1. The challenge
Globally, an estimated 35 million people are living with HIV. The pandemic is a major constraint on development as it causes not only individual suffering but also social disruption and high economic costs. Local efforts, combined with an unprecedented international mobilisation, have shown that substantial progress is possible: the number of new infections has decreased by a third in the last decade and about 10 million people now have access to live-saving treatment. Yet controlling HIV will only be successful and sustainable if hard-hit countries, supported by their international partners, further strengthen their own capacities to ensure universal access to prevention, treatment, care and support of HIV and AIDS. Major challenges in this regard are the integration of HIV-specific interventions into national health systems, the inclusion of all societal actors, including those directly affected by HIV, and effective, evidence-based use of resources.
2. Our approach
PROFILE is supporting decision-makers and implementing agencies of German Development Coopera-tion in HIV and health by offering innovative and re-sults-oriented approaches.
3. We are working in the following areas:
3.1. Policy advice on international processes regarding HIV and health
3.1.1 Global Fund to Fight AIDS, Tuberculosis and Malaria:
Germany is one of the largest donors to the Global Fund, which has contributed substantially to the progress that has been made towards controlling the three diseases. PROFILE is supporting BMZ in its role as member of the Global Fund Board, especiallly with regard to strengthening effectiveness, sustainability and a human rights based approach in Global Fund supported programmes, as well as better integrating disease control activities with health systems strengthening.
3.1.2 Multi-sectoral responses to HIV:
Integrated approaches are essential to sustainable control of HIV. For instance, preventing infections among young people requires co-operation with the education sector; strong social pro-tection programmes are needed to address socio-economic causes and consequences of HIV; and HIV services should be linked closely with services for sexual and reproductive health. PROFILE is advising BMZ with evidence-based and tailored concepts on HIV and is supporting the Federal Government in its work in inter-national organisations such as UNAIDS and the World Health Organization.
3.2. Fostering results measurement and knowledge management in health programmes
3.2.1 Results measurement and evidence:
Measuring results has become an international priority in order to improve effectiveness of cooperation and the accountability of the international community with regard to jointly agreed goals such as the Millennium Development Goals. PROFILE is strengthening results measurement in German health programmes and cooperates with international partners on this issue. For example, we are developing guidance and indicators for health programmes, is providing advice during the design of new projects and is supporting operational research to create new evidence.
3.2.2 German Health Practice Collection and web portal Healthy DEvelopments: PROFILE is publishing the German Health Practice Collection, a quality-assured publication series that includes a participative selection processs and an independent peer review. The Collection documents and shares knowledge on the experiences of successful programmes of German Development Cooperation in health and social protection. We are also managing the web portal Healthy DEvelopments (www.health.bmz.de), where programmes report on news, events as well as interesting approaches and methods.
3.3. Capacity development in partner institutions
3.3.1 Human Capacity Development:
PROFILE is supporting the development of capacities of invidual staff and partner institutions in Africa and Asia through multi-country measures on HIV-related topics, which are carried out in close cooperation with German programmes in those countries. We are using a ‘blended learning’ approach which combines different methods: modular online teaching and face-to-face seminars, South-South ex-change and knowledge networks as well as practical ex-amples and individual transfer projects. This approach does not only serve to transfer knowledge but also to encourage participants to reflect on their own attitudes towards people living with HIV.
3.3.2 University and hospital partnerships:
As part of the European ESTHER Alliance, PROFILE is supporting seven partnerships between German university clinics and hospitals in Ethiopia, Ghana, Cameroon, Malawi, Rwanda and Uganda, as well as South-South partnerships. In or-der to improve patient care, partners jointly implement activities such as trainings, individual staff exchange and operational research projects. This approach benefits both sides, strengthens international research networks and offers new ideas for development cooperation.
3.3.3 Social Determinants of Health Network (SDH-Net):
PROFILE is coordinating the SDH-Net (www.sdh-net.eu), a network co-financed by the European Union. It aims to strengthen capacities to conduct research on social determinants of health in Africa and Latin America. Partners are public health institutions in Mexico, Columbia, Brasil, South Africa, Tansania and Kenya as well as three European research institutions.
4. Benefits and success factors
These approaches foster innovation, learning and evidence at different levels: international policy processes, bilateral health programmes, local partner institutions and South-South networks. PROFILE’s areas of work cooperate closely with each other, with other programmes of German Devel-opment Cooperation and with multilateral initiatives. For instance, policy advice on the Global Fund incorporates experiences of bilateral country programmes and approaches to improve results measurement. In Eastern and Southern Africa, PROFILE and bilateral programmes are jointly supporting a multilateral initiative that strengthens cooperation between health and education ministries to improve the lives of young people with sexuality education and health services.