Programme management
National Programme for Prevention and Control of HIV/AIDS/STI (hereinafter The National Program) for 2011–2015, was developed according to the global commitments set under the Millennium Development Goal no.6 „Combat HIV/AIDS, malaria and other diseases”, Declaration of Commitment of the United Nations (hereinafter UN) General Assembly Special Session (UNGASS) for HIV/AIDS dated 2001, Universal Access initiative and strategic framework of outcomes. At the same time, the Program is developed to support the objectives of the National Development Strategy and the Health System Development Strategy for 2008-2017 and the National Health Policy.
The National Programme was adjusted to the existent political frame of the different sectors and was issued through a participative process, on the basis of the final evaluation of the National Programme 2006-2010 and Response Analysis evaluation.
The Program was funded on the principles of the public health programs of national and international level: development ofnational response according to the HIV/AIDS data; human rights based approach; gender equality, universal access to prophylaxis; treatment and care; community involvement and people living with HIV/AIDS in the process of Programme development and implementation; monitoring and evaluation.
Through the National Programme the Government assures the coordination of the response measures to HIV and sexual transmitted diseases (hereinafter STI), for 2011-2015.
The National Programme, adopted by the Decision of the Government nr. 1143, on 16th of December 2010, have recommended the municipal councils of Chisinau and Balti, Autonomous Territorial Unit of Găgăuzia (Gagauz Yeri) and rayonal councils, to develop, approve and ensure the implementation of the territorial programmes of control and prevention of HIV/AIDS and STIs for 2011-2015, to create regional committees for control and prevention of HIV/AIDS and STIs for 2011-2015 with mandate to organize and control the territorial programmes of control and prevention of HIV/AIDS and STIs.
The Central Public Authorities are committed to develop and approve the operational plans for National Programme 2011-2015 implementation
The National Programme 2011-2015 is financed in the limits of the public budget, as well as by the donors’ contribution, donations and grants.
The implementation of the National Programme is controlled by the Ministry of Health, the Central and Local Public Authorities must inform the Ministry of Health about the programme’s implementation, every year, until the 5th day of March.
The public administration authorities and organizations responsible for the implementation of the project is: Ministry of Health, Ministry of Labour, Social Protection and Family, Ministry of Education, Department of Penitentiary Institutionsof Ministry of Justice, Ministry of Youth and Sports and other authorized institutions; UN specialized agencies (UNAIDS, WHO, UNFPA, UNICEF, etc), through technical assistance and international standards informing; national and international NGOs specialized in interventions for PLHIV, interventions at the working place, IDUs, etc; local public authorities of the first and second level.
The stakeholders involved in the program implementation process are the governmental organizations and the civic society: public and private health services for lab diagnosis, clinical care, management of the patients, health education; NGOs for implementation of activities for most at risk groups, ensure support for PLHIV; institutions from private sector regarding the workplace policy implementation, social services providers for HIV response conversion into the existent services; research groups for development of the studies. The implementation of the activities will be done by the service providers and the implementers in coordination with NCC. The transparency of the implementation will be ensured by the web sites www.aids.md, www.ms.gov.md, www.cnsp.md.
The programme management is done by:
- operational researches, epidemiological surveillance system implementation, the virus circulation and resistance surveillance, implementation of informational technologies, case management and consolidation of capacity building of lab diagnosis;
- strengthening the human resources capacities through formative education, trainings in HIV/AIDS field;
- creating anenvironmentofsupportandcommunity development (advocacy and communication; institutional development, human rights and gender based programs);
- epidemiological, clinical, social, behavioral and economic studies and researches in HIV/AIDS.
The monitoring and evaluation of the programme is done by the Ministry of Health according to the Monitoring and Evaluation Plan of the Programme, through the Department of Public Health Policies, AIDS Center and National Center of Health Management.
There is only one national coordination entity – National Coordination Council TB/AIDS, which include governmental stakeholders, representatives ofpersonswithHIV positivestatus, NGOs, international community as well.
The main function of the National Coordination Council of the National Programme for Prevention and Control of HIV/AIDS/STI and TB, (hereinafter NCC TB/AIDS), is general surveillance of these Programmes: programme management, programme evaluation according to the expected outputs and financial performance.
The NCC TB/AIDS was established in 2002. In the beginning, it’s purpose was surveillance and monitoring of the project implementation “Support to National Programme for Prophylaxis of HIV/AIDS/STI and National Program TB control” financed by the World Bank and Global Fund to fight AIDS, TB and malaria.
Starting with August 2005, the NCC TB/AIDS is an intersectorial structure at the national level and reflects Republic of Moldova commitment and priorities in fighting tuberculosis, HIV/AIDS and sexually transmitted diseases, it’s functions being extended to supervision of the above mentioned National Programs implementation, as well as of the projects financed by the donors, designed to implement the National Program’s objectives.
The NCC TB/AIDS was established by the Decision of the Government Nr. 825, on 3rd of August 2005 (Annex 1). A geographical scaling-up and a larger involvement of the civic society were obtained after the amendments to this Decision. (Annex 2 – Decision of the Government Nr.375, on 6th of May 2010).
It should be mentioned that one of the major goals of the NCC TB/AIDS is to represent the main mechanism of the Global Fund to fight AIDS, TB and malaria commitments to ownership and decision-making participative process. This is the only partnership at the national level recognized by the Global Fund, which can develop and apply grant proposals according to the country’s priorities. After the grant is approved, the partnership is watching the progress and oversees the projects implementation.
NCC TB/AIDS wascreatedas aneed to unify, coordinateandstreamlinethe national response to HIV/AIDS and TB. The control of the epidemics takes the efforts of the entire society, political commitment, policy making, providingmedicalservices, preventionofnewcasesand providingcareand support for peopleinfectedor affectedbythesediseases.
The formal mandate of the NCC TB/AIDS.
The NCC TB/AIDS ensures the political commitment of the Government, intersectorial coordination, monitoring and surveillance of the NP’s activities’ implementation, as well as the partnership-based supporting programs within the Government, public institutions, civic institutions and international organizations.
The NCC represents the main mechanism of the Global Fund to fight AIDS, TB and malaria commitments to ownership and decision-making participative process. This is the only partnership at the national level recognized by the Global Fund, which can develop and apply grant proposals according to the country’s priorities. After the grant is approved, the partnership is watching the progress and oversees the projects implementation. The National Coordination Council represents an interministerial structure, established by the Decision of the Government, led by a President, assisted by two Deputy-Presidents. The NCC main concern is todevelop, integrate,monitor, correlateandmonitor HIV/AIDS/TB and STI policies.
The working principles of the NCC TB/AIDS
The working principles of the NCC TB/AIDS are established by the NCC Terms of Reference approved by the Decision of the Government nr.825, on the 3rd of August 2005. Bythisdocumentthe basicprincipleshavebeensupplemented withspecific principles.
The NCC functions as a national group based on consensus.
1. NCC members are equal partners, with full participation and decision making rights, according to the quality of the experience and proficiency level of each member.
2. The activity of the NCC is based on the Terms of Reference of NCC and this manual, which incorporate all the principles of good governance UNAIDS and Global Fund to fight HIV/AIDS/TB and malaria etc.
3. The activity of the NCC is based on principle of decentralization, which makes possible the regional participation in the decision making and operational process.
4. NCC promotes intersectorial partnership in order to develop, implement, monitor and evaluate the national programmes and to ensure the transparency of the decision-making process
5. Representatives of governmental institutions, which hold a mandate and represents the point of view of the mandatory institution.
6. NCC members, representatives of NGOs, private and academic organizations, international organizations of development must be democratically chosen, based on transparent and documented process, developed by each sector. Each member represent it’s sector in order to assure the feedback between NCC and the proper sector through: informatization, consultancy, promoting the interests of the sector particularly (taking under consideration theconflict ofinterest governing policy, according to NCC Decision nr. 3, on 20th of July 2006), and the interests of the HIV/AIDS field in generally. Attachment 2 - Conflict ofinterest governing policy
7. The results (policies, strategies, guidelines) of the NCC partnership are developed according to the national specific principle. This means that the local and international partners develop, implement and evaluate policies, project and strategies designed to support the National Programmes and are part of this programmes, ensuring their continuity and sustainability.
8. The policies within NCC TB/AIDS are aligned to the national development plans, as The National Health Policy, Millennium Development Goals, programmes of economic growth and poverty reduction etc.
The functions of NCC TB/AIDS. The most important functions of NCC:
1. Analyzes the causes and conditions which favor the spread of tuberculosis and HIV/AIDS/STI;
2. Develops and proposes for the Government approval national strategies for surveillance, control and prevention of TB and HIV/AIDS, and supervises their implementation;
3. Evaluates and proposes to the Government the provision in the state budget of the necessary funds for the implementation of national strategies in the respective fields;
4. Provides technical assistance to the competent authorities with regard to undertaken activities and the achieved results;
5. Periodically informs the Government and the competent authorities with regard to undertaken activities and the achieved results;
6. Proposes for the Government approval the measures which must be introduced for the surveillance, control, prevention and reduction of the social impact of cases of infection of TB and HIV/AIDS;
7. Formulates proposals to the international donors, approved through consensus and the majority of votes (2/3 of NCC).
8. Formulates proposals regarding the modification and completion of the legislation, as well as proposals regarding the development of new normative acts for the surveillance, control, prevention and reduction of the social impact of HIV/AIDS cases. The proposals will be forwarded to the competent institutions, which according to the law are responsible for initiating normative bills;
9. Ensures compliance to the conventions, treaties and other international documents signed by Moldova with regard to respect for the rights of people ill of tuberculosis and living with HIV/AIDS;
10. All other functions in order to accomplish its charter objectives, according to the legislation of Republic of Moldova.
The Structure of NCC:
National Coordination Council is structured in three levels:
· Decision making level – NCC members, assisted by 1 (one) National Committee of Experts.
· Coordination level – NCC Secretariat
· Operational level – Technical Working Groups (TWG)
NCC – decision making level – the highest commitment with regard to issuesrelated to HIV /AIDSandTB and represents the highest decision making body. National Coordination Council is headed by the President and assisted by the Vice-president.
· The president and at least one Vice-president represent different structures;
· The president and the Vice-presidents are nominated by a Government Decision;
· In case of refusal or release, the new Vice-president is appointed during the meeting of the announcement of dismissal of the previous one, or during the next meeting. The new Vice-president overtakes the duties and responsibilities of the resigned Vice-president.
Terms of Reference of NCC TB/AIDS President:
· Providehigh politicalcommitment of the national programs and projectsimplementation thatsupportthe national programs;
· Represent the structure/constituent/sector that delegated him through constant reporting, interests promotion, according to the conflict ofinterest governing policy (Annex 2);
· Provides the principle of active involvement and overall participation of the stakeholders from other sectors;
· Evaluatethe resolutions of thedecision-makinglevel;
· Evaluatethe resolutions of theoperationallevel, of the technical working groups;
· Facilitate activities within NCC meetings;
· Validates the decisions of the NCC meeting and sign protocols;
· Facilitate NCC extraordinary meetings when necessary;
· Ensurefairnessandtransparencyofdecision making
Terms of reference of NCC TB/AIDS Vice- presidents:
· Performtasksproposedby thePresident;
· In theabsence ofthe President,run overmeetings
The Structure of the decision making level:
The NCC cooperates with ministries, local and central public authorities subordinated institutions, international and bilateral agencies, civic society. Civic society is represented by NGOs, alliances, unions, leagues, networks and academic, religious and private sector. The civic society representatives gain 40 % of the NCC members. The NCC nominalcompositionis approved bythe Government.
NCC eligibility
Every person or institution from the above mentioned category is eligible to become a member of NCC, if the next criteria are met:
· Islegallyregisteredin Moldova;
· Undertakes activities in HIV/AIDS/ STI and/or TB, supporting the National Programme objective of control of these diseases, the Millennium Development Objectives and other national health initiatives;
· representatives of NGOs, persons infected or affected by HIV/AIDS, charitable organizations, private organizations, religious and academic organizations must be chosen by their own sector based on a transparent and documented process developed individually by each sector;
§ Accepts the basic principles and promotes the NCC idea and it’s capacity building;
§ Participates in time in NCC activities and shares relevant experience;
Application Process:
§ The protocol regarding the election process and a written application letter in free form must be submitted to the NCC secretariat. These documents must further be examined and approved by NCC members.