Mali: Innovative design of the Multi-Sectoral AIDS Project (MAP)

The Mali Multi-sectoral AIDS Project (MAP) began implementation in late 2004 and is in the preliminary phases of the project cycle. This project has been commended by the World Bank’s Board for its innovation and the involvement of the private sector to address HIV/AIDS.

Mali is one of the poorest countries in the world due to factors such as its limited resource base, land-locked status and poor infrastructure. According to the

2001 Demographic and Health Survey (DHS) published by the Ministry of Health, Mali’s HIV/AIDS prevalence rate is estimated at 1.7% in 2001. The project objective is to support the Government of Malis efforts to control the spread of the HIV/AIDS epidemic and provide sustainable access to treatment and care to those infected with or affected by HIV/AIDS. While Mali currently has a low HIV prevalence rate by Sub-Saharan African standards, it runs a high risk of experiencing an increase in prevalence rates.

Traditionally HIV/AIDS related projects are developed and implemented through the Human Development network of the World Bank. This is the first MAP project which has been prepared and is being implemented by the Private Sector Unit (PSU) in the Africa Region of the World Bank. The Mali MAP aims to leverage the know-how and the expertise of private sector institutions and to build partnerships between the public and the private sectors for a more effective and efficient implementation. The private sector will work together with the public sector and civil society in policy making.

Key components of this initiative include (a) strengthening the government’s national response to the HIV/AIDS epidemic; (b) raising the level of awareness on HIV/AIDS; (c) providing sustainable access to testing and counseling facilities; (d) providing access to treatment, care and psychosocial support to persons infected with or affected by HIV/AIDS; and (e) strengthening the government’s capacity to address the HIV/AIDS epidemic and to maintain an effective monitoring and evaluation system.

The private sector is committed to playing a key role in HIV/AIDS by means of (i) prevention activities through Information, Education, Communication (IEC); (ii) testing through the establishment and strengthening of a network of laboratories that will provide testing services ; (iii) voluntary counseling and testing (VCT) through a “franchising” system where only the VCT centers which meet certain standards can obtain the quality logo; and (iv) access to drugs leveraging pharmaceutical and private distribution networks.

Key and Innovative Project Components:

Communication Toolkits. The private sector will be involved in developing messages and communication toolkits that give various players the instruments to get the core messages out to the target audiences/ population.
Expanding Service Delivery Capacity. There is great scope for increasing the service delivery capacity of many of the existing private endeavors. Instead of just relying on traditional vehicles for public sector service delivery, the government is keen to involve the private sector in the implementation phase of the project, Enterprises such as private laboratories, pharmacies, counseling, testing, drug distribution and such related services which are usually considered public undertakings will be contracted out to private vendors.

Voluntary testing centers : These are still limited, and need to be multiplied. Private laboratories and clinics can deliver testing services. This is well within reach as technology is changing fast and quick testing kits are already available. It is key that the employees in private testing centers have the ability to deliver quality service. Working in conjunction with other NGOs, the objective is to ensure that the minimum quality standard services are met along with proper monitoring and evaluation.
Franchising : Iit is planned to franchise wholesale institutions which commit to quality service in the delivery of drugs to patients and to ensuring that the supply chain is well-managed. Distributors would deliver this service to the patients. These franchises would be paid on the basis of actual services rendered to the end-user.
Matching Grants : To further encourage quality services rendered, a “Matching Grant” scheme will be rolled out which seeks to promote private enterprises to deliver services above and beyond their contractual obligations. The grant would match the costs incurred for such activities.

Capacity Building . Although the contract management aspect has been outsourced, the Executive Secretariat will bridge the private service providers and the government’s National HIV/AIDS Commission. The contract management agency has deployed three regional antennae - in Bamako, Segou and in Mopti. These branches of the agency would have a presence in various regions to ensure that vendors and enterprises under contract have delivered services and will report their progress to the Executive Secretariat.
Key Champion. The President of Mali was a key champion for the project. His enthusiasm was a signal to the rest of the ministries that this was a priority area and should be dealt with as such. To further cut short any criticism about the outsourcing of various elements of the project, it was made clear that the monies for this project were not not go through the financial directors of the various ministries. There would be zero tolerance on any deviations from the commitments and obligations that are underwritten.
Buy-in from the private sector. Companies, such as SIDA Enterprise (a network of French firms active in Africa) have brought their extensive experiences to Mali, and the Bank has supported them by providing global knowledge about business coalitions.
Donors. The preparation of this project has entailed an intensive and successful coordination effort with several other donors including UNAIDS, the Global Fund, and the African Development Bank. Each of these donors are providing parallel financing

This Infobrief was written by Aisha Rahman Khan, Consultant, Africa Region. References include The Mali Multi-sector AIDS Project Debriefing and related project documents.


	No. 118 November 2005
	Mali: Innovative design of the Multi-Sectoral AIDS Project (MAP) The Mali Multi-sectoral AIDS Project (MAP) began implementation in late 2004 and is in the preliminary phases of the project cycle. This project has been commended by the World Bank’s Board for its innovation and the involvement of the private sector to address HIV/AIDS. Mali is one of the poorest countries in the world due to factors such as its limited resource base, land-locked status and poor infrastructure. According to the 2001 Demographic and Health Survey (DHS) published by the Ministry of Health, Mali’s HIV/AIDS prevalence rate is estimated at 1.7% in 2001. The project objective is to support the Government of Malis efforts to control the spread of the HIV/AIDS epidemic and provide sustainable access to treatment and care to those infected with or affected by HIV/AIDS. While Mali currently has a low HIV prevalence rate by Sub-Saharan African standards, it runs a high risk of experiencing an increase in prevalence rates. Traditionally HIV/AIDS related projects are developed and implemented through the Human Development network of the World Bank. This is the first MAP project which has been prepared and is being implemented by the Private Sector Unit (PSU) in the Africa Region of the World Bank. The Mali MAP aims to leverage the know-how and the expertise of private sector institutions and to build partnerships between the public and the private sectors for a more effective and efficient implementation. The private sector will work together with the public sector and civil society in policy making. Key components of this initiative include (a) strengthening the government’s national response to the HIV/AIDS epidemic; (b) raising the level of awareness on HIV/AIDS; (c) providing sustainable access to testing and counseling facilities; (d) providing access to treatment, care and psychosocial support to persons infected with or affected by HIV/AIDS; and (e) strengthening the government’s capacity to address the HIV/AIDS epidemic and to maintain an effective monitoring and evaluation system. The private sector is committed to playing a key role in HIV/AIDS by means of (i) prevention activities through Information, Education, Communication (IEC); (ii) testing through the establishment and strengthening of a network of laboratories that will provide testing services ; (iii) voluntary counseling and testing (VCT) through a “franchising” system where only the VCT centers which meet certain standards can obtain the quality logo; and (iv) access to drugs leveraging pharmaceutical and private distribution networks. Key and Innovative Project Components: Communication Toolkits. The private sector will be involved in developing messages and communication toolkits that give various players the instruments to get the core messages out to the target audiences/ population. Expanding Service Delivery Capacity. There is great scope for increasing the service delivery capacity of many of the existing private endeavors. Instead of just relying on traditional vehicles for public sector service delivery, the government is keen to involve the private sector in the implementation phase of the project, Enterprises such as private laboratories, pharmacies, counseling, testing, drug distribution and such related services which are usually considered public undertakings will be contracted out to private vendors. Voluntary testing centers : These are still limited, and need to be multiplied. Private laboratories and clinics can deliver testing services. This is well within reach as technology is changing fast and quick testing kits are already available. It is key that the employees in private testing centers have the ability to deliver quality service. Working in conjunction with other NGOs, the objective is to ensure that the minimum quality standard services are met along with proper monitoring and evaluation. Franchising : Iit is planned to franchise wholesale institutions which commit to quality service in the delivery of drugs to patients and to ensuring that the supply chain is well-managed. Distributors would deliver this service to the patients. These franchises would be paid on the basis of actual services rendered to the end-user. Matching Grants : To further encourage quality services rendered, a “Matching Grant” scheme will be rolled out which seeks to promote private enterprises to deliver services above and beyond their contractual obligations. The grant would match the costs incurred for such activities. Capacity Building . Although the contract management aspect has been outsourced, the Executive Secretariat will bridge the private service providers and the government’s National HIV/AIDS Commission. The contract management agency has deployed three regional antennae - in Bamako, Segou and in Mopti. These branches of the agency would have a presence in various regions to ensure that vendors and enterprises under contract have delivered services and will report their progress to the Executive Secretariat. Key Champion. The President of Mali was a key champion for the project. His enthusiasm was a signal to the rest of the ministries that this was a priority area and should be dealt with as such. To further cut short any criticism about the outsourcing of various elements of the project, it was made clear that the monies for this project were not not go through the financial directors of the various ministries. There would be zero tolerance on any deviations from the commitments and obligations that are underwritten. Buy-in from the private sector. Companies, such as SIDA Enterprise (a network of French firms active in Africa) have brought their extensive experiences to Mali, and the Bank has supported them by providing global knowledge about business coalitions. Donors. The preparation of this project has entailed an intensive and successful coordination effort with several other donors including UNAIDS, the Global Fund, and the African Development Bank. Each of these donors are providing parallel financing This Infobrief was written by Aisha Rahman Khan, Consultant, Africa Region. References include The Mali Multi-sector AIDS Project Debriefing and related project documents.