Promoting Leadership and Mitigating the Negative Impacts of HIV and AIDS on Human Development: An outcome evaluation of UNDP's HIV Programme in the Philippines 2009-­2011

Report Cover Image
Evaluation Plan:
2012-2018, Philippines
Evaluation Type:
Others
Planned End Date:
12/2012
Completion Date:
12/2012
Status:
Completed
Management Response:
Yes
Evaluation Budget(US $):
6,000

Share

Document Type Language Size Status Downloads
Download document TOR_Outcome Evaluation-HIV and AIDS Programme-FINAL.pdf tor English 608.30 KB Posted 896
Download document FINAL Draft Outcome Evaluation Report_21Jan2013.pdf report English 763.47 KB Posted 1010
Download document Brief_Outcome Evaluation 2013_HIVAIDS.pdf summary English 161.18 KB Posted 869
Title Promoting Leadership and Mitigating the Negative Impacts of HIV and AIDS on Human Development: An outcome evaluation of UNDP's HIV Programme in the Philippines 2009-­2011
Atlas Project Number:
Evaluation Plan: 2012-2018, Philippines
Evaluation Type: Others
Status: Completed
Completion Date: 12/2012
Planned End Date: 12/2012
Management Response: Yes
Focus Area:
  • 1. Poverty and MDG
  • 2. Cross-cutting Development Issue
Corporate Outcome and Output (UNDP Strategic Plan 2018-2021)
  • 1. Strengthened national capacity for inclusive governance and coordination of national HIV responses, and for the protection of human rights of people affected by HIV, including women and other vulnerable groups
  • 2. Strengthened national capacities for implementation of HIV funds and programmes, including those financed through multilateral initiatives like the Global Fund to fight AIDS, Tuberculosis, and Malaria
  • 3. UNDP programmes/projects integrate capacity development
  • 4. UNDP programmes/projects integrate gender equality and women's empowerment in line with the UNDP gender equality strategy, 2008-2011
  • 5. UNDP country programmes are clearly and explicitly linked with and in support of national development plans and priorities
Evaluation Budget(US $): 6,000
Source of Funding: Project funds
Joint Programme: No
Joint Evaluation: No
Evaluation Team members:
Name Title Nationality
Hussein Macarambon
GEF Evaluation: No
Key Stakeholders:
Countries: PHILIPPINES
Comments: The HIV and AIDS Programme, Promoting Leadership and Mitigating the Negative Impacts of HIV and AIDS on Human Development (2009-2011), had been designed and approved in the middle of implementation of the previous CPAP in response to the recommendations of the Outcome Evaluation in 2007 and the Assessment of Development Results in 2008, and after taking into account the emerging HIV situation in the country. Therefore, its evaluation was not included in the CO Evaluation Plan for 2005-2011, which was developed at the onset. However, as per usual protocol, Programmes had to be evaluated at the end of implementation. Considering that the Programme ended in 2011 with the previous CPAP, its evaluation was scheduled in 2012 with the budget incorporated into the AWP of the new Programme under current CPD/UNDAF.
Lessons
1.

One of the fundamental findings of the evaluation is that the UNDP Country Director was able to play as champion of HIV and AIDS in the Philippines. The Country Director had taken advantage of the comparative advantage of UNDP by tapping resources at the regional level and focusing on pressing issues such as the rising number of infections among MSMs. However, political support and policy alignment also matter. Despite the inclusion of harm reduction interventions among IDUs, UNDP had to contend with several legal constraints because of contradictions in several laws, particularly the Dangerous Drugs Act and the AIDS Law.

At the outset, the engagement of a UNDP in-house HIV specialist was instrumental in developing the Programme Document. This was also heavily based on the recommendations of the Country Office-initiated Outcome Evaluation of UNDP’s Country Programme, which was led by an independent consultant from New York in 2008. APRC’s support of the Country Office’s identified priorities also helped in securing additional funding for the other components of the HIV Programme.

Since a major reason for the delayed liquidation of project costs by implementing agencies was the common bureaucracy that required several processes and standards for both national and local government agencies and/or units, it is imperative that development partners should align themselves with the timelines of the Philippine government. This means that fiscal periods will be harmonized and that annual plans will also be in sync to enhance rates of project delivery.

Operational spot checks and audits had been conducted. These were remarkable given that some implementing agencies had opened their doors to third party evaluators to assess their institutional capacities to implement foreign-assisted projects. What was even more significant in this form of monitoring was the use of action matrix which prompted the implementing partners to deliver on identified challenges or gaps in the project cycle. However, this was not true for all the implementing agencies; this calls for a more institutionalized approach of spot-checking and auditing results in future UNDP projects.

Finally, the UN Development Assistance Framework can be a strategic entry point for UNDP in renewing its commitments to address HIV and AIDS in the Philippines. UNDAF clearly states that HIV and AIDS will be a separate “Sub-Outcome” area in line with the Philippine Development Plan, which sets the national development agenda to address cross-cutting issues such as HIV and AIDS. Also, the UN System will work closely with the Philippine government, through PNAC, to support the successful implementation of the AMTP5. In line with the UNDAF and PDP priorities, the new UNDP CPD 2012-2016 has also identified HIV and AIDS as one of its developmental priorities.


Findings
1.

Component 1: Leadership for Effective and Sustained Response to HIV and AIDS

The Department of Interior and Local Government (DILG), which coordinates and monitors the response of LGUs to the growing epidemic, had initiated to revive the Regional AIDS Assistance Teams (RAATs), in partnership with the Department of Health (DOH) and the Department of Social Welfare and Development (DSWD), in all 17 regions of the Philippines, after a longhiatus since it was created by the Philippine National AIDS Council (PNAC) in 2007. initiative facilitated the operationalization of the PNAC Resolution No. 3 to create the RAATs and had a turning point when the Joint Memorandum Circular was signed by the above agencies. RAATs will be supporting the local AIDS councils (LACs) of the LGUs by crafting an evidence- based local HIV/AIDS programme with appropriate budget allocation by the concerned LGU.


2.

Component 2: Strengthening Institutional Capacities and Partnerships on HIV and Migration

Throughout the migration cycle, the different roles of government agencies and other non- governmental or international organizations are crucial to provide the OFW with assistance against HIV. From pre-departure to onsite assistance, or even upon return for reintegration into society as PLHIVs, OFWs are entitled to assistance by the Department of Foreign Affairs (DFA), the Department of Labor and Employment (DOLE), the Philippine Overseas Employment Adminstration (POEA), the Overseas Workers Welfare Administration (OWWA), Civil Society Organization (CSOs), the Technical Education and Skills Development Authority (TESDA) and other organizations that provide services to OFWs affected by HIV and AIDS. It was thus seen fundamental for this component to strengthen institutional capacities of and partnerships among these agencies and groups to effectively address the needs of OFWs.


3.

Component 3: Mitigating the Economic and Psycho-social impact of HIV and AIDS

Despite early initiatives by DSWD in addressing social protection needs of PLHIVs, the national response called for an inter-agency approach to address their needs, including those of their families. A number of gaps have been identified in terms of programs and services for PLHIVs: limited access to PLHIV data; some LACs are non-functional or inactive; absence of focal persons on HIV and AIDS in most NGAs; service providers lack knowledge, appropriate attitude/behavior and skills in handling PLHIVs; limited funding for programs and services for HIV and AIDS; and absence of an integrated referral system for stakeholders to fulfill obligation to protect and promote the rights of PLHIVs, their children and affected families.


4.

Component 4: Strategic Information and Community Leadership among Males having Sex with Males (MSM) and Transgender (TG)

The Fourth AIDS Medium-Term Plan 2005-2010 (AMTP4) clearly stated that in order to maintain HIV prevalence below 1% of the total population by its final year, most-at-risk and highly vulnerable populations (MARPs and VPs), of which MSMs are a part, must have access to quality preventive interventions. There had been several interventions that targeted both MARPS and VPs even prior to the passing of the AIDS Law in 1998, but the epidemic was alarmingly growing and had now seen a shift in its demographic profile. From being an undetectable group in the earlier years, MSMs have now become most affected populations in the country, as they represent the most number (>80%) of newly recorded HIV infections according to the AIDS registry.


5.

Component 5: Knowledge, Communication and Advocacy to Promote Deeper Understanding of HIV and AIDS

In comparison with other countries in the Asia Pacific region, the Philippines is one of the few remaining countries which has yet to develop a national policy that explicitly supports harm reduction.The HIV/AIDS Asia Regional programme (HAARP) saw this as an opportunity to advocate for explicit and supportive inclusion of harm reduction in the next national strategic plan on HIV of the Philippines. UNDP thus facilitated this project which would forge a partnership between AusAID and the Philippine government, through PNAC.The project will undertake research activities to address the information gaps on HIV and AIDS as well as informThe project will undertake research activities to address the information gaps on HIV and AIDS as well as inform the formulation of the 5th AIDS Medium-Term Plan (AMTP5).


Recommendations
1 Focus on policy advocacy to strengthen multi-sector approach. There is the need to focus the next UNDP HIV Programme on results that may shed light on the roles and responsibilities of state institutions for more effective and efficient national response, and on measures to establish the National HIV and AIDS Plan with clear strategies, targets, operationalization framework and funding. Also, there is a need to remove all barriers to AIDS-related services and eliminate the climate of stigma that surrounds the epidemic and the people directly and indirectly affected by it.
2 Enhance evidence-based approach with quality research to inform policy; disseminate results of the studies. Evidence-based information is seen as a critical element in policy advocacy and development. Information on MSM and transgender persons was integral in the Programme?s contributions to the 5th National AIDS Medium Term Plan, and also informed the drafting of a specific strategies targeting these two key populations ? the National Comprehensive Strategic Plan for MSM and Transgender Populations. It is thus recommended that UNDP focus on its comparative advantage to link different stakeholders in conducting multi-sectoral studies and in disseminating results of these studies for enhanced awareness of issues surrounding HIV and AIDS.
3 Focus on key issues (e.g., prevention, harm reduction, PLHIV TCS, rights-based approaches, stigma and discrimination). There is a call for more emphasis on issue-specific interventions especially in the context of sexual transmission and injecting drug use as possible preventive strategies to reverse the growing trend of infection in the country. This can translate into national and local responses that adequately address gaps in prevention services and programmes among identified most-at-risk populations, including MSMs, young and female key populations at high risk, and other vulnerable groups. Other critical issues include: harm reduction; PLHIV needs for treatment,care and support; and rights-based approach.
4 Facilitate a harmonized national coordination It is recommended that UNDP capacitate both PNAC and LAC to facilitate a harmonized, government-led coordination in formulating policies, implementing them and monitoring their impact on the beneficiaries. Building the capacity of PNAC and LAC entails a comprehensive assessment of the gaps especially in the linkages of PNAC with the RAATs and the LACS. This assessment may thus provide a firm baseline to which targets of closing response gaps are monitored and evaluated against. Conditionally, the chances of this strategy to become more achievable are based on the premise that coordination between national and sub-national agencies and stakeholders is enhanced. Finally, the ?Three Ones? approach also has to be enhanced so that opportunities for advocacy and resource mobilization can be tapped.
5 Continue HIV and AIDS as a separate and full portfolio. Considering the need and urgency to respond to the growing epidemic, HIV and AIDS has earned a separate sub-outcome in the new UNDAF 2012-2018. This emphasis is consistent with UNDP?s departure from a previous project-based perspective of HIV and AIDS into a more integrated approach within a general framework of equal access to basic social protection services. In the last HIV Programme, there have been several opportunities that were tapped because of UNDP?s multi-sector response to the growing trend of HIV infections in the country; this was mainly due to the shift from being subsumed by a bigger Poverty Portfolio of the country office into its standing as a separate Programme with smaller projects of its own. There is a need to continue this thrust by mobilizing resources to keep HIV and AIDS as a full and separate portfolio in order to be consistent with the structural arrangements of UN agencies participating in the UNDAF 2012-2018 and of the Philippine government?s AMTP5.
6 Review UNDP capacity needs for HIV and AIDS. With the MDGs drawing to its deadline in 2015 amid the country?s poor performance in keeping HIV and AIDS under control, UNDP needs to actively urge the government to comply with its MDG commitments to the international community. However, UNDP can only prompt these actions from the national government by ensuring that it promotes the UN Reform of delivering as one and by enriching its comparative advantages, such as its neutrality and positive relationship with GPH; its strengths in capacity development and advocacy; and its access to an international network of experts, who may provide valuable contributions to policy formulation and to the sharing of best practice. With the Post-2015 Agenda taking shape, UNDP?s role as the lead in promoting HIV/AIDS and other sectoral concerns of MSM and TG in the national development agenda is critical in the coming years.
1. Recommendation: Focus on policy advocacy to strengthen multi-sector approach. There is the need to focus the next UNDP HIV Programme on results that may shed light on the roles and responsibilities of state institutions for more effective and efficient national response, and on measures to establish the National HIV and AIDS Plan with clear strategies, targets, operationalization framework and funding. Also, there is a need to remove all barriers to AIDS-related services and eliminate the climate of stigma that surrounds the epidemic and the people directly and indirectly affected by it.
Management Response: [Added: 2013/12/26] [Last Updated: 2014/01/06]

The PMU agrees that in order to strengthen national and local responses on HIV and AIDS in the country, policy reform should be an integral part of the response. Particularly, new policy and legislation addressing stigma and discrimination against key populations at higher risk and PLHIV, and harmonization of some provisions of the AIDS Law with other laws (e.g., the Comprehensive Dangerous Drugs Act, Anti-Trafficking in Persons Act, Vagrancy Act, etc.) needs to be crafted. Moreover, there is a need to lobby for increase in domestic public investment on AIDS in order to support implementation of programmes and services.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
1.1. Under the new CPD 2012-2016, one of the major outputs of the HIV and AIDS Programme is related to policy reform, particularly putting up of policy agenda at the national and local levels to address critical gaps.
[Added: 2014/01/06]
HIV and AIDS unit No due date No deadline established Bills amending the Philippine AIDS Law have been passed in Senate and Congress (i.e., SB 3072 and HB 5312) seeking to restructure the legal framework on AIDS and harmonizing it with evidence-based strategies and approaches following the principles of human rights, gender equality, and meaningful participation of affected communities. They also aim to clarify the roles and responsibilities of state institutions for more effective and efficient response, and establish the National HIV and AIDS Plan with clear strategies, targets, operationalization framework and funding. Also, they seek to remove all barriers to AIDS-related services and eliminate the climate of stigma that surrounds the epidemic and the people directly and indirectly affected by it.
2. Recommendation: Enhance evidence-based approach with quality research to inform policy; disseminate results of the studies. Evidence-based information is seen as a critical element in policy advocacy and development. Information on MSM and transgender persons was integral in the Programme?s contributions to the 5th National AIDS Medium Term Plan, and also informed the drafting of a specific strategies targeting these two key populations ? the National Comprehensive Strategic Plan for MSM and Transgender Populations. It is thus recommended that UNDP focus on its comparative advantage to link different stakeholders in conducting multi-sectoral studies and in disseminating results of these studies for enhanced awareness of issues surrounding HIV and AIDS.
Management Response: [Added: 2013/12/26] [Last Updated: 2014/01/06]

This recommendation will be considered in the design of the Programme in the next cycle (2012-2016).

Key Actions:

3. Recommendation: Focus on key issues (e.g., prevention, harm reduction, PLHIV TCS, rights-based approaches, stigma and discrimination). There is a call for more emphasis on issue-specific interventions especially in the context of sexual transmission and injecting drug use as possible preventive strategies to reverse the growing trend of infection in the country. This can translate into national and local responses that adequately address gaps in prevention services and programmes among identified most-at-risk populations, including MSMs, young and female key populations at high risk, and other vulnerable groups. Other critical issues include: harm reduction; PLHIV needs for treatment,care and support; and rights-based approach.
Management Response: [Added: 2013/12/26] [Last Updated: 2014/01/06]

This recommendation will be taken on jointly by the different Co-Sponsors of UNAIDS based on their comparative strengths and mandates, taking into account the UN technical support division of labour on HIV and AIDS in the Philippines. With HIV and AIDS as one of the sub-outcomes under the new UNDAF 2012-2018, UNDP will be focusing support on the following areas: (a) empowering MSM and transgender people to protect themselves from HIV infection, and to fully access antiretroviral therapy; (b) reducing sexual transmission of HIV among mobile and migrant populations; (c) removing punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS; and (d) localization of the AIDS response.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Development of the operational framework of the National Strategic Plan for MSM and Transgender Populations, which serves as the roadmap outlining priorities and activities to assist the Government to interrupt the transmission of HIV and ensure timely access to HIV treatment, care and support for MSM and transgender people.
[Added: 2014/01/06]
HIV and AIDS Unit 2012/12 Overdue-Initiated The Philippine National AIDS Council has endorsed the National Strategic Plan for MSM and Transgender Populations in April 2012, while its costed Operational Plan has been developed and validated by stakeholders in December 2012.
Continued support for capacity development of community-based MSM and transgender groups for a meaningful participation in the national and local response to HIV and AIDS.
[Added: 2014/01/06]
HIV and AIDS Unit No due date No deadline established A national network of MSM and transgender has been established; capacities of MSM and TG groups on advocacy, organization and programme development.
4. Recommendation: Facilitate a harmonized national coordination It is recommended that UNDP capacitate both PNAC and LAC to facilitate a harmonized, government-led coordination in formulating policies, implementing them and monitoring their impact on the beneficiaries. Building the capacity of PNAC and LAC entails a comprehensive assessment of the gaps especially in the linkages of PNAC with the RAATs and the LACS. This assessment may thus provide a firm baseline to which targets of closing response gaps are monitored and evaluated against. Conditionally, the chances of this strategy to become more achievable are based on the premise that coordination between national and sub-national agencies and stakeholders is enhanced. Finally, the ?Three Ones? approach also has to be enhanced so that opportunities for advocacy and resource mobilization can be tapped.
Management Response: [Added: 2013/12/26] [Last Updated: 2014/01/06]

This recommendation will be considered in the design of the Programme in the next cycle (2012-2016).

Key Actions:

5. Recommendation: Continue HIV and AIDS as a separate and full portfolio. Considering the need and urgency to respond to the growing epidemic, HIV and AIDS has earned a separate sub-outcome in the new UNDAF 2012-2018. This emphasis is consistent with UNDP?s departure from a previous project-based perspective of HIV and AIDS into a more integrated approach within a general framework of equal access to basic social protection services. In the last HIV Programme, there have been several opportunities that were tapped because of UNDP?s multi-sector response to the growing trend of HIV infections in the country; this was mainly due to the shift from being subsumed by a bigger Poverty Portfolio of the country office into its standing as a separate Programme with smaller projects of its own. There is a need to continue this thrust by mobilizing resources to keep HIV and AIDS as a full and separate portfolio in order to be consistent with the structural arrangements of UN agencies participating in the UNDAF 2012-2018 and of the Philippine government?s AMTP5.
Management Response: [Added: 2013/12/26] [Last Updated: 2014/01/06]

This recommendation will be considered in the design of the Programme in the next cycle (2012-2016).

Key Actions:

6. Recommendation: Review UNDP capacity needs for HIV and AIDS. With the MDGs drawing to its deadline in 2015 amid the country?s poor performance in keeping HIV and AIDS under control, UNDP needs to actively urge the government to comply with its MDG commitments to the international community. However, UNDP can only prompt these actions from the national government by ensuring that it promotes the UN Reform of delivering as one and by enriching its comparative advantages, such as its neutrality and positive relationship with GPH; its strengths in capacity development and advocacy; and its access to an international network of experts, who may provide valuable contributions to policy formulation and to the sharing of best practice. With the Post-2015 Agenda taking shape, UNDP?s role as the lead in promoting HIV/AIDS and other sectoral concerns of MSM and TG in the national development agenda is critical in the coming years.
Management Response: [Added: 2013/12/26] [Last Updated: 2014/01/06]

This recommendation will be considered in the design of the Programme in the next cycle (2012-2016).

Key Actions:

Latest Evaluations

Contact us

1 UN Plaza
DC1-20th Floor
New York, NY 10017
Tel. +1 646 781 4200
Fax. +1 646 781 4213
erc.support@undp.org