National Aids Commissions and Country Coordinating Mechanisms : perceptions of functioning of the two national HIV governance structures in Lesotho
Date
2008-03
Authors
Munro, Gregory Dave
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: A number of countries in sub-Saharan Africa are recipients of major international
investments for HIV. Funding has required that different governance structures be
established, with the creation of independent Country Coordinating Mechanisms
(CCM) for the oversight of Global Fund grants in country, and National AIDS
Commissions (NAC) have been established as part of the World Bank Multi-country
AIDS Programme (MAP) for coordination of national HIV efforts. In addition UNAIDS
and SADC have endorsed the concept of one national coordinating authority. The
NAC in Lesotho reports to the Office of the Prime Minister and its structure and
function is governed by statute. The CCM has broad stakeholder representation and
functioning is determined by Global Fund guidelines. The Global Fund is by far the
largest donor to HIV programmes in Lesotho, with current potential funding
amounting to USD 100 million. This study seeks to determine perceptions of
members of the two HIV governance structures in Lesotho on their respective roles,
reporting lines, responsibilities, levels of tension and integration of HIV in
developmental agendas, through the administration of a pre-tested questionnaire to
CCM members and NAC management in Lesotho.
Lack of clarity on the roles and functions exists for both CCM and NAC, with each
group more likely to consider their own body as being more representative and
having a clear and defined mandate. Strong disagreement exists on the extent of
NAC functions beyond the classic coordination, advocacy and communication role,
with NAC viewing their role as extending into direct programme implementation and
management of funds. While the National Composite Policy Index for Lesotho
indicates inclusion of HIV in broad developmental and health agendas, there is little
tangible evidence of this being practically implemented. The structure and
functioning of both NAC and CCM largely limits the inclusion of HIV into national
developmental programmes. While the status quo of NAC reporting to the Office of
the Prime Minister is supported, NAC members were significantly more likely than
their CCM counterparts to want CCM to report to them. Not surprisingly, levels of
tension between these two bodies is demonstrated in this study.
In spite of one-third of respondents desiring the creation of a single oversight body
for HIV, this study argues for the maintenance of two structures but that NAC should
limit itself to its original intended mandate of coordination, that practical interpretation
of the universal NAC role of ”coordination” be developed, and that internal NAC
performance measures be adopted which are subject to periodic external review.
Furthermore CCMs should be formally established by Ministerial decree or
proclamation, and each body should have formal representation of the other in their
membership. Membership of both NAC and CCM should include non-HIV
developmental role players in the country. CCMs must also systematically report on
Global Fund activities to NAC, so that NAC can fulfil its coordination function.
Improved reporting to the public by both bodies on summarised indicators via the
media is also recommended.
AFRIKAANSE OPSOMMING: Die doel van die studie is om die verskillende persepsies van die verskillende fondsadministreringsliggame in Lesotho the bepaal ten opsigte van onderskeidelike rolle, lyne van rapportering, verantwoordelikhede, moontlike spanningsvlakke en die integrasie van MIV agendas. ‘n Vraelys is gebruik om data in te samel; data is verwerk en aanbeveling ter verbetering van die situasie in Lesotho word gemaak.
AFRIKAANSE OPSOMMING: Die doel van die studie is om die verskillende persepsies van die verskillende fondsadministreringsliggame in Lesotho the bepaal ten opsigte van onderskeidelike rolle, lyne van rapportering, verantwoordelikhede, moontlike spanningsvlakke en die integrasie van MIV agendas. ‘n Vraelys is gebruik om data in te samel; data is verwerk en aanbeveling ter verbetering van die situasie in Lesotho word gemaak.
Description
Thesis (MPhil)--Stellenbosch University, 2008.
Keywords
National AIDS Commission (Lesotho), National AIDS Commission (Lesotho) -- Management, National AIDS Commission (Lesotho) -- Finance -- Management, Country Coordinating Mechanism (Lesotho), Country Coordinating Mechanism (Lesotho) -- Management, Country Coordinating Mechanism (Lesotho) -- Finance -- Management, HIV infections -- Lesotho -- Prevention, AIDS (Disease) -- Lesotho -- Prevention, Dissertations -- Industrial psychology, Dissertations -- HIV/AIDS management, Theses -- HIV/AIDS management, Theses -- Industrial psychology