Project description

Title: Support for implementation of the multisectoral HIV/AIDS strategy
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Madagascar
Lead executing agency: Executive Secretariat of the national AIDS council
Overall term: 2004 to 2016

Context

With 0.3 per cent of its population infected by HIV (2007), Madagascar is one of the African countries least affected by AIDS. However, the AIDS rate has increased sevenfold since 1999. The population’s poverty facilitates its spread due to inadequate or non-existent sex education and the resulting lack of access to effective protection against HIV. A lack of future prospects, particularly among young people, leads to a greater willingness to take risks and to a greater risk of infection, for example through prostitution.

Since 1988, fighting HIV/AIDS has been a focus of the Madagascan government’s domestic policy. However, there is a lack of conceptual and technical competence and efficiency for nation-wide implementation.

Objective

The HIV infection rate has stabilised in high-risk areas and among the target groups particularly at risk, such as young people, sex workers and their customers and migrant workers.

Approach

GIZ advises on behalf of the BMZ in drawing up, managing and implementing national priorities in fighting AIDS. It supports implementation in selected districts and for selected groups of people. This local experience is passed on through advising on national policy.

In order to reach the different target groups, various institutions have been recruited to communicate measures to fight HIV among different target groups. These institutions include as public service, non-governmental organisations, enterprises and other development cooperation projects and their staff. Since the spread of HIV is low but the risk factor is high, the focus is on broad prevention work. In addition to sex education, it comprises services such as the provision of condoms, HIV tests and consultancy services and the treatment of sexually-transmitted diseases, AIDS-related infections and AIDS.

Results achieved so far

GIZ has supported the Madagascan government in introducing and implementing a national policy to combat HIV/AIDS. New instruments have been developed in order to monitor and evaluate prevention and treatment measures, as well to map high-risk areas.

The national HIV/AIDS council has improved coordination among the technical and financial partners. Integrated regional plans describe activities and sources of finance. GIZ is working for the benefit of people at high risk in a number of regions of Madagascar (Menabe, Boeny and Antsinanana). Those particularly affected are sex workers and young people on the fringes of society who have sexually-transmitted diseases in high-risk regions.

Improved support for people with HIV/AIDS has reduced the risk of further spread. Thirteen civil society associations are using the technical and logistic assistance for improved psychological care for people with HIV/AIDS. These associations have helped those with HIV/AIDS face less discrimination and reintegrate into society.

Nine large private companies have been enabled to set up and implement their own corporate action plans to fight HIV/AIDS. Their sensitised employees behave more responsibly, and high-risk practices are on the decline.