1995_1_guiding principles

Guiding principles for coordinating HIV/AIDS programmes

In 1993, the Management Committee of WHO's Global Programme on AIDS established a Task Force on HIV/AIDS Coordination. It comprised three representatives each from four "constituencies": 1) countries donating funds to National AIDS Programmes (NAPs) in developing countries, 2) countries receiving funding for NAPs, 3) UN system agencies and 4) people living with HIV/AIDS, community-based organizations and NGOs (PHIV/NGOs).1

The Task Force mandate was to examine how collaboration and coordination could be improved among organizations involved in HIV/AIDS-related work at the international and national levels. After collecting information on obstacles to coordination, the Task Force produced a document called Framework of Guiding Principles for HIV/AIDS Coordination at Country Level. Early drafts were submitted to members of the four constituencies and their feedback was incorporated. Excerpts from the Framework are given here as they may provide a good basis for planning collaborative work on interventions.

Definition of coordination

If organizations are to collaborate successfully, they must agree on what coordination entails. The Task Force proposes that the following definition be used:

Coordination of HIV/AIDS activities and decision-making about such activities is a process (rather than a structure) which promotes information exchange, builds alliances between different organizations and facilitates the creation of cooperation and programmes which are complementary, collaborative and reinforce one another. It should not be a mechanism of control. The process should build a relationship among partners for mutually respectful work with jointly accepted goals and targets formulated in national and lower-level strategies and plans.

It is important that organizations acknowledge that the scope and content of coordination efforts are influenced by how the politics of power are reflected in discussions on coordination.

Purpose of coordination

The principal purpose of coordination is to enhance the "collective capacity" of a country, region and/or community to respond effectively to the HIV/AIDS epidemic. This should be done in a way which improves the overall response by avoiding gaps and unnecessary overlaps and by building bridges between interventions carried out by organizations in different sectors.

For coordination to work, the parties concerned must agree to develop a process together and use it thereafter. Coordination will happen when collaborating organizations commit themselves to working together from the start to end of activities, including the critical stages of policy development and strategy planning.

The importance of partnership

An effective response to the HIV/AIDS epidemic requires a partnership approach. Governments have a state responsibility vis-à-vis their citizens to plan, coordinate and implement a multisectoral response which involves all concerned partners. This also means they must ensure respect for and protection of the human rights of people affected by HIV/AIDS.

In exercising their responsibility, governments must recognize that all other parties engaged in HIV/AIDS and STD-related activities have both rights and responsibilities which entitle them to participate in the coordination process. This includes PHIV/NGOs, private sector organizations, UN agencies and donors. It is further important that communities be supported in taking responsibility for identifying important issues and planning/implementing activities.

The coordination process

Important elements for developing a coordination process include:

recognition that all the parties concerned must be equal partners

openness to contributions made by all parties concerned

flexibility so that different views on approaches can be recognized and discussed

choosing people to be responsible for ensuring coordination who are respected and recognized by all those concerned

maintenance of the trust of involved communities

use of methodologies and skills which can facilitate, evaluate and modify the process where needed.

To achieve an open and participatory process, those involved should commit themselves to respecting decisions reached through a genuine consensus process and if necessary modify their own activities accordingly.

Technical expertise and support

Any structures used for coordination should include or have easy access to appropriate technical expertise. To support the development and management of national and regional HIV/AIDS plans, coordinating structures must facilitate information exchange from and to participants. The reporting must be presented in a format enabling people at the action level to use the information in a way which facilitates their participation in planning and implementation.

Coordinating structures and mechanisms must further receive adequate financial, technical and manpower resources to develop and maintain information exchange. Other agencies should facilitate the participation of NGOs/PHIV through active outreach and provision of resources insofar as possible.

Ensuring the appropriateness of coordination mechanisms

There are no universally applicable and appropriate coordination structures and mechanisms. Choices on how to ensure coordination will be the result of a country's specific circumstances (existing structures/mechanisms, stage of the epidemic, range of agencies involved). Suggested sample structures and mechanisms, both formal and informal, are described in the Framework, which can be obtained free of charge in English, French, Spanish and Russian from the address below.

1 The members of the Task Force were: 1) The Netherlands, Sweden and the USA; 2) Botswana (first year), Bulgaria, India and Sudan (second year); 3) UNDP, WHO and the World Bank; 4) AIDS Coordination Group, The Netherlands; ENDA Tiers Monde, Senegal and GNP+, United Kingdom.

GMC Task Force on HIV/AIDS Coordination, Secretariat, c/o World Health Organization, CH-1211 Geneva 27, Switzerland; fax: 41-22-791-0746.