The Parliamentary Oversight Committee on Defense and Presidential Affairs provide oversight on all workplaces under the office of the President.  A cross section of its members met with the management of the National AIDS Secretariat on Wednesday 16th June 2010 to get first hand information on the Secretariat’s activities and to acquaint management with the roles and responsibilities of the Committee.

The Director of NAS, Dr. Brima Kargbo gave a background on the national response to HIV since the first case was reported in 1987 under the auspices of the Ministry of Health and Sanitation.  He noted the establishment of the Secretariat and the National AIDS Council through a Cabinet Paper in 2002 to access a US$15.6 million from the World Bank to respond HIV and AIDS through a multi sectoral approach, under the Sierra Leone HIV and AIDS Response Project (SHARP).  The National AIDS Council is the overall body responsible for policy formulation, advocacy and resource mobilization whilst the Secretariat is the administrative arm that helps in the interpretation of those policies and coordination of the implementation activities undertaken by partner organizations.

Dr. Brima Kargbo also highlighted some of the achievements made by the Secretariat since 2002 in a bid to reduce the HIV prevalence and mitigate its impact on those infected with and affected by the epidemic.  The most crucial is the development of policy documents such as the National HIV and AIDS Prevention and Control Act 2007, National Strategic Plan (NSP) 2006 – 2010,  implemented under the Universal Principle of ‘Three Ones’ (one coordinating body, one national strategic plan and one M & E frame work).  The NSP sets out 6 priority interventions (i) Prevention of new infections [(ii) Access to Treatment, Care and Support to Persons Living with HIV, their families and communities (iii) Protection of human and legal rights (iv) Decentralization (v) Research, Monitoring and Evaluation (vi) Key Sectoral Response] whilst the Monitoring and Evaluation Framework sets out core indicators to monitor the implementation of the interventions.

The Director noted that the year 2010 is crucial to the national response, as its sets the benchmark in the commitments made by Governments in the Abuja  and Brazzaville Summits and the UN General Assembly Special Session on HIV and AIDS (UNGASS) to achieve ‘Universal Access by 2010’.  The mandate of the Secretariat is to translate these commitments into actions. He informed the Parliamentary Committee that the progress reports on the UNGASS declaration and Universal Access were presented to the National AIDS Council during its fourth meeting under the chairmanship of H.E. Dr. Ernest B. Koroma at the State House, on 4th June 2010.

The Director further informed the committee that the HIV and AIDS epidemic in the general population is on the verge of stabilizing at 1.5% since 2005. whilst the prevalence among pregnant women showed a declining trend from 4.4% in 2006 to 3.5% in 2007 and preliminary ANC survey report in 2010 at 3.2%. To substantiate all the successes, the Director highlighted some of the studies carried out in ascertaining the effectiveness of the Interventions.  Among others are (i) the Survival Analysis for PLHIVs on Antiretroviral Therapy at the rate of 84.3% and (ii) the HIV prevalence among children born to HIV infected mothers who had complete Prevention of Mother to Child Transmission intervention at 9%; which is clearly above the global target.

Speaking on the issue of resource mobilization and sustainability of the response, he informed the Parliamentary Committee that the recent National AIDS Spending Assessment (NASA) revealed a 98% funding from donor partners and 2% from the Government of Sierra Leone. This issue was also raised during the fourth NAC meeting where His Excellency promised to step up resource allocation to HIV and AIDS Campaign. Dr. Kargbo pointed out that The Global Fund to fight HIV and AIDS, Tuberculosis and Malaria is the major funding partner after the phasing out of the World Bank’s US$15.6 million loan towards the implementation of the SHARP, in 2007. The Country Coordinating Mechanism (CCM) comprise of key stakeholders provide oversight on Global Fund activities in Sierra Leone, whilst NAS as Principal Recipient (PR) of the Fund provides guidance and monitoring of Sub Recipient’s (SRs) implementation of activities.  The grant is performance-based and the country has been opportune in receiving three Rounds (4, 6 and 9) of funding; the most recent is the Round 9, which has been harmonized with Round 6 to help address previous gaps and consolidate Health Systems Strengthening.  The signing of the grant agreement between the CCM and the Global Fund has been scheduled for June 2010.  In order to effectively monitor the grants, the Local Funding Agents, based in Ghana does quarterly verification of reports and monitoring of PR and SR activities, whilst KPMG undertakes the finance and procurement management.

He called on Parliamentary Committee to support the ratification of the amended 2007 HIV and AIDS Prevention and Control Act and the Establishment of a National AIDS Commission that will enhance resource allocation by the Government.

The Deputy Director, Mr. Abdul Rahman Sessay appealed to the Committee to address the peculiar task of the Secretariat in tackling new infections due to emerging groups like Men having Sex with Men (MSM) and Injecting Drug Users (IDUs). He also encouraged the MPs to heighten their advocacy role and participate in dissemination of harmonized messages to their constituents.

In his remarks, the National AIDS Control Programme Manager, Dr. Momodu Sesay commented on the key challenges encountered by NAS and its partners; (i) the translation of knowledge on HIV and AIDS to adoption of positive behaviour.  He advised members of Parliament to talk about HIV and AIDS at every given opportunity, and support the Ministry of Health and Sanitation to access more resources to sustain its efforts in providing technical backstop to the national response and thus achieve universal access to prevention, treatment, care and support. (ii) the misconceptions posed by Faith-Based Organizations in giving false assurance to PLHIVs on spiritual healing against Antiretro Viral (ARV) therapy, which has hindered adherence to ARV, and longevity of PLHIVs.

On behalf of the Parliamentary Committee, Hon. Charles H. Kalawa expressed delight on the achievements of the Secretariat which are remarkable and assured members of the committee’s support to ensure the availability of financial resources by the Government to enhance sustainability of such gains and prevent a devastating reverse of the epidemic.

The other Parliamentary Committee Members commended the Secretariat for the information provided which is an evidence of performance. It was suggested that the Secretariat embarks on small scale industrial activities like Agriculture, Income generation, advocate for employment of PLHIV, to enhance revenue generation and  thus help in sustainability of care and support services.

There were calls to strengthen HIV and AIDS Sensitization along the border communities where international trade occurs, like Kambia, Kailahun and Bo Waterside - Zimi. Similar call was made for Tertiary institutions where prevalence were recorded to be high in both 2005 and 2008, National Sero-prevalence survey and Demographic Health Survey respectively.

In conclusion;

• Committee promised to continue effective collaboration with NAS and accelerate the ratification of the amended HIV and AIDS Law and the Commissioning of NAS
  
• Committee requested a briefing package from NAS to facilitate its advocacy role
• Committee promised to be actively involved in dissemination of information on HIV and AIDS prevention, treatment, care and support, to their constituents at every given opportunity
• The call for Parliamentary committee to take the lead in the HIV testing, was noted for implementation
• NAS Management donated a collection of publications done since inception of the Secretariat, to the Parliamentary committee for display in their library
• Management of NAS thanked the visitors for their commitment and encouraged them to pay subsequent visits to the Secretariat.  Also promised to involve the Parliamentary Committee in the development of Global Fund Round 11 proposal to support the implementation of HIV and AIDS activities by Parliamentarians.

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Some photos of the meeting between Oversight Committee on Defense and Presidential Affairs and staff of NAS