The Afghanistan HIV/AIDS Prevention Project (AHAPP), implemented by the Ministry of Public Health, sought to slow the spread of HIV and build national capacity to respond to the epidemic focusing on key populations at high risk of infection and generating epidemiological evidence. The AHAPP supported improvements in several key outcomes:
- Access to HIV prevention services for IDU reached 90.2 percent in 2012 (IBBS 2012), up from 62.4 percent in 2009 (IBBS 2009). By the closure of the project, 3,479 non-imprisoned IDU had been reached.
- IBBS was expanded to six sites in 2012 up from four sites in 2009. This achievement helped provide rigorous national surveillance data across a broad geographic scope and included men who have sex with men (MSM) for the first time in Afghanistan.
- The number of urban centers that had completed high risk mapping doubled from a baseline of three to an end line of six, exceeding the target by 50 percent.
There is a strong partnership among development partners in Afghanistan’s health sector, namely the European Union (EU), the U.S. Agency for International Development (USAID) and the World Bank. Partners agreed that the Bank was well placed to respond to the government’s request for assistance with HIV prevention given its previous experience in assisting other countries in the region deal with HIV systematically. The Bank’s US$10 million IDA grant for AHAPP, implemented by the Ministry of Public Health, was complemented by approximately US$8.4 million for HIV prevention related activities from the Global Fund to Fight AIDS, Tuberculosis and Malaria channeled through two principle recipients, the Ministry of Public Health and Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), the German Society for International Cooperation. One of the cornerstones of the project was the partnering with NGOs as implementers and service providers through contracting.
The next phase of IDA support for the health sector in Afghanistan is the US$100 million System Enhancement for Health Action in Transition (SEHAT), approved in February, 2013. SEHAT will receive US$350 million cofinancing from the Afghanistan Reconstruction Trust Fund (ARTF). SEHAT sets out the health priorities for the country – especially Maternal and Child Health, and expanding secure provision of a basic package of health services. Several elements built under AHAPP will be continued under SEHAT, namely using the successful modality of contracting NGOs for service delivery – especially the provision of services for marginalized populations such as prisoners and HIV prevention services for target population sub-groups who are at an elevated risk for HIV-infection.