeth Glazer Pediatric AIDS Foundation (EGPAF)  EngenderHealth  Expanding Services Delivery Project, Management Sciences for Health, Pathfinder (USAID)  Family Health International (FHI)  Global Health Fellows Program (GHFP)  ICAP/Rwanda  IPPF  Johns Hopkins  Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (JHUCCP)  Liverpool VCT/SA  Pathfinder  Population Council – Kenya, New York, South Africa  Population Services International (PSI)  United States Agency for International Development (USAID)  World Bank  World Health Organization (WHO)  UNAIDS  UNFPA  University Research Co. (URC) World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 23 Annex 4. FP-HIV Integration Interagency Working Group: Organizations and Experts FP-HIV Integration Working Group Counseling and Testing Panel Organizing CA: PSI Panel Facilitators: Dvora Joseph (PSI) and Alden Dillow (Pathfinder) USG Point Person(s): Alison Surdo, USAID/OHA and Stephanie Behel (CDC) Last Name First Degrees Title Department Organizatio Email Phone City Name n *Abeyta- Mary Sr. Tech. Advisor USAID mabeyta-behnke@usaid.gov 202.712.5849 Washington Behnke Ann Adamchak Susan PhD Scientist Health FHI sadamchak@fhi.org 785.293.5197 Kansas Services Res Axemo Pia Snr Health Spec HDNHE/HN World Bank paxemo@worldbank.org 202.473.2555 Washington (RH) P Askew Ian Sr. Associate Reproductive Pop Council iaskew@popcouncil.org 254.20.27.1.3480 Nairobi, Health Kenya Bradley Heather Johns hbradley@jhsph.edu 202.258.2722 Baltimore Hopkins Behel Stephani MPH Epidemiologist Global AIDS CDC sbehel@cdc.gov 404.639.4700 Altanta e Prog Chowdhur Sadia MD, Sr. Health Reprod Child World Bank schowdhury@worldbank.or Washington y MPH Specialist Health g Dillow Alden MPH HIV/AIDS Techn Serv's Pathfinder adillow@pathfind.org 617.924.7200 x206 Boston Advisor Unit Gillespie Duff PhD Prof and Sr. Johns dgillesp@jhsph.edu 410.502.0696 Baltimore Scholar Hopkins Grant April MPA Intern Office USAID agrant@usaid.gov 202-712-5602 Washington HIV/AIDS Higgins Donna Technical Officer WHO higginsd@sho.int 41.22.791.4557 Geneva Janowitz Barbara PhD Director Health FHI bjanowitz@fhi.org 919.544.7040 Durham, NC Services Res Joseph Dvora MPH Acting Director HIV PSI djoseph@psi.org 202.572.4645 Washington World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 24 FP-HIV Integration Working Group Counseling and Testing Panel Organizing CA: PSI Panel Facilitators: Dvora Joseph (PSI) and Alden Dillow (Pathfinder) USG Point Person(s): Alison Surdo, USAID/OHA and Stephanie Behel (CDC) Last Name First Degrees Title Department Organizatio Email Phone City Name n Department Karklins Sabrina MPA Snr Rsrch Prog Pop/Fam/RH- Johns skarklin@jhsph.edu 410.502.5681 Baltimore Coord BMGI Hopkins Lamprecht Virginia MPH, Sr. Technical Adv. Office of PRH USAID vlamprecht@usaid.gov 202.712.0146 Washington MA Liambila Wilson MSc Program Officer Com Health Population wliambila@popcouncil.org 254.2.2713480.83 Council Menziwa Mantshi MPH Sr. Program Reprod Population mmenziwa@popcouncil.org 27.11.781.7590/759 South Africa Officer Health Council 4 *Neuse Margaret MPH Consultant NA GHFP mneuse@verizon.net 202.237.8934 Washington Obichere Uchechi MSc Program Officer RH/FP ESD (MSH) uobichere@esdproj.org 202.775.1977 x309 Washington Prosser Wendy Technical Advisor PSI WProsser@psi.org.mz Mozambique Surdo Alison MPH Sr. CT Advisor Office USAID asurdo@usaid.gov 202.712.0676 Washington HIV/AIDS Todd Alex Office of PRH USAID atodd@usaid.gov 202.712.1162 Washington Vatsia Usha Consultant HDNHE World Bank vatsiau@hotmail.com 301.580.8015 Washington Wekesa Paul MD,MB Ag Dir. of Services NA Liverpool pwekesa@liverpoolvct.org 254.20.2714590 Kenya A VCT/SA Weis Peter MD, MSc Medical Officer ADGO/FCH WHO weisp@who.int 41.22.791.2965 Geneva Yacobson Irina FHI iyacobson@fhi.org 919.544.7040 x431 Durham, NC *Intermittent status World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 25 FP-HIV Integration Working Group Prevention of Mother-to-Child Transmission Organizing CA: Pathfinder (ESD Project) Panel Facilitators: Godfrey Sikipa (ESD (MSH) and Tabitha Sripipatana (EGPAF) USG Point Person(s): Glenn Post (USAID/GH/OHA); Nathan Shaffer (CDC) Last Name First Organization Email Phone Degrees Title Department City Name Abeyta- Mary Ann USAID mabeyta-behnke@usaid.gov 202.712.5849 Sr. Tech. GH/PRH/SD Washington Behnke Advisor I Flanagan Elizabeth EGPAF eflanagan@pedaids.org 202.448.8412 Washington Jacobs Troy USAID tjacobs@usaid.gov 202.712.2847 MD GHF Tech GH/HIDN Washington Advisor Israel Ellen Pathfinder eisrael@pathfind.org 617.924.7200 x Boston 277 Lamprecht Virginia USAID vlamprecht@usaid.gov 202.712.0146 MPH, Sr. Tech. GH/PRH/SD Washington MA Advisor I Lusti- Manjula WHO lustinarasimhanm@who.int 41.22.791.1414 Geneva Narasimhan Neuse Margaret GHFP mneuse@verizon.net Washington Consultant Norton Maureen USAID mnorton@usaid.gov 202.712-1334 GH/PRH/SD Washington I Perchal Paul EngenderHealt pperchal@engenderhealth.or 212.993.9831 New York h g Post Glenn USAID gpost@usaid.gov PMTCT Peds GH/OHA Washington Post May ESD mpost@esdproj.org 202.544.1977 x231 Washington (Pathfinder) Rivero Estela Population erivero@popcouncil.org Council Shaffer Nathan CDC nas4@cdc.gov Atlanta Sikipa Godfrey ESD (MSH) gsikipa@esdproj.org 202-775-1977 Ext Technical Washington 251 Director World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 26 FP-HIV Integration Working Group Prevention of Mother-to-Child Transmission Organizing CA: Pathfinder (ESD Project) Panel Facilitators: Godfrey Sikipa (ESD (MSH) and Tabitha Sripipatana (EGPAF) USG Point Person(s): Glenn Post (USAID/GH/OHA); Nathan Shaffer (CDC) Last Name First Organization Email Phone Degrees Title Department City Name Sripipatana Tabitha EGPAF tabitha@pedaids.org 310.491.3129 Washington Tsague Landry ICAP Rwanda lt2278@columbia.edu Kigali, Rwanda Warren Charlotte Population cwarren@popcouncil.org 254 20 2713480/1 RH Associate Nairobi Council Weiss Deborah Population eweiss@popcouncil.org 212.339.0694 New York Council FP-HIV Integration Working Group Care and Treatment (including ART and Home-based Care) Organizing CA: FHI Panel Facilitators: Rose Wilcher (main contact, FHI), Susan Adamchak (FHI) and Heidi Reynolds (FHI) USG Point Person: TBD (USAID Point Person) and Pam Bachanas (CDC) Last Name First Organization Email Phone Degree Title Department City Name s Abeyta- Mary USAID mabeyta-behnke@usaid.gov 202.712.5849 MPH Sr. Tech. Washingto Behnke Ann Advisor n Adamchak Susan FHI sadamchak@fhi.org 785.293.5197 PhD Scientist Applied Research Kansas Bachanas Pamela CDC Dtt6@cdc.gov 404.639.8110 PhD TL HIV Prev Global AIDS Atlanta Ind/Fam Prgm Curtis Kate CDC kmc6@cdc.gov Atlanta Dillow Alden Pathfinder adillow@pathfind.org 617.924.7200 MPH HIV/AIDS Technical Services Boston x206 Advisor Unit Farrell Betty EngenderHealt BFarrell@engenderhealth.org 212.561.8035 New York h World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 27 FP-HIV Integration Working Group Care and Treatment (including ART and Home-based Care) Organizing CA: FHI Panel Facilitators: Rose Wilcher (main contact, FHI), Susan Adamchak (FHI) and Heidi Reynolds (FHI) USG Point Person: TBD (USAID Point Person) and Pam Bachanas (CDC) Last Name First Organization Email Phone Degree Title Department City Name s Flanagan Elizabet EGPAF eflanagan@pedaids.org 202.448.8412 Sr. Tech. Prev. Care and Tx. Washingto h Officer Ser. n Jamieson Denise CDC djj0@cdc.gov Atlanta Johnson Sarah WHO johnsons@who.int 41.22.791.396 Geneva 7 Lamprecht Virginia USAID vlamprecht@usaid.gov 202.712.0146 Sr Tech GH/PRH/SDI Washingto Advisor n Livesley Nigel URC nlivesley@URC-CHS.COM 301.941.8557 Washingto n O'Reilly Kevin WHO oreillyk@who.int Geneva Neuse Margare GHFP mneuse@verizon.net Consultant Washingto t n Reynolds Heidi FHI hreynolds@fhi.org 919.544.7040 PhD Scientist Applied Research Durham, x510 NC Rinehart Ward JHUCCP wrinehar@jhuccp.org Baltimore Rosenburg Nora CDC Atlanta Sikipa Godfrey ESD gsikipa@esdproj.org 202.775.1977 Washingto x251 n Subramania Laura EngenderHealt lsubramanian@engenderhealth.or Geneva n h g Wilcher Rose FHI rwilcher@fhi.org 919.544.7040 MPH Sr Prog Officer Applied Research Durham, x406 NC World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 28 Annex 5. Family Planning/HIV Interagency Working Group, October 2008 Meeting Concept Paper FP/HIV Integration Working Group Technical Workshop The FP/HIV Interagency Working Group (IWG) will convene a workshop October 21- 22, 2008 in Washington, DC that will focus on the technical aspects of FP/HIV integration. The workshop will be sponsored by USAID and WHO will chair the meeting. Purpose and Objectives The overall purpose of the workshop will be to review promising integration models and practices and the circumstances in which integrated programs can achieve both family planning and HIV/AIDS public health objectives. The objectives of the workshop will be to: 1. Review what is known to date about FP/HIV integration, 2. Discuss and confirm draft technical recommendations for field programs integrating FP and HIV developed by expert panels. Preparation for the Workshop Prior to the workshop, three expert panels will review FP and HIV research studies and the results of programmatic experiences, including new expanded Cochrane review as well as in-depth country assessments by FHI. The panels, who will meet periodically over the summer via teleconference, will analyze and synthesize the knowledge relating to the integration of FP and HIV services in the areas of 1) testing and counseling, 2) prevention of mother-to-child transmission, and 3) care and treatment, including anti- retroviral treatment and home-based care. Each panel will draft technical recommendations relevant to field programs, indicating how integration can best be achieved and under what circumstances it makes the most sense to support integrated FP/HIV programs. The panels will also identify gaps in knowledge about integration that can be addressed by future research. Panel members will consist of experts in FP/HIV integration, including both researchers and program implementers directly involved with FP/HIV efforts in the field, as well as representatives and observers from major donors (including USAID, CDC, WHO, UNAIDS, etc), NGOs, and persons living with HIV/AIDS. It is anticipated that each panel will consist of about 12-15 persons each. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 29 Workshop Participants Participants in the workshop in October will include panel members as well as high level technical experts, observers and government officials. About 50 persons are expected to attend the workshop. Workshop Activities During the workshop, researchers involved in current reviews of the literature and programmatic experience will summarize their findings, panels will present an overview of their discussions and draft technical recommendations, and workshop participants will confirm, or amend, the technical recommendations drafted by the panels prior to the workshop. Main Outcomes of the Workshop The main outcome of the meeting will be a set of annotated technical recommendations informed by the latest evidence and programmatic experience, and will highlight under what circumstances FP/HIV integration is recommended. It is anticipated that the October workshop will inform future IWG meetings. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 30 FP/HIV Interagency Working Group Technical Workshop Overview and Instructions for Panel Members I. Overview of the Expert Technical Panels and the Workshop The FP/HIV Interagency Working Group (IWG) will convene a workshop October 21-22, 2008 at the Washington Club that will focus on the technical aspects of FP/HIV integration. The overall purpose of the workshop will be to clarify promising integration models and practices and the circumstances in which integrated programs can achieve both family planning and HIV/AIDS public health objectives. The specific objectives of the workshop will be to: 1. Review what is known to date about FP/HIV integration, and 2. Discuss and confirm draft technical recommendations for field programs integrating FP and HIV developed by expert panels. The workshop will be chaired by the World Health Organization (WHO). Prior to the workshop, three expert panels will review research studies and the results of programmatic experiences addressing FP and HIV integration, including new expanded Cochrane review as well as in-depth country assessments by FHI. The panels will meet periodically over the summer via teleconference and will analyze and synthesize the knowledge relating to the integration of FP and HIV services in the areas of 1) testing and counseling, 2) prevention of mother-to-child transmission, and 3) care and treatment, including anti-retroviral treatment and home-based care. Panel members will consist of experts in FP/HIV integration, including both researchers and program implementers directly involved with FP/HIV efforts in the field, as well as representatives and observers from major donors (including USAID, CDC, WHO, UNAIDS, etc), NGOs, and persons living with HIV/AIDS. It is anticipated that each panel will consist of about 12- 15 persons each. Each panel will draft technical recommendations relevant to field programs, indicating how integration can best be achieved and under what circumstances it makes the most sense to support integrated FP/HIV programs. The panels will identify what approaches to integration and models of integration are likely to work, taking into consideration the programmatic context, including the directionality of the integration efforts as well as the specific services being integrated, the effects on FP and HIV programming, the challenges and barriers to integration, the policy environment and funding for both family planning and HIV/AIDS and integrated programs. The panels will also identify gaps in knowledge about integration that can be addressed by future research. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 31 Workshop Participants Participants in the workshop in October will include panel members as well as high level technical experts, representatives from donors, NGOs, and local governments, as well as those living with HIV/AIDS. About 50 persons are expected to attend the workshop. Workshop Activities During the workshop, researchers involved in current reviews of the literature and programmatic experience will summarize their research findings, panels will present an overview of their discussions and draft technical recommendations, and workshop participants will confirm, or amend, the technical recommendations drafted by the panels prior to the workshop. Outcomes of the Workshop The main output of the meeting will be a set of technical recommendations relevant to field programs attempting to integrate FP and HIV services. The technical recommendations will be informed by the latest evidence and programmatic experience. II. Specific Information for Panel Members 1. Description of the Panels The three panels are described here and will cover the following topics: A. Family Planning and Counseling and Testing (FP/CT). This includes programs that have been implemented at the facility and/or community level designed to identify 1) counseling and HIV testing clients with unmet family planning needs and to link them with family planning methods via onsite choice and provision or referral, or 2) family planning clients with a need for HIV testing to link them with HIV testing via onsite provision or referral. B. Family Planning and Prevention of Mother-to-Child Transmission (FP/PMTCT). This includes programs that have been implemented at the facility and/or community level designed to identify HIV+ antenatal care clients and HIV+ postpartum clients who will have a desire to use family planning or have a current unmet need for family planning and to link them with family planning methods via onsite choice and provision or via a referral. C. Family Planning and Care and Treatment (FP/C&Tx). This includes anti-retroviral therapy and home-based care (FP/CTx) includes programs that have been implemented at the facility and/or community level designed to bring family planning methods or referrals to people living with HIV and AIDS to health facilities or home-based care in the community. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 32 2. Panel Member Roles and Responsibilities Each panel will be asked to complete the following tasks prior to September 12, 2008 as preparation for the October meeting: Task 1: Review the literature Panel members will review key articles and documents—including research results due to be released this year—identified by the panel facilitators in collaboration with the panel members. Panel members will read, analyze, and extract relevant information from the articles and documents with the aim of identifying how integration can best be achieved and under what circumstances it makes the most sense to support integrated programs. The panels will identify what approaches to integration and models of integration are likely to work, taking into consideration the programmatic context, including the directionality of the integration efforts as well as the specific services being integrated, the effects on FP and HIV programming, the challenges and barriers to integration, the policy environment and funding for both family planning and HIV/AIDS and integrated programs. The panels will also identify gaps in knowledge about integration that can be addressed by future research. Relevant articles and documents may be found from the following sources:  The expanded Cochrane1 Review, being prepared by researchers from Johns Hopkins and the University of California at San Francisco;  Country Assessments of FP/HIV integration being conducted in select PEPFAR focus countries being prepared by Family Health International (FHI);  Documents found on the www.hivandsrh.org website (which includes sources listed on the Zoomerang survey (see below), as well as other published articles;  Bibliographical reviews prepared by USG (United States Government) or other partner cooperating agencies; and the  ‘Gray’ literature FHI is preparing a consolidated reference list that will be made available to the panels and will include many of the relevant documents used in the Cochrane Review and that A Zoomerang survey has been distributed by email to panel members and others who have participated in FP/HIV integration meetings in Washington. The purpose of the survey is to identify the most important documents related to FP/HIV integration as identified by the FP-HIV integration community. When survey results are available, panel members will review the final list of the top 20 documents most frequently selected for their technical focus areas and confirm (or make suggestions for substitutions) the probable usefulness of the documents for the broader community of stakeholders involved in FP/HIV integration. The final list selected by each of the three panels will be used as a resource to the global health community and will be posted on the WHO Implementing Best Practices Initiative (IBP) website and distributed widely. are on the website. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 33 Task 2: Actively participate in discussion via teleconferences Panel members will participate in a series of teleconferences over the summer to discuss articles, programs and issues relating to FP/HIV integration. It is anticipated that each panel will meet about four or five times between June and September. Task 3: Help draft programmatic recommendations Based upon the discussions, each panel will draft recommendations relevant to field programs. The draft recommendations are to be ready by September 12, 2008. Task 4: Attend the October workshop and work to confirm or amend draft technical recommendations Panel members will be invited to the IWG workshop in October, where they will participate in discussions relating to FP/HIV integration and work with other panels and workshop participants to confirm (or amend) the draft recommendations. 1 Cochrane methodology for searching the published literature and was included in the systematic review section of the report if it met the following criteria: (1) Published in a peer-reviewed journal between January 1, 1990 and March 17, 2007. (2) Presented post-intervention evaluation data of an SRH-HIV linkage intervention. (3) Used a pre-post or multi-arm comparison of individuals or communities who received the intervention versus those who did not to assess quantitative outcomes of interest. Articles that did not meet the rigorous study design criteria of the systematic review were included in a review of “promising practices� if they met the following criteria: (1) Published between January 1, 1990 and December 31, 2007, or if publication date was unclear, presented data on a program that was ongoing after January 1, 1990. (2) Presented evaluation data from an SRH-HIV linkage intervention. (“Evaluation data� is considered to any information that helps determine whether the intervention was successful or not. This included quantitative and qualitative data and process or outcome data. Program summaries and lessons learned as reported by program implementers were also included) (3) Program/project was implemented in a low- or middle-income country, as categorized by the World Bank. World Bank, HNP, Pop RH Team June 2008 Strengthening the Linkages Between Sexual and Reproductive Health and HIV/AIDS in the World Bank’s Assistance Strategy: A Preliminary Assessment 34 Process for the CT Panel in Preparing for the October 21-22 Technical Workshop for the FP/HIV Integration Working Group Proposed Timeline June - Tuesday, June 24, 2:30 pm EST- Panel conference call/meeting to discuss the steps forward with the review - All assignments will be distributed to panel members for review July - Monday, July 14- all inputs/recommendations should be submitted via the form available on the Zoho website - Findings from the Cochrane review discussed - End of July- Inputs/recommendations will be reviewed by Panel facilitators - Week of July 28- Conference call/meeting to be scheduled for all Panel members to discuss overarching perspectives and different iterations. August - Aug 3-6: International AIDS Conference in Mexico City—identify any additional best practices - Monday, August 18- Draft Technical Recommendations will be sent out to the Panel for feedback/comments Early September - Finish draft Technical Recommendations and send to USAID contacts (Mary Ann Abeyta-Behnke and Virginia Lamprecht) by September 12 Mid September - Draft Technical Recommendations will be reviewed for clarity, comprehension, etc. at USAID and WHO October - Workshop- October 21-22 World Bank, HNP, Pop RH Team June 2008