II. Partnership Frameworks


The first stage plan is negotiating a signed Partnership Framework which focuses on establishing a collaborative relationship with the government and other relevant counterparts, defining goals for the arrangement, and setting the stage for a process to define the specific work of the partnership through the Partnership Framework Implementation Plan.

1. Establishing a design team and conducting consultations

Country teams should establish a Partnership Framework design team with responsibility for leading the development of the Partnership Framework. The design team should include representatives of all USG agencies in country, the government, and other relevant partners. Using this Framework Guidance, the design team should develop a plan and timeline for designing, jointly reviewing, and negotiating both the Partnership Framework and Implementation Plan.

To reach an understanding with the government (with input from civil society, other donors, international organizations and the private sector) on joint strategic goals, broad consultations will be necessary. The design team should consider convening one or more workshops or meetings involving critical stakeholders. Objectives could include: (1) mapping existing HIV services, programs, health systems, and policies and their impact, (2) identifying program and policy gaps that could be addressed by the Framework including a mapping of all donor activities in the sector, and (3) identifying bottlenecks to achievement of program goals. These consultations will contribute to the development of baseline assessments, as described in sections III.A.1. and III.B.2. of this document.

As elements of the Partnership Framework are proposed and discussed, in addition to dialogue, written communication with stakeholders is recommended to assure accuracy and to document decisions. The design team will be responsible for achieving consensus on priorities for the Framework.

2. Goals, objectives, and contributions

This first-stage Framework document should define the fundamental structure and relationships of the collaboration to address HIV/AIDS within the context of the national HIV/AIDS strategy. The document should propose a limited number (for example, three to five) of high-level goals that encompass the breadth of activities included within the Framework. Examples might include: reduce HIV incidence by x%; increase PMTCT coverage to x%; or expand access to quality HIV treatment for x% of those in need. Objectives should include the programmatic interventions proposed to achieve each goal. Contributions will describe the overall support expected from each partner to realize each objective. Illustrative Tables 1 and 3 provide additional examples of the level of detail anticipated at the goal, objective and contribution levels.

Goals, objectives, and commitments


The Partnership Framework should succinctly set out the 5-year collaborative strategy between the USG PEPFAR team and the government. It must contain the following sections and may contain additional ones if the parties so choose: 1) Purpose and principles; 2) Five-year strategic overview; 3) Partners’ respective roles and commitments; 4) Plans for developing the Partnership Framework Implementation Plan; 5) Management and communications, and 6) Signatures.

1. Purpose and principles

Describe the value of the Partnership Framework as a 5-year collaborative strategic framework for the USG PEPFAR team and the government, with appropriate support for the government from other partners, and how it lays the foundation for the Partnership Framework Implementation Plan. List and briefly describe key principles of the Partnership Framework that the partner government and country team deem important (for example, how the Framework builds country government capacity and ownership; supports the National Plan for HIV/AIDS; is aligned with the Three Ones; reflects accountability and transparency; and promotes participation of partners, a multi-sectoral approach, integrating HIV/AIDS with health systems; etc.).

2. Five-year strategic overview

Articulate the strategy to promote greater ownership of programs and activities by the country government and local organizations over the five years represented by the Partnership Framework, and provide a clear description of the state of the national response at the end of the five years. Describe the overall Partnership Framework goals and the scope of the activities to be carried out through this Partnership Framework to achieve these goals. This scope should include which program areas (e.g., PMTCT service provision, OVC support, lab strengthening, healthcare worker training, etc.) and policy reforms (e.g., gender-based violence, opt-out testing, etc.) will be addressed through the Partnership and what steps will be taken to transition from direct USG implementation of services, in many cases through external organizations, to assumption of a technical assistance role strengthening government management and delivery of services at the national, provincial, district, and village levels. Describe how Partnership Framework activities help build sustainability and expand country government capacity to plan, oversee, manage, implement, and finance HIV programs and help realize the National Strategic Plan on HIV/AIDS, the country’s other long-term health and development plans, and PEPFAR numerical program goals. For example, describe how USG technical assistance will promote increased government capacity, how targeted policy reforms (Annex 1) will strengthen the government’s role in overseeing its HIV/AIDS and health national strategic plans, and how the government’s financial systems will be strengthened. Identify barriers to government ownership of the HIV/AIDS response, and a strategy to address them.

3. Partners: roles and commitments

List USG, government, and other partners and describe their respective roles and high-level commitments to achieve 5-year goals for service delivery, policy reform, capacity-building, and projected financial and activity contributions. This section should put Partnership Framework objectives and contributions into the larger context by referencing the roles of all key partners, e.g., GFATM, the UN system, private foundations, and key bilateral donors. While Partnership Frameworks may not include an exhaustive list of other partner activities related to a given objective, every effort must be made to provide information on other partners (i.e., Global Fund, UN system, bilateral donors, major foundations) that is as complete as possible in the Partnership Framework Implementation Plan. This information is essential to ensuring that both the Partnership Framework and Partnership Framework Implementation Plan are truly harmonized and aligned in favor of sustainable country-owned strategies. Indicate what key steps will need to be taken to further develop this information for the Partnership Framework Implementation Plan.

Country teams may opt to present this information in a tabular form, which can then be expanded for the Partnership Framework Implementation Plan. Illustrative Table 1, below, provides an example of such a table.

Table 1. Example of tabular format of goals and high-level commitments:

Five-Year Goal

Prevention: Reduce HIV Incidence by 50%



Expected Contributions

Steps Required for Development of Partnership Framework Implementation Plan










Ensure provision of HIV prophylactic treatment of 85% of pregnant women who require this intervention

·         GOV procures prophylactic drugs and HIV test kits

·         GOV provides leadership in strategic planning and review of PMTCT effort

·         USG supports training in PMTCT

·         USG provides technical assistance in planning and management to the MOH at the national and provincial levels

·         GF procures prophylactic drugs

·         WHO supports planning and review processes

·         NGOs support community mobilization

·         Review costing information and negotiate drug procurement contributions by partner

·         Conduct training needs assessment

Ensure all relevant target populations receive appropriate prevention interventions associated with HIV risk behaviors

·         GOV incorporates life-skills training curricula in primary and secondary schools


·         USG supports a  combination prevention pilot

·         USG works with UNAIDS to develop quality standards for prevention programs

·         GF supports model expansion

·         UNAIDS supports development of prevention quality standards

·         PLHA org. supports PwP programs

·         Country Business Coalition increases work-place prevention programs

·         Update national prevention strategy

·         Develop strategy and timeline for combination prevention pilot

Increase the availability of male circumcision services

·         GOV ensures favorable policy environment to support expansion of MC

·         GOV funds training of MC providers

·         USG supports  government to develop a national strategy for MC rollout and fund MC rollout in three provinces



·         WHO supports monitoring of MC quality, adverse events


·         Review and finalize MC policy

·         Conduct baseline assessment of facilities to determine readiness for MC provision

·         Develop targets

Improve the quality of HIV laboratory services

·         GOV supports National Reference Laboratory functions

·         GOV supports development of QA/QC standards and protocols

·         USG supports training of new lab technicians

·         USG funds construction costs for new laboratories


·         Conduct baseline assessment of laboratory services

·         Agree on construction plan

4. Plans for developing Partnership Framework Implementation Plan

Include a timeline and those responsible for development of the Partnership Framework Implementation Plan. This information should follow from the last column in Table 1.

5. Management and communications

Establishing a Partnership Framework represents a new emphasis on formalizing the relationship between the USG and country government, with the government assuming leadership over the efforts of the USG and other relevant stakeholders involved with the national HIV/AIDS response. Describe plans for government management of the Partnership Framework, including decision-making structures, coordination bodies, and communications strategies as well as approaches to conflict resolution. In considering Framework governance and implementation, the ideal is to make governmental structures successful in their management, planning and coordination functions. It is up to governments to decide whether to use existing governmental structures, modified structures, or newly established structures. Governments may opt to establish a government-led Partnership Framework Steering Committee to receive input from diverse partners and stakeholders, or to use an existing successful CCM, IHP+ compact, or other entity to support the government in its planning and coordination roles. The bottom line is that the decision on how best to manage the Partnership – and all HIV/AIDS efforts in country – rests with the government; the USG is to play a supportive role.

6. Signatures

List the agency, title, and name of all signatories. Include a clause allowing for future modification of the Partnership Framework such as: “This Partnership Framework may be modified in writing by all signatories.” This will allow for flexibility as the environment changes (e.g., elections, new national strategic plans, etc).

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