CONCEPT NOTE AND TERMS OF REFERENCE FOR DEVELOPMENT OF THE THEMATIC GROUP REPORT ON HIV AND AIDS FOR THE MEDIUM TERM PLAN (MTP) III 2018-2022 1.0 Introduction The country has embarked on the development of the Third Kenya Vision 2030 Medium Term Plan (MTP 2018-2022) that will succeed the Second MTP 2013-2017. Like its two predecessors, it will be guided by Kenya Vision 2030- the country s long term development strategy which seeks to transform Kenya into a newly industrializing upper middle income country providing a high quality of life to all its citizens by 2030. It will also be informed by the priorities outlined in the Manifesto of the Political Party forming the government after the next general elections scheduled in August 2017. The Third MTP will endeavor to move the economy to move towards a high growth trajectory to achieve the 10 percent economic growth rate target by the end of the Plan period. It will prioritize policies, programmes and projects which generate broad based inclusive Socio- economic development involving faster job creation, reduction of poverty and inequality, taking into account climate change impacts, and meeting the 17 Global Sustainable Development Goals (SDGs) and the goals of the African Union Agenda 2063. The plan will build on gains made so far in key sectors of the economy including completing projects initiated during the Second MTP. It will target not only at increasing the level of investments, as well as raising productivity in all sectors of the economy. The Thematic Groups on HIV and AIDS and Climate have been identified as critical in the development of the MTP III the process for the realization of the above outcomes among others. 2.0 Rationale The MTP II targeted to reduce HIV prevalence from 5.6% in 2012 to 5% and 4% by 2015 and 2017 respectively 1. However the Kenya HIV estimates report of 2015 indicates that the HIV prevalence is at 5.9%. The reduction in new HIV infections among the adult population (15 years 1 Medium Term Plan 2013-2017 Page 1 of 6
and above) stood at 19% and those among children (less than14 years) at 49%. However there was a notable increase of new HIV infections among young people (15-24 years) at 17% and this calls for strategic focus on the young people. The HIV prevalence in the country is heterogeneous, with nine (9) counties having HIV prevalence above the national average namely Homa Bay (26.0%), Siaya (24.8%), Kisumu (19.9%), Migori (14.3%), Mombasa (7.5%), Busia (6.7%), Nyamira (6.4%), Taita Taveta (6.3%), and Nairobi (6.1%). Three (3) counties have maintained a HIV prevalence lower than 1%, namely Wajir (0.4%), Mandera (0.8%), and Garissa (0.9%) counties. The remaining thirty-five counties have HIV prevalence marginally lower than the national average ranging between 1%-5%2. As was the case with HIV prevalence, there is geographical heterogeneity in estimated number of annual new HIV infection in the country. In 2015, only 5 out of the 47 counties contributed to half of the total new HIV infections. The new HIV infections also affects young people disproportionately, with 51% of new adult HIV infections occurring among young people (15-24 years), with two-thirds of these occurring among adolescent girls and young women3. Over the past decade, the annual AIDS related deaths sharply declined from approximately 98,000 in 2000 to 30,800 in 2015 among adults aged 15 years and older. A Similar trend was observed among children (0-14 years), with the estimated annual AIDS related deaths declining from about 22,900 in 2000 to 5,000 in 2015 (Kenya HIV Estimates 2015). The significant decline in AIDS related deaths is credited to scale-up of access to antiretroviral therapy (ART) in the country. The resources to effectively fight HIV and AIDS are inadequate with the shift in priorities by development partners who have been the major funders for HIV and AIDS programmes in the country. This calls for sustainable financing in order to not erode the gains made so far. The management of HIV and AIDS is intricate and requires involvement of all the key stakeholders across the levels of government and sectors. The Kenya AIDS Strategic Framework 2014/15-2018/19 and County HIV and AIDS Strategic Plans for the 47 counties were developed after the MTP III. The MTP III provides an opportunity to link the priorities of the KASF and County plans to MTP III. Also only HIV prevalence has 2 Kenya HIV County Profiles 2016 3 Kenya AIDS Response Progress Report (KARPR) 2016 Page 2 of 6
been identified as a measure on the progress being made towards the HIV response leaving out critical indicators on reduction of new HIV infections and improvement of quality of life. The development of the MTP III provides an opportunity to review the indicators of measuring the progress outcome. 3.0 Purpose The purpose of the Thematic Group on HIV and AIDS is to ensure that HIV and AIDS is mainstreamed across the sectors of the three pillars (Economic, Social and Political) for the realization of the MTP III targets and Vision 2030. 4.0 Specific Objectives To evaluate the progress made, identify challenges encountered under the implementation of the prioritized interventions in Sector Plans, MTP II and make recommendations for consideration in the MTP III development. To link the Kenya AIDS Strategic Framework and County AIDS Strategic Plans priorities with the MTP III and Sector plans for implementation. 5.0 Expected Output Comprehensive Report on the HIV and AIDS to inform the development of MTP chapter on Social Pillar and Sector Specific HIV and AIDS activities for implementation. 6.0 Methodology and Timelines The development of the Report on HIV and AIDS will be done by engaging the Key stakeholders involved in the HIV response across the sectors and the two government (National and County) levels. The Sector engagement will be at National level involving the Technical Secretaries for the MTP III development while County consultations will be carried out at the county level. A Thematic Group on HIV and AIDS will be reconstituted at the national level (see Annex 1 for the Terms of Reference). The membership of the Thematic Working group will be drawn from the Key Sectors that include; PLHIV, Organizations dealing with Key Populations, Research Institutions, Public, Private, and Faith Sectors among others. The group will also be charged with responsibility of developing/reviewing the tools and the report format to be used during the process. Page 3 of 6
During the engagements, stakeholders will be required to review the progress made towards achievement of the Sector and MTP II targets, identify challenges encountered in the implementation of the prioritized HIV interventions in the 2013-2017 Sector Plans and MTP II and make recommendations. After collation of the information from the counties, the Thematic Group will retreat to draft the report that will be submitted to the MTP III drafting team to inform the development of MTP III 2018-2022. The report will be reviewed and validated by stakeholders before submission to the MTP III Drafting Team. The table below indicates the key activities and the timelines. Activity Timelines Development of the concept note and tools May 9-12, 2017 Establishment of the HIV and AIDS Thematic Working Group (HATWG) May 9-12, 2017 Planning meeting for the HATWG to approve the process and TORs, June 5, 2017 identify priority Areas, develop/review tools, develop report structure Sector Representatives meeting and County Consultations June 1-15, 2017 Second HATWG meeting to assess progress and receive reports June 21, 2017 Third HATWG meeting to review Zero draft June 27, 2017 Validation meeting by Stakeholders June 29, 2017 Page 4 of 6
Annex 1: Terms of Reference for the HIV and AIDS Thematic Working Group The Thematic Working Group will be involved in all the aspects of the development of the Report on HIV and AIDS for the working group. The objective, key outputs and timeliness have been provided in the Concept Note. The membership of the Working Group has been provided in Annex 2. Specifically, the group will carry out the following tasks; Undertake situation analysis for the sectors highlighting achievements, constrains, bottlenecks in achieving the targets and remaining challenges. The situation analysis above should also highlight inequalities in achievement of indicators based on gender and location. Develop implementation plan for selected Vision 2030 Flagships Projects for 2018-2022 if any. Identify programmes/projects and key policies other than the flagship projects for implementation in the next 5 years. o Identify programmes for implementation by the National government, County government and those to be implemented jointly by National and County governments. o Identify projects to be funded under Private Public Partnership. (PPP) Identify the risks and likely adverse shocks which may impact achievements of the sector targets and propose mitigation measures. Identify the policy, legal and institution framework/ reforms required. Mainstream gender issues. Mainstream climate change issues into the sector, programmes. Develop indicators/ targets for monitoring and implementation of sector plans, policies, and programmes including those aimed at addressing inequalities based on gender and location. Prepare an implementation matrix which costs the programmes, projects and also indicate the timelines as well as implementing agencies. Page 5 of 6
Annex 2: Proposed Membership List for the HIV and AIDS Thematic Working Group MTP III 1. National AIDS Control Council 2. Ministry of Health, NASCOP, TB, 3. Kenya Medical Supplies Authority- KEMSA 4. Kenya Medical Research Institute- KEMRI 5. The National Treasury 6. State Department of Planning and Statistics 7. Ministry of Interior and National Coordination 8. MoE 9. Council of Governors 10. KIPRA 11. Development Partners a) UNAIDS b) IAVI c) UNDP d) PEPFAR e) USAID f) WHO g) UNICEF h) Bill & Melinda Gates Foundation 12. NEPHAK 13. CHAK 14. CSO Representatives 3 15. Key Population Representative 1 16. NCCK 17. SUPKEM 18. NACADA 19. FKE 20. UNITID 21. Nurses Association 22. Medical Practitioners and Dentists Association 23. Pharmacy and Poisons Board 24. Kenyatta National Hospital 25. Aga Khan University Teaching Hospital 26. National Hospital Insurance Fund 27. University of Nairobi- Medical School 28. Kenyatta University Medical School 29. Sector Technical Representatives involved in the MTP Process (10) Page 6 of 6