PEPFAR: Community and Faith-Based Organizations (September 2005)

PDF version   

Report to Congress Mandated by Report 108-599, Accompanying H.R. 4818 

The President's Emergency Plan for AIDS Relief works with a broad range of partners in order to achieve its ambitious goals for HIV/AIDS prevention, treatment, and care. Report 108-599, accompanying H.R. 4818, called upon the Office of the United States Global AIDS Coordinator to submit a report on its achievements in involving such organizations in the Emergency Plan.

The President's Emergency Plan has brought unprecedented focus to building the institutional capacity of local organizations - including host governments and community- and faith-based organizations - to plan, implement, and manage HIV/AIDS programs to ensure sustainability. The organizing structure, management, coordination, and leadership provided by capable host governments are essential to an effective, efficient HIV/AIDS response. Local community- and faith-based organizations remain an underutilized resource for expanding the reach of quality services. They are among the first responders to community needs, with a reach that enables them to deliver effective services for hard-to-reach or underserved populations, such as people living with HIV/AIDS and orphans. Community- and faith-based groups, trained in program management and HIV/AIDS best practices, often design the most culturally appropriate and responsive interventions and have the legitimacy and authority to implement successful programs that deal with normally sensitive subjects. The Emergency Plan has provided technical assistance and infusions of key resources to help host governments and local organizations develop and maintain high-quality services, with training in both HIV/AIDS service provision and improving managerial
capacity.

The Emergency Plan prioritizes the development of new partnerships with local groups and organizations as a key strategy for increasing access and building sustainability. Review of the U.S. five-year strategy and the annual country operations plan in each country includes an evaluation of efforts to increase the number of indigenous organizations partnering with the Plan. This emphasis has led to impressive results.

As the attached table on indigenous partners demonstrates, in fiscal year 2004:

• More than 1,000 (80 percent) of over 1,200 partners (both prime and subcontractors) were indigenous. This figure is expected to rise in fiscal year 2005.
• More than 47 percent of the Emergency Plan's “prime” partners - organizations with the program and financial management expertise to receive U.S. funds directly - were indigenous. This figure is expected to rise to almost 53 percent in fiscal year 2005.
• More than 83 percent of subpartners receiving support under the management supervision of an eligible prime partner were indigenous. This figure is expected to rise to over 87 percent in fiscal year 2005.

The Emergency Plan is pursuing innovative approaches to strengthening the capacity of local nongovernmental organizations (NGOs). In Botswana, the United States initiated and supported Tebelopele, the largest provider of voluntary counseling and testing, with 16 freestanding sites and four mobile caravans. In fiscal year 2004, Tebelopele was “spun off” to become an independent NGO, with all staff and assets transferred from the U.S. Mission. A U.S. Government-funded partner is working with Tebelopele to expand management capacity and ensure that it succeeds as a sustainable organization.

Faith-based groups are priority local partners. In many focus countries, more than 80 percent of citizens participate in religious institutions. In certain nations, upwards of 50 percent of health services are provided through faith-based institutions, making them crucial delivery points for HIV/AIDS information and services. In fiscal year 2004, more than 20 percent of all Emergency Plan partners (including both prime and subcontractors) were faith-based. In fiscal year 2005, planned activities indicate that this proportion will rise to nearly a quarter of all partners. (See table below.)

To support expanded faith-based work, South Africa's Emergency Plan program is developing strategic plans with five faith-based communities for training, other capacity development, and service delivery. Tanzania's program is supporting a national needs assessment within the Islamic community to assess current HIV/AIDS work and next steps, with additional plans under way to support voluntary counseling and testing and prevention of mother-to-child transmission services in 30 dioceses, 13 church denominations, and 20 mosques. The Emergency Plan has launched pilot programs in multiple countries that allow small groups to apply directly to Emergency Plan country teams for rapid approval of small grants in order to get funds quickly to local organizations doing needed work
on the ground.

One impediment to working with many local groups is the limited technical expertise in accounting, auditing practices, and other activities required to receive funding directly from the U.S. Government. Under the Emergency Plan, the U.S. Mission in South Africa is using a local “umbrella” contractor to manage these activities for local organizations for a small fee. In fiscal year 2005, several focus countries will pursue the use of local umbrella contractors, including those that serve as local fiduciary agents for the Global Fund to Fight AIDS, Tuberculosis and Malaria. In addition, the Emergency Plan is working to incorporate “graduation” language in contracts and grants with its non-indigenous prime partners. This language provides for the performance of these prime partners to be evaluated, in part, on their success in transferring skills to their indigenous subpartners, who can, in turn, become prime partners of the Emergency Plan.

Notes:
FY04 Annual Report data are still in the process of being cleaned and will likely be revised.

FY05 Country Operation Plan data are what is planned for the year as of 12/15/04.

Data cannot be summed for primes and subs as it is possible that some funding could be going through prime indigenous to sub indigenous.

For FY05, financial data are planned figures. At time of Country Operation Plan submission, planned figures for some % of subs were still to be determined by primes. Therefore, the amount of planned funds for subs is an underestimate.

Notes:
FY04 Annual Report data are still in the process of being cleaned and will likely be revised.

FY05 Country Operation Plan data are what is planned for the year as of 12/15/04.

Data cannot be summed for primes and subs as it is possible that some funding could be going through prime FBOs to sub FBOs.

For FY05, financial data are planned figures. At time of Country Operation Plan submission, planned figures for some % of subs were still to be determined by primes. Therefore, the amount of planned funds for subs is an underestimate.

Released: October 5, 2005