Unclassified Cable to All Diplomatic and Consular Posts: Involving Civil Society as Part of Country-level Planning

June 13, 2013


VZCZCWEO0928                           UNCLASSIFIED

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E.O. 13526: N/A

1.  This is an information cable. All posts may draw upon background
information provided when briefing officials and other country

2.  SUMMARY: In November 2012, the Obama Administration released the
PEPFAR Blueprint: Creating an AIDS-free Generation (Blueprint). This
document presents four roadmaps for how the U.S. government will
work to help achieve an AIDS-free generation. One of the major goals
outlined in the document is to increase civil society involvement in
HIV/AIDS planning and implementation, both for the U.S. government
and its partner countries. This cable provides some initial
information for Chiefs of Mission (COMs) on how to involve civil
society groups, with more detailed guidance to be released as part
of PEPFAR's Fiscal Year (FY) 2014 Country Operational Plan (COP)
guidance. END SUMMARY


3.  Our progress to date in the fight against AIDS, both globally
and domestically is due in no small part to the active involvement
of the communities living with and affected by HIV. Persons living
with HIV (PLHIV), their families, and their friends are critical as
partners in creating an AIDS-free generation. Recipients of PEPFAR
and country services must be empowered to play a meaningful role to
advocate for, design, and implement local HIV prevention, treatment,
and care services for greatest impact. In many countries where
PEPFAR operates, PLHIV are often providers of HIV/AIDS services. Yet
too often, individuals face stigma and discrimination when they try
to get involved. Many times, the experiences of people living with
HIV and key populations are ignored by governments and the medical
profession as they design HIV/AIDS prevention, care, and treatment
programs and activities targeted to meet the needs of this

4.  As part of implementing the Blueprint, PEPFAR is emphasizing the
importance of PLHIV, health service users, and civil society
involvement in its communication to partner countries. PEPFAR is
particularly concerned about the ability of these groups to
influence the planning, designing, and implementation of HIV
programming. Using various channels, PEPFAR has worked to support
civil society groups, ranging from groups of PLHIV to key
populations to women's groups to faith-based organizations. As part
of the Blueprint, PEPFAR is working to expand involvement of civil
society groups, particularly those of PLHIV, key populations, and
others who use our services. Through the upcoming Local Capacity
Initiative (LCI), PEPFAR funding will support civil society
organizations in various countries at national, district, and local
levels to build their capacity as advocates and service providers.
PEPFAR is also a major supporter of the Robert Carr Civil Society
Networks Fund, a collaborative multilateral mechanism for delivering
technical and capacity-building support to civil society networks at
the global, regional, and national levels.


5.  PEPFAR's vision of country ownership is one that ensures civil
society voices, particularly those of people living with HIV, key
populations, and those who use health services, are represented in
conversations with partner governments, and integrated as partners
in the country-level AIDS response. PEPFAR cannot mandate this
involvement, but it can work to expand its own engagement with civil
society as a way to spur greater civil society engagement by
partner-country governments, and is adding civil society engagement
as an explicit component within the COP process. This expanded
engagement is particularly important in countries where civil
society may be marginalized or heavily restricted in the activities
it is able to undertake, and will require COMs to champion the
benefits of civil society in discussions with country counterparts.

6. There are three steps that each country team should take while
preparing its COP to expand civil society engagement. In some cases,
PEPFAR country teams may need, as a precondition of expansion of
engagement, to hold a meeting with a wide range of civil society
groups and solicit their input as to how best they can be
represented in the process. More information on these steps will be
forthcoming in the FY 2014 COP guidance.

7. First, PEPFAR teams should hold a pre-COP submission meeting,
early in the planning process, with civil society, including both
PEPFAR implementing organizations and organizations representing
communities living with and affected by HIV. At this meeting, teams
should outline the proposed goals and priorities of PEPFAR for the
upcoming year, particularly regarding how they support country
HIV/AIDS plans and align with WHO guidelines and epidemic needs.
They should also highlight changes to the program proposed as part
of the COP submission, and the expected impact on users of the
program. As part of this meeting, country teams should also solicit
written comments from civil society representatives on these
priorities and plans. Country teams should also consider reaching
out to civil society later in the COP development process if
specific inputs or feedback would help to enhance the COP

8. Second, PEPFAR teams should submit the COP to headquarters with a
section documenting how civil society has been involved, the
comments raised by civil society, and the way in which the COP has
taken into account these comments.

9. Finally, following completion of the COP process, PEPFAR should
provide a formal written response to civil society, documenting the
way in which comments were considered in the process and, if not
included, the reasons for their exclusion.

10. This overall process should be viewed as an ongoing dialogue
that supports a relationship extending beyond the COP period. The
goal of this outreach is not to abdicate responsibility for program
decisions and oversight, but to ensure that our programs are
designed based upon meaningful input from PLHIV, key populations,
and other civil society groups. It is PEPFAR's obligation to both
listen and respond to concerns and suggestions from those who use
our services.

11. Given PEPFAR's commitment to supporting country ownership, to
the greatest extent possible in each country context, this
engagement should take place through existing, representative
mechanisms for civil society engagement at the country level.


12. Ultimately, the responsibility of civil society engagement lies
with the country government, which should ensure that it is
involving its citizens within planning processes. However, many of
the key populations affected by HIV, such as PLHIV, men who have sex
with men, people who use drugs, and sex workers, are often
marginalized and left out of host-government dialogues. Partner
governments should involve civil society in the development of
national strategies and implementation of programs to enable more
effective, sustainable and self-correcting HIV efforts. They should
also be held accountable by civil society for achieving goals and
ensuring that marginalized populations have equal access to HIV
services. PEPFAR's COP planning process, as noted above, is one
place for engagement with civil society, but is not the only
mechanism that should be used. As part of diplomatic dialogue, the
U.S. government should encourage country counterparts to involve
civil society, particularly PLHIV, key populations, and those who
use services, in planning for HIV/AIDS programs. In addition, PEPFAR
should work through other mechanisms to involve local civil society,
such as the Global Fund's Country Coordinating Mechanisms or other
existing representative consultative bodies at country level.

13. ADDITIONAL INFORMATION: More detailed guidance to be released as
part of PEPFAR's FY 2014 Country Operational Plan (COP) guidance.




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