Analysis and Advocacy (A 2) Proj ect in Guangxi, China : Key findings and impact The Analysis and Advocacy (A 2) Project brings together modelers, What’s been accomplished ? epidemiologists, economists, advocacy specialists, policy Key Findings: Policy and Program Impact makers and program managers in an effort to bridge the HIV/AIDS 2 evidence-policy divide. A builds Guangxi Zhang Autonomous Region 2 local capacity for data analysis currently has the third highest cumulative A baseline projections showed that the and evidence-based advocacy to number of reported HIV infections in number of new HIV infections will continue promote effective national policies to rise in Guangxi in the absence of more and appropriately targeted and China. resourced programs. A 2 achieves effective HIV interventions. its results through: (1) collecting and synthesizing HIV- The most-at-risk population groups Figure: AEM baseline projection for Guangxi include injecting drug users (IDUs), female related data; (2) developing a Overall epidemic situation 160000 local model of the HIV epidemic sex workers (FSWs) and their clients. and its future course using the 140000 Asian Epidemic Model (AEM); (3) analyzing the cost and impact of Without the scale-up of the current HIV 120000 different program choices using response, A2 modeling results indicate that linked AEM/GOALS modeling; the number of new HIV infections will 100000 and, (4) utilizing strategic information to advocate for continue to grow rapidly from 80000 improved responses. approximately 10,800 per year in 2005 to 60000 almost 16,000 per year by 2010. Num ber of infections A2 is implemented in Thailand, 40000 Bangladesh, Vietnam (Ho Chi Minh City), and China (Yunnan Province Guangxi’s Five Year Action Plan and 20000 & Guangxi Province) by local budget for 2006-2010 includes allocation teams from ministries of health, 0 of resources to expand interventions for 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 centers for disease control, IDUs, FSWs and their clients, as well as provincial AIDS committees, New HIV Cumulative HIV Current HIV academic institutes, and NGOs. A anti-retroviral therapy (ART), prevention Regional Management Team of mother-to-child transmission services, comprised of representatives from 2 Family Health International, East- and methadone maintenance therapy. A projections have led to modifications in West Center and USAID’s Health Guangxi’s Five Year Action Plan and budget Policy Initiative (now RTI Interventions for men who have sex with for 2006-2010. Most notably, the revised International; formerly Constella - men (MSM) remain limited but have been five-year plan now includes prevention Futures) provides overall project 2 coordination and technical support expanded in the revised action plan. efforts among MSM, which the A models to country and provincial teams. showed were among the highest at-risk groups. Due to the number of MSM in these A2 in Guangxi, China began in Achieving the targets in the Guangxi’s sites, Guangxi CDC selected Baise, Beihai and mid-2005 and is a collaborative Five-Year Action Plan would reduce the Guilin cities to conduct HIV/AIDS initiative of the following agencies: expected number of new HIV infections Family Health International/China, interventions among MSM. USAID’s Health Policy Initiative annually by the year 2010 to 7,387— (now RTI International and compared with 15,957 if current The Guangxi Provincial Government also formerly Constella - Futures), East- interventions remain unchanged. increased its five-year HIV/AIDS prevention West Center, Guangxi Center for budget in order to appropriately fund HIV/AIDS Prevention and Control, programs for MSM. Guangxi Center for Disease At the current funding level, there remains Control, and Guangxi Health a resource gap of about 1,504 million RMB A2 policy and cost-analysis scenarios have Bureau. to implement the proposed plans. influenced Luzhai County, a HIV hot-spot in Guangxi, to significantly increase its allocation of funds for HIV prevention. Based on A2 policy analysis of resource needs, Luzhai Country Government released special funds for HIV prevention and control and increased the number of government-funded staff working in HIV/AIDS. Details of new resources made available by the Advo cacy and Media Luzhai Country Government include: o five additional personnel in Luzhai County The A2 project’s policy scenarios successfully CDC convinced local governments to increase funding for o 200,000 RMB allocated to the county for HIV/AIDS prevention and control. Guangxi HIV/AIDS Provincial Government allocated resources for o free methadone maintenance treatment interventions among MSM based on A 2 projections; provided to IDUs the Luzhai County Government significantly o five additional medical staff at ART site increased its expenditure for HIV prevention. o establishment of HIV/AIDS prevention and 2 control funds Convinced of the utility of the A model, the State Council AIDS Working Committee Office will Guangxi Provincial Government has used the expand the use of the model to 12 other provinces linked AEM-GOALS model to identify populations 2 as a decision-making tool for strategy and resource at-risk and resource needs. A cost-estimations allocation. have been presented and referenced in meetings of Guangxi AIDS Working Committee as a decision- The results of various policy scenarios and resource making tool to identify and address resource needs needs were presented to the Guangxi HIV/AIDS and gaps in the provincial HIV/AIDS program. Working Committee. 2 World Bank used A2 results in their evaluation of Results of A data analysis have been presented to HIV/AIDS in Guangxi to plan future programs. policymakers and decision makers at the meetings listed below: o A2 Introduction Meeting, Beijing, August 2005 Capacity Development o A2 and AEM Introduction Workshop for Hunan and Sichuan province, September Key technical staff of the Guangxi Health Bureau 2006 and Guangxi CDC have been trained on how to use o Guangxi CDC presented the AEM projection at AEM and GOALS. Through hands-on mentoring in the National CDC, Beijing, September 2006. data collection and policy analysis, staff have o Guangxi Senior Policy Symposium, September become proficient in implementing the model. In 2006 fact, staff from Guangxi CDC have started to serve o Guangxi Annual AIDS Working Meeting, as technical resource persons for the national CDC February, 2007 and provide AEM training to the national CDC and other provinces. The State Council AIDS Working Committee Office has begun to train 12 more provinces to use and apply the GOALS model for resource needs and budget planning. The national CDC has begun to train and pilot AEM in a number of other provinces to inform the national HIV projection and drafting of the next five-year action plan. To facilitate capacity building, the resource needs module of the GOALS model has been adapted, simplified, and translated into the Chinese language. Photo: Guangxi Senior Policy Symposium, Nanning, September 13, 2006. This document is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents of this document are the sole responsibility of Family Health International, East- West Center and RTI International and do not necessarily reflect the views of USAID or the United States Government. For more information on A 2, please contact [email protected] . .