On June 4, 2009, U.S. Ambassador to Swaziland Maurice S. Parker and Prime Minister of the Kingdom of Swaziland (GKOS) Dr. Barnabas S. Dlamini signed the Swaziland Partnership Framework on HIV and AIDS 2009-2013 (PF). Through the Swaziland PF, the U.S. government intends to contribute to, and align efforts with, GKOS’s implementation of the goals, objectives, strategies, and actions under Swaziland’s multi-sectoral National Strategic Framework on HIV/AIDS (NSF 2009-2014). This PF is the second of its kind (after Malawi) established between the U.S. Government PEPFAR program and a host government. The Swaziland PF focuses on developing a comprehensive national HIV prevention program, improving the coverage and quality of HIV-related treatment and care, mitigating the impacts of HIV/AIDS with a focus on children, increasing access to high quality medical male circumcision, and building the human and institutional capacity needed to achieve and sustain these goals.
The signing of this partnership framework represents the culmination of a dialogue between the USG and GOKS that began in 2008 with the reauthorization of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).1 This law introduced support for the USG to enter into PFs with host governments as a means of strengthening collaboration to promote national ownership of sustainable HIV programs. PFs, such as this one signed in Swaziland, provide a 5-year joint strategic framework focused on service delivery, HIV/AIDS policy reform, and shared financial and/or in-kind commitments. Partners in Swaziland are now working to develop a more detailed 5-year PF Implementation Plan, with annual benchmarks for progress against the Framework and a matrix detailing partner inputs to the PF objectives.
Swaziland’s Partnership Framework
Swaziland bears the unfortunate distinction of having the world’s highest rates of HIV and TB infection. Since 2003, the USG through PEPFAR has been supporting important but limited activities to build systems assisting in the national HIV/AIDS/TB response. With the increased resources made available by the American people under the PF, PEPFAR is now well-positioned to ramp up support, along with other partners, to provide a genuine national scale-up of services in HIV prevention, care and treatment.
This Partnership Framework represents a commitment to enhanced engagement by the GKOS, with enhanced support from PEPFAR, to respond to the HIV/AIDS epidemic in Swaziland, and highlights an innovative model for collaboration and coordination among the USG, GKOS, and other country stakeholders. In tandem with the development of the PF, the USG PEPFAR Swaziland team, other donors and implementing partners supported GKOS’s effort to develop Swaziland’s National Strategic Framework 2009-2013, which was finalized in February 2009.
The PF presents a collaborative approach to expansion of HIV/AIDS services to the Swazi people and describes a coordinated effort, emphasizing key purposes and principles of the PF, a jointly held five-year strategic overview, partner’s roles and commitments, and oversight and management considerations to ensure PF success. Programmatically, the PF focuses on support for the GKOS’s efforts in the following five intervention areas: reducing new HIV infections; improving the coverage and quality of HIV care and treatment services through decentralization; mitigating the impacts of HIV/AIDS with a special focus on children; expanding access to high quality medical male circumcision; and strengthening human resources and support systems, including laboratory services and strategic information. Under each of the stated goals, PEPFAR and the GKOS jointly identified overarching national targets, specific program areas to be addressed, key policy reforms needed to achieve and sustain the stated goals, and five-year benchmarks to measure success. The document also lays out the expected areas of support by PEPFAR, the GKOS, and other stakeholders. The PF will be supplemented by a more detailed Implementation Plan with benchmarks for progress and a matrix detailing partner inputs to the PF objectives.
This PF represents a significant innovation, as this is the first time in Swaziland and just the second time under PEPFAR worldwide that a partner government has formally committed to HIV/AIDS policy reforms related to USG engagement. These bilateral commitments, while not legally binding, will create a policy environment that supports and sustains USG investments, as well as the long-term success of Swaziland’s efforts to fight HIV/AIDS.
Finally, the PF delineates the roles and responsibilities of each stakeholder and the methods by which the partners are to oversee the implementation of the PF. The PF was developed through a consultative process that relied on existing Swazi structures (e.g., technical working groups and the National Emergency Response Council for HIV/AIDS-NERCHA) to establish common understandings. The PF is designed to work within these structures to ensure oversight, accountability and achievement of established objectives. These structures further provide an efficacious platform for aligning and harmonizing PEPFAR activities with those of the GKOS and other development partners.
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