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AFRICITIES SUMMIT 2006

    Report on Africities Special Session

    Localising Responses to HIV/AIDS:

    Achievements and Constraints

    Nairobi, Kenya

    20 September 2006

     1

    TABLE OF CONTENTS

    ACKNOWLEDGEMENTS …...…………………………………………………………………………….3

    BACKGROUND…………………………………………………………………………………………..4

    THE SPECIAL SESSION - Localising Responses to HIV/AIDS: Achievements and Constraints ……………………………………………………...5

    INTRODUCTION…………………………………………………………………………………………..5

KEY THEMES

    1. Scaling Up……………………………………………………………………………………...6

    2. Urbanisation……………………………………………………………………………………6

    3. Working ‘Bottom Up’…………………………………………………………………………..7

    4. Localising the ‘Three Ones’…………………………………………………………………..7

    5. Localising Monitoring and Evaluation……………………………………………………….8

    6. Localising a Multi-Sectoral Response………………………………………………………8

    7. Challenges facing a New AMICAALL Programme………………………………………...9

    8. Partnerships: City to City Cooperation……………………………………………………...9

APPENDICES

    1. Special Session on HIV/AIDS Agenda………………………………………………….10

    2. Special Session - Communiqué and Recommendations……………………………….11

    3. Africities 2006 - Thematic Session on MDG 6 HIV……………………………………...15

    4. City of Toronto, Alliance and FCM Proclamation on HIV/AIDS August 2006 ……..20

    5. African Coalition of Cities against Racism and Discrimination: Nairobi Declaration….22

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    ACKNOWLEDGEMENTS

    The Alliance of Mayors and Municipal Leaders on HIV/AIDS extends its appreciation to Africities for the opportunity to share experiences and knowledge in the management of cities in Africa in this era of HIV/AIDS.

    Special thanks go to the AMICAALL Team in Kenya, headed by Margaret Jobita, who welcomed members of the Alliance/AMICAALL network and facilitated the effective participation of all at the Africities Summit. To all the members of the Alliance/AMICAALL network and partners who contributed to the Special and Thematic Sessions, thank you for your excellent presentations and collaboration.

    Thanks go to the UN AMICAALL Partnership Programme, UNDP and UNAIDS for facilitating the organisation of the Special Session on HIV/AIDS and contributing to the preparation of the Thematic Session on HIV/AIDS in collaboration with UNAIDS and WHO as well as the session organised by UNESCO on Cities, Racism and Discrimination and for its assistance with the preparation of this report.

     3

    BACKGROUND

    The first Africities Summit took place in Abidjan in 1998 and witnessed the emergence of the African municipal movement on the regional and international scene. The second Summit

    was held in Windhoek in 2000 and marked the beginning of the structuring of the African

    municipal movement and of a Pan-African dialogue on decentralization and local

    development. The third Summit in Yaoundé in 2003 marked the development of the

    unification framework of the African municipal movement and of its participation in the world municipal movement.

    The fourth Africities Summit took place in Nairobi, Kenya, 18-22 September 2006. The theme

    of the Summit was “Building Local Coalitions for the Implementation of the Millennium

    Development Goals (MDGs) in African Local Governments”. The primary goal of Africities

    Summit is to strengthen the voice of mayors and locally elected leaders by mobilizing

    dialogue between local and central government and civil society and with development

    agencies responsible for decentralisation and local governance.

During the Africities Summit 2006 special and thematic sessions provided opportunities for

    stakeholders to share information and experiences, to discuss achievements and constraints

    towards attaining the MDGs, and to make recommendations for ways forward.

A Special Session on HIV/AIDS was organised by the Alliance of Mayors and Municipal

    Leaders on HIV/AIDS in collaboration with the UN AMICAALL Partnership Programme (UN 1APP). During the Special Session on HIV/AIDS presentations were made from Burkina Faso, Cameroon, Kenya, Mali, Swaziland, Uganda and Zambia. These highlighted action taken by

    local governments across Africa to address the challenges of the HIV epidemic at the local

    level. Key issues emerging from these sessions are included in the following section. A

    presentation on HIV and women drew attention to the particular impact of the epidemic on

    women and young girls.

The Special Session also provided an opportunity to share experiences on city to city

    cooperation and to share the Toronto Proclamation issued by the City of Toronto, the

    Alliance of Mayors and Municipal Leaders on HIV/AIDS and Federation of Canadian

    Municipalities (FCM) during the XVI International Conference on AIDS (13-18 August 2006,

    Toronto, Canada (Appendix 4). A communiqué was issued from the Special Session

    containing recommendations for various stakeholders (Appendix 2).

The Alliance of Mayors and Municipal Leaders on HIV/AIDS and UN APP also contributed to

    the Thematic Session on MDG 6 (HIV, Malaria and TB) in collaboration with UNAIDS and

    WHO (see Appendix 3), and to the UNESCO session on Racism and Discrimination.

    (Appendix 5).

     1 Appendix 1 contains the agenda for the Special Session

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    Localising Responses to HIV/AIDS: Achievements and

    Constraints - Special Session

INTRODUCTION

Within the context of the Summit theme of building local coalitions for the implementation of

    the Millennium Development Goals, the Special Session was organised by the Alliance of

    Mayors and Municipal Leaders on HIV/AIDS in Africa and the United Nations AMICAALL

    Partnership Programme (UN APP).

While some progress has been made in achieving the Millennium Development Goals since

    2001, many of the targets contained in the Declaration of Commitment have not yet been met.

    The HIV epidemic continues to expand. Globally, women now represent half of all people

    living with HIV. In Africa 60% of those infected are women and girls. At a roundtable held

    during UNGASS+5, a delegation of mayors, sponsored by United Cities and Local

    Governments, pointed out that prevention, treatment and care responses need the

    involvement of local authorities to ensure that they respond to local needs and address the

    specific cultural and social sensitivities surrounding the epidemic.

The purpose of the Special Session was to focus upon MDG no 6, which addresses

    HIV/AIDS, to explore action undertaken on the issue by local governments and local leaders

    and to highlight related achievements and constraints.

This section provides an overview and analysis of key themes explored in the Special

    Session.

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    KEY THEMES

1. Scaling Up [AMICAALL Swaziland Presentation]

In Swaziland, and in collaboration with over 30 partner organizations, the AMICAALL

    Programme is working to scale up the response to HIV/AIDS. The AMICAALL Swaziland

    programme operates in all twelve towns of the country, covering about 25 per cent of the

    total population, comprising approximately 215,000 people.

Achievement of the millennium development goal on HIV/AIDS rests in part upon successful

    scaling up of access to prevention, treatment, care and support services by all who need

    them. Scaling up includes increasing coverage, comprehensiveness and intensity of

    interventions together with and expanded „stakeholder-ship‟. Facilitating factors include

    implementation through partnerships arrangements (including private/public sectors),

    involvement and participation of local communities and utilization of community volunteer

    services.

Governance practices that encourage decentralization, good financial management, reduce

    bureaucracy, facilitate collaboration amongst different programmes and respond to felt needs

    of people and communities are also crucial. Access to and availability of resources are

    increased by demonstrable need, political will, relationships between individual programmes

    and the national response, a reputation for strong financial management and ability to

    respond to the needs of funding agencies, good governance practices as well as

    organizational visibility, for example, through participation in national fora.

2. Urbanisation [AMICAALL Uganda Presentation]

Urbanisation is rapidly growing in sub-Saharan Africa. In Uganda, approximately 16% of the

    population lives in urban areas. This figure is expected to reach 65% by the year 2020,

    highlighting the critical role of urban local government in providing effective leadership and

    coordination within the overall framework of decentralized governance within Uganda.

    Furthermore, in the context of the conflict situation which prevails in Northern Uganda, urban

    centres also serve as centres of refuge for the large proportion of the rural population,

    especially children, who seek security and shelter each night.

The AMICAALL Uganda Chapter was launched in November 2000. It now includes all 103

    urban councils in the country and the AMICAALL Programme is in the process of

    implementation of 15 urban authorities. The specific objectives of the Uganda AMICAALL

    Programme include enhancing advocacy, leadership and commitment for HIV/AIDS

    response in the local government; building the Institutional capacity of urban local

    government to respond effectively to the epidemic at the local level; and strengthening

    coordination of the multi-sectoral HIV/AIDS response within urban authorities.

So far emphasis has been placed on training urban authorities in planning and management

    of workplace based HIV/AIDS programmes. A Workplace Policy Guide has been developed

    and disseminated to urban councils. Support has also been provided to urban authorities to

    develop appropriate HIV/AIDS related policies (bye-laws) in four urban councils. Further

    examples of activities undertaken to date include the establishment of an Orphans and

    Vulnerable Children (OVC) Psychosocial Support Centre in Kampala and community-based

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HIV/AIDS initiatives in the urban areas in Kitgum and Gulu, located in the conflict zone of

    northern Uganda.

Challenges identified so far include inadequate human resource capacity at the National

    AMICAALL Coordination Office to respond to the increased demand for AMICAALL services

    countrywide. Weak Institutional capacity within urban local governments hampers effective

    local responses to the epidemic and funds disbursed to districts for HIV/AIDS activities are

    not being accessed by urban authorities. All of this occurs within a context of periodic political

    transition which leads in turn to changes in local government leadership.

3. Working ‘Bottom Up’ [AMICAALL Zambia Presentation]

In Zambia, with the support of the National Aids Council (NAC) and UNDP, the AMICAALL

    Programme is building HIV/AIDS-related capacity among local government and district-level

    stakeholders in order to:

    1. Improve efficiency and effectiveness in the delivery of HIV/AIDS related services;

    2. Mainstream HIV/AIDS within workplace and municipal service delivery and

    3. Ensure a “bottom-up” flow of integrated development planning and budgeting for

    HIV/AIDS responses.

Experience to date highlights the need for:

    1. Central government to devolve functions, resources and authority to democratically

    elected local authorities for a sustainable, cost effective and coordinated local

    response to HIV/AIDS;

    2. Local authorities to strengthen their sub-district structures for meaningful engagement

    with citizens in achieving HIV/AIDS-related goals; and

    3. For NAC‟s to recognise the fact that local authorities are the legal coordinating

    structures at the local level.

4. Localising the ‘Three Ones’ [AMICAALL Cameroon Presentation]

In Cameroon AMICAALL is helping to „localise the „Three Ones‟‟ within the context of the

    National Strategic Plan on HIV/AIDS for 2006-1010. Through the Alliance and AMICAALL,

    commitment and engagement of local government authorities have been secured.

Opportunities have been created to decentralise the country‟s response to HIV/AIDS through

    collaborative and coordinated action between local and central government and civil

    society/communities, facilitated by the mechanism of Municipal HIV/AIDS Teams.

Planning is facilitated through the creation and use of municipal profiles and directories,

    together with needs and response-capacity assessments which identify gaps in the response,

    together with inputs needed for local planning in line with national goals and local realities.

Key challenges include building sustainable capacity in local government authorities and

    resource mobilization.

5. Localising Monitoring and Evaluation [AMICAALL Burkina Faso

    Presentation]

     7

In Burkina Faso efforts are being made to decentralize monitoring and evaluation in order to

    assist planning and implementation of local activities in response to HIV/AIDS in line with the national framework, to assist the flow of information from local to central levels and to providing monitoring support to local actors. Monitoring tools include the provincial framework for coordination activities and the provincial multisectoral plan, quarterly coordination reports, statistical information baseline, financial protocols, supervision visits, and coordination and planning meetings. Information gathered in this way is used to improve project and programme planning and performance, for needs assessment, resource mobilisation and decision making.

    Difficulties encountered at local level include insufficient information on the implementation of the system, inadequate implementation of the multisectoral decentralised approach, weak engagement on the part of local authorities with action undertaken on the ground, lack of accurate information about the epidemic to assist planning, weak communication infrastructure and illiteracy combined with lack of tools translated into local languages.

    Experience so far indicates that the extent to which monitoring and evaluation are taken into consideration in the response to HIV/AIDS is insufficient. Local leaders need to become more engaged and work together with other local actors if concepts of monitoring and evaluation are to be translated into meaningful action at local level.

6. Localising a Multi-Sectoral Approach [AMICAALL Mali Presentation]

In Mali, interventions have been infrequently integrated and are often „uni-sectoral‟ rather

    than multisectoral in approach. As a result, interventions have little impact in terms of local ownership, risk and vulnerability reduction, or elimination of HIV/AIDS-related stigmatisation and discrimination.

    Key weakness in the response so far have been in relation to decentralisation of national structures and bodies; coordination of actions, activities, and support; complex and discordant procedures and management, unreliable financial, human, technical, and material resources and poor outreach and national coverage. Gathering, compilation, and analysis of strategic information is weak and development of activities to reduce the socio-cultural and economic impact of HIV/AIDS is still in its infancy.

    Key challenges include the need to develop sustainable local responses through decentralisation and community capacity building together with democratic management of the response, and the participation of stakeholders with respect to their legal competence, strengths, skills, and comparative advantages.

    At national level, progress has been made through the development in 11 Ministerial departments of 5-year sectoral action plans (2004-2008). At local level, communities are being mobilised and local fund-raising successfully undertaken. Collaboration between local government authorities and NGOs is underway in all districts which have established Municipal HIV/AIDS Teams. These teams include the local government representatives, NGOs, and other organisations (religious and customary chiefs, community based organizations, women and youth associations, etc.). Weaknesses so far include the slow pace of implementation and insufficient resources for monitoring and evaluation.

     8

7. Challenges facing a New AMICAALL Programme [AMICAALL Kenya

    Presentation]

    While Kenyan local authorities are accessing funding in support of their HIV/AIDS activities, AMICAALL Kenya (at two years old, the youngest member of the AMICAALL family) faces

    two significant challenges. First, responding to the high expectations expressed by leaders of

    Local Authorities; and second, securing the resources necessary for effective delivery of

    capacity building services. A number of achievements have been made so far.

AMICAALL has been recognized by NACC as a key player in the national response and is

    now represented at the Inter-Country Coordinating Committee (ICC), the second highest

    policy making committee in the country. The Ministry of Local Government, also recognizes

    the role of AMICAALL in the national response, and has appointed an officer to support us.

    UNDP has continued to provide funding for two UN Volunteers, workshops for local

    government leaders in order to enhance their commitment and response to HIV/AIDS,

    together with the provision of other technical support. The AMICAALL Strategic Plan is at an

    advanced stage of development and will be launched when AMICAALL holds its annual

    review and conference. UN Habitat has funded ward level and citywide consultations for one

    local authority. Some funding has also been provided by the World Bank to enhance the

    capacity of the AMICAALL Programme to respond to requests from local authorities.

    Potential future partners include FAO and USAID.

For the future, AMICAALL Kenya will conduct training for the remaining local authority

    leaders and for desk officers, as well as facilitating the development of municipal HIV/AIDS

    Teams in six Local Authorities together with the development of HIV Service Directories for

    each Authority. AMICAALL Kenya is partnering with organizations providing Home Based

    Care and advocating for land and inheritance rights for both OVCs and widows, problems

    which already existed in Kenya but which are now exacerbated by HIV/AIDS.

8. Partnerships : South East District, Botswana and the City of Toronto,

    Canada [Presentation]

A presentation was made describing a partnership between the South East District,

    Botswana and the City of Toronto, Canada. The goal of the partnership, which began in

    2002, is to build community capacity in both Toronto and in the South East District of

    Botswana to address issues of HIV/AIDS through facilitating „local government to local

    government‟ relationships.

Key areas of focus include palliative care and support (including the incorporation of palliative

    care within home-based care), and addressing stigmatisation and discrimination. Skills

    transfer is accomplished through exchange visits and mentoring. Youth engagement

    strategies include the „Kicking AIDS Out (KAO)‟ approach which promotes sexual health and life skills education and leadership development through sport.

Lessons learned so far highlight the importance of involving a range of partners and

    promoting clear and honest communication among them. Working with networks (such as

    KAO) has also been important as a way of leveraging resources. The initiative has been

    most effective when it is supported by local and regional linkages. Strong, committed and

    continuous leadership is crucial. Local government and communities need to work together

    and local authorities have a vital role to play in responding to HIV/AIDS.

     9

    APPENDIX 1

    AFRICITIES SUMMIT 2006

    Nairobi, Kenya

    20 September 2006 (2:00 6:00 p.m.)

    Special Session on Localising Responses to HIV/AIDS:

     Achievement and Constraints

Mr. Salim Kisauji, Alliance Coordinator (5 minutes) Introduction of Panel

     Presentations

    Chair Mayor Nokuthula Mthembu, Swaziland Panel 1

    Mayors and Civil Society Working Together at the Local Level (45 minutes) Presentations by: Kenya Team

     Prof. Orago Director of National AIDS Control Council

     Mr. John Kamigwi, NACC

     Mayor & Chair of Alliance/AMICAALL Kenya

     Ms. Margaret Jobita, National Coordinator, AMICAALL Kenya

     GROOTS Representative and PLWH

    Chair Mayor Zenabou Drabo, Burkina Faso Panel 2

    Three Ones at Local Level Coordination, Planning Monitoring and Evaluation:

    Linking Local with National (45 minutes)

    Presentations by: Mr. Ken Mwansa, National Coordinator, AMICAALL Zambia

     Ms. Annie Michèle Salla Nzie, National Coordinator,

     AMICAALL Cameroon

     Mr. Amidou Kabore, National Coordinator, AMICAALL

     Burkina Faso

    (Followed by 15 minutes of discussion/questions for panels 1 and 2)

    Coffee Break (15 minutes)

    Chair Mayor Felix Koa, Cameroon Panel 3

    Scaling Up Services and Closing the “Implementation Gap” (45 minutes) Presentations by: Ms. Drabo Niangadou, National Coordinator, AMICAALL Mali

     Mr. Rudolph Maziya, National Coordinator, AMICAALL Swaziland

     Dr. John Mugisa, National Coordinator, AMICAALL Uganda

     Mr. Shingi Mushamba, FCM, Women and HIV Chair Mayor Zenabou Drabo, Burkina Faso Panel 4

    Decentralised Cooperation: Partnerships and Collaboration (45 minutes) Presentations by: Ms. Barbara Emanuel, City of Toronto, Canada

     Ms. Gamodimo, South East District, Botswana

    Presentation of Toronto Proclamation by: Mr Fisho Mwale, Alliance

    (Followed by 15 minutes of discussion/questions for panels 3 and 4) Mr. Salim Kisauji, Alliance Coordinator (10 minutes) Wrap Up,

    Communiqué and

    Closing

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