USAID CBJ FY 2002: Guyana

Summary: With the second highest HIV prevalence rate in Latin American and the Caribbean, USAID's HIV/AIDS Special Objective seeks to increase Guyana's prevention efforts and slow the rate of new infections. While segments of the Guyanese population have a general awareness about HIV/AIDS and sexually transmitted infections, the seriousness of the problem, the accuracy of information about transmission, and the recognition of personal risk are low, particularly among youth. There does not appear to be a sense of urgency in tackling the increasing HIV/AIDS problem among most government and religious leaders due in part to the paucity of country-wide surveillance data on the extent of the problem and underreporting. Bilateral donors have also been slow to recognize the extent of the problem and its potential impact on Guyana's development prospects. With the nascent state of Guyana's NGOs, USAID's overall strategy is to develop and catalyze six NGOs to expand HIV/AIDS prevention activities targeted to youth in three of the largest urban areas. The initiation of this new collaborative process in which NGOs are working together, for the first time, using a common strategy and shared responsibilities for implementation of HIV/AIDS activities, has already resulted in increased NGO technical capacity and more extensive and effective outreach to targeted youth.

Key Results: Three key intermediate results are necessary to reach this objective: (1) strengthened NGO capacity to deliver HIV/AIDS programs to targeted groups; (2) increased knowledge of HIV/AIDS in targeted groups; and (3) increased use of HIV/AIDS prevention strategies in targeted groups.

Performance and Prospects: In the spring of 2000, a coalition of six Guyanese NGOs was formed to expand HIV/AIDS prevention to targeted youth outside the formal school setting. The program got off to a rapid start, focusing on three urban areas and three groups: youth in organized groups, "limers" or youth "hanging out", and mini-bus drivers and conductors. The program is centered on behavior change interventions using a series of mini-campaigns after which sessions on lessons learned are used to formulate future activities. A steering committee makes policy and implementation decisions using a highly participative model and includes representatives from each NGO, the United Nations Acquired Immunodeficiency Syndrome (UNAIDS) Theme Group, Guyana's primary STI (sexually transmitted infections) clinic, Pan American Health Organization/World Health Organization, the National AIDS Program Secretariat, and the Peace Corps. Family Health International is providing technical assistance with a Peace Corps Volunteer serving as program coordinator for the first year. High profile events and early recognition of the groups' efforts has kept commitment and enthusiasm high.

The first phase of the HIV/AIDS program focussed on promoting self-risk assessment activities and a rapid assessment of the knowledge, attitudes and behavior of 750 youth in the three urban areas. The data collected provided baseline information and is helping to shape media materials and messages and future prevention campaigns. Through a series of workshops, NGOs' technical capacity in activity design, materials development, and peer education has been strengthened. Throughout the first year, the NGOs carried out a series of structured "mini campaigns" addressing the issues surrounding HIV/AIDS/STI. The theme they developed ("Ready Body! Is It Really Ready?") to promote a healthy lifestyle and safe sexual behavior has proven to be immensely popular among youth and forms the basis for development of numerous written and media materials. The program implemented awareness and prevention activities such as street fairs, walkathons, World AIDS Day rallies, a performance at the National Cultural Center, and many peer education outreach programs and workshops. The increase in the number of youth reached through these combined efforts is astounding, going from 1,700 in 1999 to almost 34,000 in 2000. There have been 80 media appearances promoting HIV/AIDS prevention and over 450 media ads.

In addition, condom distribution by the six NGOs increased from 205,000 to 370,000. With USAID's assistance, the NGOs submitted a proposal to the Japanese for communications and office equipment and furniture through the Grass Roots Grant Mechanism and received a $45,000 grant. This grant increased the NGOs' capacity in office and program management and materials production.

Based on the first year's accomplishments, prospects for success of USAID's HIV/AIDS prevention program are high. As the program enters its second full year, it will expand prevention activities to two additional geographic sites and incorporate two additional NGOs. These efforts will enable the program to reach targeted hinterland areas where Amerindians working in logging and mining camps are at high risk for infection. An indigenous peer education manual developed by the program will be tested. It will serve as a model to be used in all Guyanese HIV/AIDS/STI peer education programs, thereby unifying the messages and assuring that accurate and culturally appropriate methods are integrated into existing and burgeoning programs. A monitoring and evaluation plan created in tandem with the Steering Committee will be fully implemented after an organizational capacity assessment is conducted for each of the NGOs involved. A recently completed assessment of current procurement, logistics, and distribution of condoms will form the basis of a two-year plan to address weaknesses in the current system to ensure that an adequate number of condoms are available at appropriate distribution sites throughout the country. USAID will continue its successful collaboration with the Peace Corps, using volunteers in rural and hinterland communities to further the reach of HIV/AIDS prevention activities, conduct an assessment of HIV/STI related services, and initiate an outreach program to Guyana's diverse religious community.

Of the $798,000 in FY 2001 funds, $600,000 will be used to increase the capacity and outreach activities of indigenous NGOs; $175,000 will be used to strengthen the National AIDS Program Secretariat's condom distribution logistics and forecasting system; and $23,000 will be used to conduct a condom social marketing assessment. Of the $1,000,000 in FY 2002 proposed funds, it is anticipated that $740,000 will be used to continue to strengthen NGO program based management and technical abilities while supporting their outreach activities; $110,000 to continue to the technical support of the National AIDS Program Secretariat's condom distribution and demand forecasting systems; and $150,000 to begin a condom social marketing pilot program.

Possible Adjustments to Plans: In light of additional financial resources made available in FY 2001 and FY 2002, a review of options for expanding the scope, activities and targets of the Special Objective will be conducted in mid-2001. With additional FY 2001 resources, USAID is already expanding the program to strengthen the capacity of the GOG in developing condom forecasting, logistics, and distribution systems. These funds will also strengthen the capacity of NGOs in appropriate condom storage and condom distribution data collection.

Other Donor Programs: While awareness of the serious nature of the HIV/AIDS epidemic is rising, concerted bilateral donor efforts have been slow in materializing. PAHO/WHO initially took the lead in working with the GOG and indigenous NGOs to develop the National AIDS Program Strategic Plan, providing the framework for the government program and donor assistance. The UN agencies are providing coordination and modest assistance through the UN Theme Group. To date, bilateral donors (European Union, DFID, and CIDA) have funded HIV/AIDS activities for Guyana as part of their overall regional effort. However, CIDA is currently designing a program to strengthen the Ministry of Health's capacity to manage communicable diseases including HIV/AIDS and TB and to develop a communicable disease database. In addition, the European Union recently developed a new regional HIV/AIDS program with Guyana as a special emphasis country. In FY 2000, the Japanese provided funding through their grass roots funding mechanism to NGOs supported by USAID's HIV/AIDS program. However, greater bilateral donor funding and collaboration will be needed to address and arrest the growing HIV/AIDS epidemic.

Principal Contractors, Grantees, or Agencies: USAID will implement its HIV/AIDS activities through the Global Bureau's Cooperative Agreement with Family Health International (IMPACT Project), and U.S. contractors John Snow Inc. (DELIVER Project) and TvT Associates Inc. (Synergy Project).

Guyana 504-003

U.S. Financing

(In thousands of dollars)

	Obligations		Expenditures		Unliquidated
Through September 30, 1999	0	DA	0	DA	0	DA
	0	CSD	0	CSD	0	CSD
	0	ESF	0	ESF	0	ESF
	0	SEED	0	SEED	0	SEED
	0	FSA	0	FSA	0	FSA
	0	DFA	0	DFA	0	DFA
Fiscal Year 2000	0	DA	0	DA
	200	CSD	120	CSD
	0	ESF	0	ESF
	0	SEED	0	SEED
	0	FSA	0	FSA
	0	DFA	0	DFA
Through September 30, 2000	0	DA	0	DA	0	DA
	200	CSD	120	CSD	80	CSD
	0	ESF	0	ESF	0	ESF
	0	SEED	0	SEED	0	SEED
	0	FSA	0	FSA	0	FSA
	0	DFA	0	DFA	0	DFA
Prior Year Unobligated Funds*	0	DA
	0	CSD
	0	ESF
	0	SEED
	0	FSA
	0	DFA
Planned Fiscal Year 2001 NOA		DA
	798	CSD
	0	ESF
	0	SEED
	0	FSA
	0	DFA
Total Planned Fiscal Year 2001		DA
	798	CSD
	0	ESF
	0	SEED
	0	FSA
	0	DFA
			Future Obligations		Est. Total Cost
Proposed Fiscal Year 2002 NOA	0	DA	0	DA	0	DA
	1,000	CSD	2,400	CSD	4,398	CSD
	0	ESF	0	ESF	0	ESF
	0	SEED	0	SEED	0	SEED
	0	FSA	0	FSA	0	FSA
	0	DFA	0	DFA	0	DFA

Guyana

Activity Data Sheet

Guyana 504-003

U.S. Financing