33807 URBAN NOTES LOCAL GOVERNMENT RESPONSES TO HIV/AIDS THE WORLD BANK, WASHINGTON, DC Urban Note No. UN-1 September 2005 "Mainstreaming HIV/AIDS into Urban/Local Government Projects: A Guidance Note" Mainstreaming HIV/AIDS into the Urban lending portfolio is essential if we accept HIV/AIDS as a development--rather than purely a health--issue. This is a new subject area for many Task Team Leaders (TTLS), and this note is intended to provide some basic guidance on why, where, when and how to mainstream HIV/AIDS into Bank projects. Additional support and guidance is available to all TTLs who wish to learn more. 1. DETERMINE THE LOCAL RISK 3. Are there elements in the project that could (with marginal modification or support) What is the national and urban prevalence of contribute positively to the national and local HIV/AIDS? (Presume that the urban prevalence responses to HIV/AIDS? is higher than the national prevalence): 2. IDENTIFY THE MOST APPROPRIATE a) If the urban prevalence is above 5%, this is APPROACH a generalized epidemic--and not addressing HIV/AIDS poses a risk to all project Given the above considerations: Does it objectives. Must act. make sense to do any or some of the b) If the urban prevalence is between 1-5%, following? this is a medium to high-risk situation--and addressing HIV/AIDS can have a valuable 1. Prepare a separate HIV/AIDS project impact on preventing the onset of a component. generalized epidemic. Highly 2. Integrate responses to HIV/AIDS into recommended to act. planned project activities within other c) If the urban prevalence is below 1%, this components (training, capacity building, may be considered a low risk situation--and municipal/district development planning, identifying vulnerable groups and providing municipal development grants, research, some information regarding HIV/AIDS into construction, human resource the project can support low prevalence. management). Not essential but can be effective. 3. Conduct an awareness raising activity for the project team, including what resources When asked to `mainstream' HIV/AIDS into our and support are possible from HIV/AIDS work, there are three inter-related issues to projects. consider: 4. Not address HIV/AIDS at this time, but create a place marker for HIV/AIDS 1. How will the HIV/AIDS epidemic impact the component. Preparation can then be project objectives (short-, medium-, and financed through project funds during long-term)? implementation. 2. Is there a possibility or likelihood that the 5. Not address HIV/AIDS at all. project will increase HIV prevalence or impact negatively on activities designed to fight the epidemic? Page 2 Urban Note No. UN-1 September 2005 capacity building programs; workplace policy Things to think about: Does it make sense to have a separate HIV/AIDS Project Component (1) or to address implicit (staff time for funerals) integrate HIV/AIDS into other components (2)? and explicit (absenteeism) impact on local · Stand-Alone: Small consultancies can be easy government functioning; monitoring and to design and supervise--especially when high- evaluation; and project management. quality firms are employed. Requires minimal · Infrastructure sub-projects: include a expertise from team. menu option relating to HIV/AIDS (i.e., AIDS Integration: May require more consideration/ orphanage, Voluntary Counselling & Testing expertise in design (i.e., designing training modules, center (e.g., Congo)). developing survey questions, etc.) but in high-risk countries, it is likely to be more responsive to client · Design of project M&E to include HIV/AIDS- priorities (i.e., most Ministry of Local Governments, related indicators. and most CAS, have identified HIV/AIDS as a priority issue; most Local Government Authorities are HOW TO OPERATIONALIZE mandated with some new HIV/AIDS responsibilities). Awareness raising, sensitization and training of trainers (on HIV/AIDS and relevant After selecting the best approach, you will need interventions) to identify available resources: · WB Urban project teams, project · Knowledge resources: examples, TORs management units (for projects--AGETIPE, from other projects (i.e., impact assessment, PCUs, PIUs), training institutes and consultancy, etc.), Local Government AIDS consultants. Handbook, CD-ROM training tool, and Coordinating internal linkages partner and consultant database. · Linking Urban projects with MAP (and/or · Project staff, consultants (TUDUR advisory health) projects support). · Linking with IFC and private sector initiatives · Preparation funds (trust fund allocations, (when working with large municipal service PHRD). providers: power, water, etc., and/or private · MAP funds and programs that may be contractors, etc.). financing complementary activities. Creating an enabling environment. Project · Grant money on HIV/AIDS for all IDA teams wanting to address HIV/AIDS may countries (as per IDA 13). require: · Management (Sector Board) support in project reviews. Safe space reviews. How much to include in your project? · Supervision/preparation support--either in A percentage of the project? e.g., .025% terms of budget or in terms of committed A minimum amount? e.g., $200,000 (and paid for) advisory support.1 · IDA funds to cover HIV/AIDS activities WHAT ARE THE OPTIONS (could increase portfolio without increasing lending). What types of interventions might an Urban project support? · IEC (information, education and For more information, contact Kate Kuper communication) component for local (AFTU1), Sylvie Debomy (AFTU2), or Nina government, public works staff and/or Schuler (TUDUR). communities. · Complete workplace interventions for local government staff--from information, training, and treatment (e.g., Chad, Cameroon). · Analytical work (e.g., Environmental Impact Assessment, PHRD Impact Assessment (e.g., Nigeria, Senegal)). · Capacity building for LGAs (e.g., Benin, Uganda, Mozambique). 1Urban HIV/AIDS Trust Fund (a proposed idea, not yet · Budgeting and planning (i.e., raising a reality)--i.e., committed funds that would allow TTLs HIV/AIDS during PRAs, etc.); training to have access to variable budget to address HIV/AIDS modules on HIV/AIDS integrated into LGA during project preparation and implementation.