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Expanding HIV/AIDS Prevention in Bangladesh Funded by The Global Fund

HIV/AIDS Program of Save the Children in Bangladesh As a Principal Recipient (PR) of the current Global Fund supported HIV/AIDS program in Bangladesh, Save the Children is leading the National Response in coordination with Government of Bangladesh and other NGOs. In 2009, Bangladesh has been awarded an additional 6 years of funding by the Global Fund to expand HIV/AIDS interventions under the national program through the ‘Rolling Continuation Channel’ (RCC, 2009-15). This award was based on the high level of Performance of Save the Children managed Round 2 (2004-2009) Program, which specifically targeted young people and has been appreciated as a “best practice” example in Asia. Through funding granted in Round 6 (2007-2012); also managed by Save the Children, Bangladesh had been taking action to reduce the spread of HIV infection among Most at Risk Populations (MARP), particularly Injecting Drug Users (IDU) and Female Sex Workers (FSW), to scale up existing HIV services targeted at vulnerable youth and to provide treatment, care & support for people living with HIV (PLHIV).

Major Objectives The RCC will finance the continuation and scale of interventions from Rounds 2 and 6 with these objectives:

A BCC Session at Drop in Centers for Injecting Drug Users

1. Increase the scale of prevention services for key populations at higher risk: Injecting Drug Users(IDUs), Sex Workers (FSWs), hijras (transgendered) & Men who have Sex with Men (MSM) 2. Increase the scale of the most effective HIV/AIDS activities conducted through Round 2 and 3. Build capacity of partners to increase scale of national response to the HIV/AIDS epidemic. HIV/AIDS Program Strategies of Save the Children

Principal Recipients and Key Implementers

Religious leaders showing their commitment to fight HIV

With the aim to keep the current low HIV prevalence rate (<1%), the Govt. of Bangladesh has developed collaborative partnership with Save the Children USA for efficient management of Global Fund supported Round 2 and Round 6 HIV/AIDS programs. Following the Public-Private Partnership approach in program implementation, 13 consortiums were selected that consists of 61 NGOs (national & international) partners including corporate/business sector, community based organizations and research organizations for effective and target oriented interventions. Besides, 185 strategic partner NGOs and 211 youth clubs and relevant government

departments are also involved with this program. The Global Fund Round-6 project Signing Ceremony with Implementing Partners

Bangladesh CCM has established public-private partnership with three Principle Recipients (PRs) for ongoing RCC program (Dec 2009-Nov 2015, US$ 91 millions):

Capacity building and coordination HIV prevention and risk reduction at workplace (garment factories)

Information campaign thru mass, local & print media

care, support and treatment for PLHIV

Youth friendly health services, life skill education and accessing condom HIV & AIDS information into national text curriculumn

Essential services for Injecting Drug Users & Female sex workers Advocacy & mainstreaming of HIV/AIDS

information generation for evidence -based strategic directions

PR-1: Government/ National AIDS/STD program (NASP)-15% PR-2: Save the Children USA (SC USA)- 51% PR-3: ICDDR,B- 34% Classroom Education

Evidence created for program and policies- Baseline survey, Operations Research, rapid assessments, impact assessments, annual review etc HIV/AIDS chapter is included with National Text Books(Grade VI-XII) in 2007

Key Achievements – Highlights LSE session at Garments Workplace

A Condom Demonestration session at a Drop in Center for Female Sex Workers

1. Overall HIV Prevalence remains <1% 2. HIV/AIDS information is included in text books of secondary and higher secondary level education, from grades VI to XII, in both Bangla and English. 3. HIV/AIDS prevention, care & support related information now mainstreamed within the training curriculum of five different Ministries. 4. National standards for Youth Friendly Health Services (YFHS) have been established, now practiced in public, NGO & private health service facilities countrywide. 5.Standard Operating Procedures (SOP) for services to PLHIV have been endorsed by the government 6. Public-private partnership has been proved to be an effective model for fighting AIDS 7. 500+ people living with HIV and AIDS (PLHIV) are receiving anti-retroviral treatment (ARV) 8. Workplace policy on Life Skills-based Education (LSE) on HIV/AIDS endorsed by Bangladesh Garments Manufacturers’ association (BGMEA) 9. Under the Ministry of Religious Affairs, 4 booklets on HIV/AIDS have been published for the 4 major practicing religions in the country

Policy Change for impact: Standardization of Youth Friendly Health Services and MIS incorporation, Endorsed LSE workplace policy on HIV/AIDS by BGMEA and SOP for services for PLHIV

Knowledge has increased in HIV Prevention (2004-2008)

Source: Operation Research on Mass Media, ICDDR,B, 2008

Condom use has increased among most at risk populations

Challenges Although resources for HIV have increased and the number of partners involved in the response has also expanded, including strong NGO participation and a vibrant civil society, significant challenges remain in preventing Bangladesh from progressing to a concentrated epidemic. There is an urgent need to address these key areas of work in the coming years:

A court yard meeting to reduce stigma and discrimination

1. Capacity of all the partners has to be built in a unified manner; ranging from Government, NGOs, private sector organizations, FBOs and CBOs

Source: National HIV Sero-survelliance, 2007

2. Quality and minimum standards must be assured during the scale up so new services fit with national roll-out plans & resources are used accountably to reduce transmission & maximize impact 3. National guidelines that are properly put into use and appropriately trained staff will ensure that interventions are effective and of quality. 4. The existing social and legal obstacles to reach the Most-at-Risk Populations (MARPs) must be overcome through concerted efforts by all partners. A LSE training session for Young people

5. Sensitive messages must be tailored for effective advocacy, awareness raising, social mobilization for the general population as well as the most-at-risk 6. Targeted programs with participation of diverse groups and utilization of their local knowledge and personal experiences must be implemented 7. Optimum planning, coordination, management, monitoring & supervision must come from the best practices and lessons learned from previous programs

Acknowledgement The Global Fund to fight AIDS, Tuberculosis and Malaria, National AIDS/STD Program of Ministry of Health and Family Welfare, Bangladesh, Implementing partners, community people of Bangladesh

Young people showing their commitment to fight HIV AIDS in a awareness raising concert

For more information, contact-

HIV/AIDS Sector, Save the Children USA, Bangladesh Country Office Phone: (+880-2) 8828081, 9885651, Fax: (+880-2) 9886372, E-Mail: bdcohivinfo@savechildren.org

HIV/AIDS Prevention campaign through multiple channels Nat ional AIDS/STD Programme

Directorate General of Health Services, Minist r y of Healt h & Family Welf are


Expanding HIV Prevention in Bangladesh