In order to undertake a true strategic planning exercise, engaging all USG agency staff as well as government counterparts and key implementing partners, this funding will support the USG to host a COP 2008 Strategic Planning Retreat. It will be held for 5 days; the first two days will consist of USG Inter-agency technical Teams (ITTs) identifying gaps and reviewing partner portfolios by technical areas. The remaining 3 days will be held with key government ministries, counterparts and partners working in our established larger TWGs. This retreat will provide the necessary time for policy and program planners to look at progress against targets, partner performance and gaps to facilitate the development of FY 2008 objectives and priorities in true partnership.

Targets

Target Target Value Not Applicable People reached through dissemination workshops  Number of local organizations provided with technical assistance for 8
strategic information activities Number of individuals trained in strategic information (includes  M&E, surveillance, and/or HMIS)

Table 3.3.14: Program Planning Overview Program Area: Other/Policy Analysis and System Strengthening Budget Code: OHPS Program Area Code: 14 Total Planned Funding for Program Area: $ 6,969,462.00

Program Area Context:

The MoHSS is currently in its third National Strategic Plan on HIV/AIDS for 2004-2009 (Medium Term Plan III [MTP III]). The USG supports the MTPIII, including the following subcomponents: Policy and Law Reform; Access to Treatment, Care and Support, to support expanded treatment, care and support programs; and Developing HIV/AIDS Management Capacity including Institutional Capacity.

Since 2005, the USG has provided support for strengthening the pharmaceutical policy environment to support the scale up and decentralization of palliative care and ART services. In 07, support will be provided for policy development for the selection of medicines for the palliative care essential medicines list, HBC kits and increasing the prescribing rights of nurses to include all medicines in the World Health Organization (WHO) recommended palliative care essential medicines list. Currently some medicines including pain management Opiates like Codeine and Morphine, antidepressants like Amitriptyline and anti-diarrheals like Loperamide are not within the prescription rights of nurses. In 07, support will be provided to bring MoHSS policy makers and stakeholders together to review issues and to advocate for policy change to improve access to these medicines in line with the MoHSS decentralization objective and the strengthening of the continuum of care. This activity will result in greater access to medicines and improvement in care provided by all partners working in the areas of HBC and Palliative care. Continuing efforts will also support the implementation of the Medicines Information, Pharmacovigilance and ADR systems and continue support to the Therapeutics Information and Pharmacovigilance Center.

The MoHSS's Directorate of Special Programs, which oversees HIV/AIDS activities, is just now building its human and financial capacity, which has hampered its ability to coordinate and provide oversight to national programs and development partners. The USG has supported capacity building in the new Directorate, contracting staff to fill key positions, and providing infrastructure support. During FY05, the USG provided the Directorate with technical advisors in ART, PMTCT, CT, rapid testing, HMIS, and surveillance and provided a laboratory scientist advisor to the Namibia Institute of Pathology to support PCR testing. During FY06, it provided technical advisors for strategic information, STI/HIV, and quality assurance and modest renovations completed to accommodate additional staff in the Directorate. The government notes that sustainability in terms of human resource capacity and some program costs will require more than five years to achieve. The government, to address this, is increasing its leadership, management, technical, and monitoring and evaluation capability, enhancing fund-raising capabilities of FBOs/NGOs, building their financial, administrative, and technical expertise and positioning them to absorb development funds directly and provide technical assistance and support to the private sector.

The government took HIV/AIDS into account in planning staffing in the health sector and the MoHSS has recently developed a "Ten Year Strategic Human Resource Plan 2003-2012". The USG is supporting the MoHSS in estimating staffing requirements for ART, and ongoing assessment will be required. Of 10,000 MoHSS positions, approximately 2,000 remain unfilled due to a government-wide hiring freeze, low output from training institutions, and a severe scarcity of senior-level health personnel, who cannot be trained in-country. Only a small pool of trained Namibian technical and managerial staff exists. Most doctors, pharmacists, and laboratory technologists are third country nationals temporarily working in Namibia. Support will be continued in FY07 for scholarships to Namibian students to train as doctors, nurses, pharmacists, and medical technologists. Strong partnerships exist between the USG and the MoHSS, National and Regional Health Training Centers, where enrolled nurses and pharmacy assistants are trained and HIV/AIDS-related in-service training for health workers is conducted. The USG also supports the University of Namibia (UNAM) to increase the output of registered nurses. Namibians have access to medical schools, pharmacy and laboratory technology training in the Southern Africa region. However, roughly half of current pre-med students at UNAM are unable to pass courses due to weaknesses in math and science programs in secondary school education. The Ministry of has a very limited number of scholarships for external training that falls well short of national demand for these professions.

While NGOs and FBOs have increased their capacity locally in recent years, these organizations still face a lack of experience and expertise. With support from the USG, over 35 indigenous organizations have received technical assistance, training, and targeted capacity-building over the past six years, especially around issues of organizational and financial management, program design and implementation, monitoring and evaluation.

Program Area Target: Number of local organizations provided with technical assistance for 52 HIV-related policy development Number of local organizations provided with technical assistance for 88 HIV-related institutional capacity building Number of individuals trained in HIV-related policy development 96 Number of individuals trained in HIV-related institutional capacity building 165 Number of individuals trained in HIV-related stigma and discrimination 2,507 reduction Number of individuals trained in HIV-related community mobilization for 2,380 prevention, care and/or treatment

Table 3.3.14:

The Department of State will implement three projects in this area. The Ambassador's HIV/AIDS Self Help Program will directly reach an average of 100 community members per project through 15 small community-based HIV/AIDS projects with prevention messages, support services, training, capacity enhancement or other resources. Activities funded by the program will involve capacity-building for grass-roots and community-based organizations to conduct HIV/AIDS programs: • Support for one full-time Self-Help coordinator • Develop project guidelines, promotional materials, application and other documents • Advertise/market new program to communities • Commence acceptance of applications, qualification of projects and dispersal of funds The second activity will fund the production of art murals about HIV/AIDS issues, both in Windhoek and around the nation. The activity will provide HIV/AIDS awareness training to young artists. The murals will be produced at 5 schools and a local art center. The third activity will fund a professional science journalist from the U.S. to lead workshops for local journalists on how to responsibly cover HIV/AIDS issues. The primary emphasis of the fourth project is training of leaders in the field of HIV/AIDS treatment and prevention through International Visitor Leadership Program (IVLP) short-term professional study tours in the U.S. The Namibians chosen by the U.S. Mission IVLP nominating committee for these visits are primarily grassroots leaders in the field with wide ranging influence and a comprehensive approach to HIV/AIDS and prevention. The legislative issues addressed during the exchanges encompass a wide range of gender, wrap around, stigma and discrimination issues. PEPFAR links with the IVLP program in funding this program, with PEPFAR funding per diem and international airfare and State Department funding the cost of domestic U.S. transportation and other logistical programming and escort/interpreter costs. IVLP participants spend three weeks in the U.S. meeting with USG officials, professional counterparts and a variety of grassroots organizations to gain firsthand knowledge on how the U.S. manages HIV/AIDS. Past IVLP participants in the field of HIV/AIDS - from grassroots community leaders to local community health officials - have established close collaborative relationships with each other sharing ideas and resources. The fifth activity provides Youth for Hope clubs with speakers raising awareness of HIV/AIDS and promoting health behaviors and lifestyles. The Youth for Hope clubs were formed to promote: gender equity; improved male norms and behaviors; education through a wide array of educational opportunities including reading, science, health, information technology, and other activities; stigma and discrimination reduction through HIV/AIDS educational counseling and written materials that will complement club activities; and volunteerism with the approximately 70 Namibian volunteer club leaders/counselors to be recruited for this project. Youth for Hope groups work with a variety of U.S. and Namibian organizations, including Peace Corps, the youth and sports ministry, Namibian Basketball Federation, Johns Hopkins University, the National Library system, OVC centers, schools, faith-based organizations and various other grassroots organizations. The target audiences are youth aged 7-18. Funds will also be used to produce a PEPFAR Namibia press packet and other press materials.

The plus up funding ($25,000) will go towards expanding upon a new activity funded by the Plus-up; a men's conference lead by the Ministry of Health and Social Services to be held in August/September of 2007. After conversations with key individuals and policy makers in the MoHSS, it was decided the way forward to both intimately involve as well as strategically address men's roles in stopping the spread of HIV/AIDS was to solicit their feedback on a variety of topic. in order to adequately develop strategies to address male norms and behaviors. This conference is being planned in conjunction with the work Namibia is undertaking as part of the OGAC Gender/Male Norms initiative. During this conference, identified religious, cultural and targeted most at-risk men will come together to discuss their perception of their role in HIV prevention, care and treatment. The additional male circumcision funding is being added ($25K) to this activity in order to leverage the the event to bring in a global expert as well as a regional teams from another SADC country with more experience in dealing with rolling out MC services in order to share lessons learned and facilitate an action plan to address MC within Namibia. We see the facilitation of such an experiential learning partnership essential in helping Namibia understand the various issues involved and learn from how other similar countries have planned and dealt with the increased demand for MC both within and outside of the formal health sector.

This activity will fund support for the PEPFAR Coordinator's office, including ICASS support, travel support, an administrative assistant and a driver. This activity will aslo fund a PEPFAR public diplomacy position. This position will assist in the management of PEPFAR public diplomacy activities, including U.S. speakers and visitors, the production of press releases and press materials, liaison with all USG agencies, and other activities as necessary. An estimated $90K of the $250K requested is needed for ICASS.

The pluup funding of $120,000 will fund an SI position, a part of the EP Coordinator's office. The SI advisor will work directly with the Coordinator and all USG agencies (CDC, USAID, MoD, PC, State) on OGAC reporting and taskers as well as monitoring and evaluation across agencies. Responsibilities will include the managing the processes of the COP, Annual Report, Semi-annual report, all reprogramming, plus ups, and additional OGAC requests.

Table 3.3.15: