Since the early 1990s, the AFAO International Program has worked to support stronger civil society responses to HIV, health and human rights in Asia and the Pacific. Grounded in principles of community ownership and a partnership approach, AFAO’s International Program works closely with communities most affected by HIV to engage in capacity development, organisational strengthening, policy, advocacy and strategic planning.
More recently, AFAO leads multi-country programs in Asia and the Pacific to ensure responses to HIV are sustainable. With an expanded scope, AFAO’s International Program is working with respective country governments and communities to scale up effective programs that can reduce HIV transmission in the region, sustain investments in community-led HIV prevention programs, and influence more efficient HIV financing policies.
Building on AFAO’s partnership approach, the International Program currently works with over 20 civil society and community-based organisations, the United Nations, World Health Organisation (WHO), the World Bank as well as Ministries of Health and other government stakeholders across ten countries in the Asia and the Pacific.
Sustainability of HIV Services for Key Populations in Southeast Asia Program (SKPA-2)
The Sustainability of HIV Services for Key Populations in Southeast Asia (SKPA-2) is a three-year, USD$12.5m program funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria for the period 1 July 2022 to 30 June 2025.
The Australian Federation of AIDS Organisations (AFAO) is the Principal Recipient of the grant and provides technical assistance and support to local and regional partners.
SKPA-2 builds upon the work and achievements of the first iteration of the program called SKPA-1 which promoted HIV prevention services for key populations.
The aim of SKPA-2 is to improve sustainability of evidence-informed prioritized HIV services for key populations in Bhutan, Mongolia, the Philippines, and Sri Lanka. There are four program objectives:
- Accelerate financial sustainability.
- Improve strategic information availability and use.
- Promote programmatic sustainability.
- Remove human rights- and gender-related barriers to services.
Key populations bear the greatest burden of HIV in the countries in which SKPA-2 operates. Key populations are defined as:
- Gay men and other men who have sex with men
- Transgender people
- Female, male, and transgender sex workers
- People who inject drugs
- People in prison and other closed settings
It is critical that key populations are identified by their governments and within National Strategic Plans to ensure that appropriate community and peer-led services are scaled up and sustainably funded.
Ensuring the above is achieved is key as countries shift towards middle-income status their eligibility for international development funding reduces. Middle-income countries are expected to fully fund health and HIV programs domestically. However, funding services for key populations remains a contentious in many countries. This is because stigma and discrimination continue to act as barriers to prevention and treatment service provision. Human rights and gender related barriers including criminalization, religious laws, cultural norms, and violence also prevent key populations from accessing services.
As a result of these sensitivities, domestic government spending on key populations remains minimal. SKPA-2 aims to change this. A Theory of Change underpins SKPA-2 which outlines the application of a series of interventions that will institutionalise and scale up prioritised HIV services for key populations with domestic co-financing.
AFAO is accountable for achieving SKPA-2 objectives and provides strategic, programmatic, and technical leadership and coordination across the program. AFAO manages performance, monitoring and evaluation, and liaises with the Global Fund, technical partners, and key stakeholders. AFAO leads a consortium of organisations to implement the program.
In year 1, a comprehensive baseline assessment will be conducted in each country. The baseline will help partners to understand the financial landscape, political economy, strategic information needs, operational policy and regulatory barriers, and human rights and gender situation in each country. It will also assess the extent to which each country is prepared for financial sustainability of services for key populations and the extent to which key populations and people living with HIV are meaningfully engaged in their country’s national HIV responses.
The baseline will provide a blueprint to support national HIV programs and community-based partners to develop long-term, evidence-based HIV investment and sustainability plans. This is especially important as new National Strategic Plans will be developed during the grant period in most SKPA-2 countries.
An end-of-program review in Year 3 will be conducted to assess progress and performance of activities against the initial baseline assessment.
SKPA Program Partners
AFAO as Principal Recipient leads a consortium of partners including country sub-recipients, regional and implementing partners.
Implementing and technical partners
Implementing and technical partners are engaged to provide expertise on areas such as cost modelling, PrEP, and community-led monitoring.
Governance of SKPA-2
The Regional Steering Committee, chaired by UNAIDS Asia-Pacific which provides stewardship and strategic direction at the regional and national levels to the SKPA-2 program. Membership of the Committee comprises a government and civil society representative from the Country Coordinating Mechanism (CCM) of each country, representatives from World Health Organisation, World Bank Global Practice Team, and the Australian Department of Foreign Affairs & Trade
The Committee ensures that the HIV strategies of participating countries guide SKPA-2 activities. The Committee also helps identify and remove barriers to effective implementation and facilitates cross-regional learning.
Key population participation is ensured through the Community Voice Standing Committee which facilitates greater learning across the region and the global south. This Committee feeds into the Regional Steering Committee and is comprised of regional and country networks of key populations and people living with HIV. The committee brings a critical voice to SKPA-2 oversight.