THIS IS A NEW ACTIVITY.

This narrative is being submitted by each agency to allow for flexibility in working with the MCC in relevant

high-prevalence regions. Since each agency has existing partner networks in different areas, the final

decision on partnerships will be made based on an analysis of MCC's final selection of project sites.

In February 2008 President Bush signed a $698.1 million Millennium Challenge Compact with the

Government of Tanzania (GOT) to rehabilitate and improve infrastructure in the Transport, Energy and

Water sectors. Nearly half the Compact is dedicated to road construction projects.

MCC recognizes that its road construction projects have the potential to negatively impact communities by

increasing exposure to and interaction with higher risk mobile populations. These risks have been well

documented throughout Africa in areas where roads are being constructed and where contractors establish

camps to house their typically unaccompanied male staff. Often these workers are isolated from their

families for long periods of time and have disposable income which facilitates risk-taking behaviors that

result in the spread of HIV/AIDS. MCC and PEPFAR/Tanzania are committed to working together on HIV

prevention programs that will reduce the risk of HIV transmission among MCC project beneficiaries, and will

also diminish other unintended consequences that could put the MCC goals of economic development and

poverty reduction at risk.

In addition to project-specific assessments, MCC recommends a tiered approach to identify the level of

attention needed for HIV/AIDS risk reduction activities. For high-risk countries, such as Tanzania, draft

MCC guidance recommends an HIV/AIDS risk mitigation assessment and strategy as part of any relevant

sector project design. While specific activities between PEPFAR and MCC are in the development phase, a

robust MCC-PEPFAR partnership is envisioned.

Activities will build upon the following MCC principles:

- HIV/ AIDS Expertise among MCC contractors: Persons with demonstrated and contextually relevant

HIV/AIDS expertise will be involved in the design and implementation of program activities. To ensure that

appropriate expertise and sound planning are integrated, language on required HIV/AIDS expertise will be

woven throughout all Terms of Reference and bidding documents.

- Public Consultation: Stakeholders will be involved in project workshops to discuss lessons learned and

recommendations for improvement strategies for future HIV prevention activities. Consultations will ensure

that relevant stakeholders are included in discussions surrounding vulnerable groups such as women,

elderly, disabled, migrant workers, and ethnic or religious minorities.

- Gender Integration and Targeting Vulnerable Populations: Efforts will ensure that women are adequately

represented in public consultation and stakeholder meetings. Assessments will address gender inequalities

and biases against people perceived to be at high risk for HIV, including sex workers and men who have

sex with men. Behavior change communication materials will be culturally and linguistically appropriate,

participatory, and take into account the possibility of low literacy and education levels.

Examples of MCC-PEPFAR collaboration for HIV/AIDS awareness and prevention activities include:

- Public education and sensitization campaigns to increase HIV/AIDS awareness and understanding of

prevention methods in communities along the construction routes and transport corridors;

- Support for prevention programs that include condom distribution for local communities;

- Targeted interventions with construction workers that include individual risk assessments and risk

reduction planning;

- Counseling and testing for construction workers and communities;

- Public-private partnerships with local businesses and construction companies for HIV prevention

workplace programs;

- Targeted HIV prevention programs in bars and other high-risk settings in construction areas and along

roads;

- Integration of alcohol abuse and gender-based violence prevention messages into HIV prevention and

awareness programs;

- Collaboration with local leaders and faith-based organizations in HIV prevention advocacy efforts.

Linking PEPFAR programs with MCC activities will allow for a comprehensive approach to HIV/AIDS in

affected communities. PEPFAR will expand its reach to populations newly exposed to elevated HIV/AIDS

transmission risks, while MCC will be able to leverage PEPFAR's expertise and experience in implementing

effective, state-of-the-are prevention programs. The funding level is currently at $0, as MCC has dedicated

funding for HIV/AIDS prevention activities linked to its projects. MCC and PEPFAR will collaborate closely

and joint prevention activities may involve a variety of partnerships, including PEPFAR- technical assistance

to MCC projects, joint funding of PEPFAR HIV prevention implementing partners, or direct MCC funding of

specific PEPFAR HIV prevention activities.

Linkages:

It is envisioned that MCC and PEPFAR Tanzania will work closely together to implement the above

activities and to link MCC contract workers and community members from MCC road construction areas to

HIV prevention, counseling and testing and care and support services in the neighboring areas. Since each

USG PEPFAR agency has existing partner networks in different areas, each agency has submitted a similar

narrative to allow for flexibility in working with the MCC. Actual MCC/PEPFAR partnerships will be

established based on an analysis of MCC's final selection of project sites. Partnerships with local

government and other stakeholders are equally critical to maximizing the benefits received by targeted

communities.

M&E:

As part of its overall M&E plan, MCC will collect baseline and follow-up data on a sample of communities

near roads. The data will include:

1) Major public services (will collect GPS readings of nearest public medical facility, secondary school, post

office, etc.)

Activity Narrative: 2) Perception of well-being (asking people about acceptable levels of certain services, including health)

3) Education level and health status of the population (from focus groups)

Data collected will include communities near the rehabilitated roads and elsewhere for comparison

purposes, while also controlling for other factors (i.e. economic growth or recession, drought, etc.).

Sustainability:

MCC recognizes that the reduction of HIV/AIDS risks must be viewed on two levels: first are the risks

associated with construction; these risks are addressed though the responsibilities of contractors as

described in standard bidding documents and project-specific requirements. The second level includes the

risks associated with increased mobility and activities that are the results of the project. MCC believes that

both risks should be assessed and addressed in different ways in the Compact, and that it should support

capacity building in local entities to assure the sustainability of HIV/AIDS awareness, prevention and

support after the completion of the construction project

It is vital to the sustainability of HIV/AIDS activities that local NGOs working in the sector and local

communities and government authorities be included in planning and implementing activities to ensure that

upon project completion there is not a vacuum where there had previously been support. Work towards

capacity-building and training to transfer skills and knowledge to affected local communities should be

explored to maximize collaborative benefits for partnership, information sharing, and co-financing

opportunities with the goal of long-term sustainability.

New/Continuing Activity: New Activity

Continuing Activity:

Table 3.3.03: