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Areas of action
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Political dialogue: Cooperation and coordination among the various actors
Germany designs its development policy in the form of long-term cooperation between partners on a basis of equality.
At the international level, the BMZ feeds the lessons learned in the fight against HIV into the strategy discussion processes of the various organisations.
In Germany’s bilateral dialogue with developing countries the focus is on the specific problems of the respective partner country. The aim of this dialogue is, invariably, to find ways of combating HIV that are optimally tailored to each country.
The BMZ is pushing for stronger strategic cooperation between national and international actors and for greater donor harmonisation. To achieve this, on the one hand German experience of HIV control is made available to the international community, for example in the context of the German Health Practice Collection, which makes successful health projects supported by German development cooperation available to the general public. On the other hand, lessons learned in international cooperation and the standards set are integrated into German development cooperation.
Against this background, cooperation with a number of international organisations, civil society and the private sector acquires a strategically important role.
Joint United Nations Programme on HIV/AIDS (UNAIDS)
The German government maintains close contacts with UNAIDS, both at the multilateral level and at local level in partner countries. The key components of this cooperation are set out in a cooperation agreement within the scope of the BACKUP Initiative. Special emphasis in this cooperation is placed on supporting partner countries in their dealings with the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and building national capacities in regard to gender equality and HIV. International recommendations are jointly elaborated and their implementation in partner countries promoted.
As part of the efforts to network multilateral and bilateral cooperation, partner countries receive assistance with coordinating financial contributions and integrating them into national health strategies, with planning and implementing HIV responses and developing monitoring and evaluation systems.
Germany also cooperates closely with UNAIDS on developing and promoting multi-sectoral approaches and mainstreaming activities to fight HIV across all areas of development cooperation. UNAIDS is developing and disseminating as best practices several approaches used successfully under German development cooperation.
World Health Organization (WHO)
The German government supports the work of the WHO. It gears its HIV programme approaches to the international health-policy strategies and technical standards developed by the WHO. Cooperation with the WHO includes quality assessment of generic drugs and the development of guidelines and instruments. The WHO has set up regional knowledge hubs for Africa, Eastern Europe and Central Asia, and these receive support from Germany. The WHO and Germany also cooperate on developing standards for HIV prevention and the treatment and care of people living with HIV.
Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)
According to the GFATM, up until the end of 2011 it had pledged a total of 22.6 billion US dollars to more than 1,000 programmes in 150 countries. This enabled 3.3 million people with HIV and 8.6 million people with tuberculosis to receive treatment, as well as 230 million insecticide-impregnated mosquito nets to be distributed as a preventive measure. The GFATM has been supporting programmes to strengthen health systems since 2008. The German government played an active role on the administrative board of the GFATM – as it did in regard to the introduction of a gender strategy covering both women and girls and sexual minorities.
Germany is one of the biggest donors to the GFATM. One of the strengths of the Fund is that all the relevant actors (donors and recipient countries, representatives of affected persons, non-governmental organisations, private foundations and the private sector) decide jointly on the Fund’s strategies. In addition, civil society is always closely involved in all processes in the relevant countries when it comes to spending the GFATM’s financial resources.
Germany also supports the GFATM’s work through the BACKUP Initiative, which is an innovative model of multilateral and bilateral Technical Cooperation: Close cooperation with international organisations on the one hand and advising state and civil society organisations in partner countries on the other facilitate the sharing of information and experience. That way, funding provided by the GFATM can be used more effectively to more rapidly, more effectively and more sustainably fight infectious diseases like AIDS, tuberculosis and malaria.
Since 2002, the BACKUP Initiative has supported more than 400 measures by partner organisations in some 70 countries, with special emphasis on three cross-cutting issues: strengthening civil society, gender equality and strengthening health systems.
Debt2Health
The Debt2Health initiative was introduced at the second replenishment conference of the GFATM held in Berlin in 2007: The debt swap initiative aims to release national financial resources through targeted debt relief and to redirect those resources with the help of the Fund to benefit urgently needed health measures to combat HIV, tuberculosis and malaria.
The Global Fund and Germany have already signed agreements with Indonesia, Pakistan and Côte d’Ivoire. As a result, up to 55 million euros has already been mobilised to benefit Debt2Health measures in these countries.
International Labour Organization (ILO)
In 2000, the International Labour Organization (ILO) launched a Programme on HIV/AIDS and the World of Work (ILO/AIDS).
The basis for implementation is the ILO’s Code of Practice on HIV/AIDS and the World of Work, a joint document by representatives of the public and private sectors and the unions. The Code of Practice was revised in 2010 and now incorporates HIV and tuberculosis control more into health and safety measures than was the case in the past.
In partnership with ILO and ILO/AIDS, Germany promotes private sector involvement, joint financing models, implementation of the new Code of Practice and advice for decision-makers at national and regional level. Other important elements of Germany’s cooperation with ILO/AIDS are upgrading measures for workplace programmes, documenting knowledge and experience, and research into the social and economic impacts of the HIV epidemic.
World Bank and the regional development banks
At the end of the 1990s, the World Bank, on the initiative of the German government, launched a Multi-Country HIV/AIDS Program for Africa (MAP). The programme sets out to support rapid universal expansion of HIV prevention and the care and treatment of sufferers.
The rapid provision of long-term assured funding is aimed at strengthening partnerships and promoting community involvement.
European Union (EU)
The European Union, to which Germany is the biggest net contributor, has increased its commitment to HIV substantially in recent years and today is one of the largest donors in the world. The EU’s Programme for Action to Confront HIV/AIDS, Malaria and Tuberculosis forms the basis for that commitment.
The key element in the Programme for Action is improving access to health care services, especially affordable medicines, as well as overcoming the shortage of skilled health care professionals. Another important pillar of the programme is promoting research into and the development of new global instruments in response to HIV, malaria and tuberculosis at the national, regional and global level. It was for this purpose that the initiative "European and Developing Countries Clinical Trials Partnership" (EDCTP) was set up.
Other key topics in the Programme for Action are: realising human rights; sexual and reproductive health and rights; and addressing the needs of orphans, vulnerable children and disadvantaged population groups.
The EU came out at an early stage in the WTO negotiations in favour of a differential pricing system for antiretrovirals, coupled with a ban on the re-import of these cheaper medicines into affluent countries. In this way, the EU has done a great deal towards improving the availability of affordable treatments in developing countries. Germany supports the EU in this endeavour.
Private sector
Public-private partnerships (PPPs) between German development cooperation and private companies have proved highly effective in many areas of development policy, including the fight against HIV. Many companies in Africa have recognised the importance of introducing workplace programmes to combat HIV as part of their responsibility to their staff and staff’s families. By doing so they avoid productivity losses and the rising costs of health care, new recruitment and retraining – and gain recognition as socially responsible companies. As a result of this type of action, the private sector has become an important partner in the fight against HIV.
Civil society
Cooperation with non-state actors is important if there is to be universal access to prevention, treatment and care for all sectors of the population in developing countries. Civil society organisations often enjoy a better level of public acceptance than state institutions. International, German and local non-governmental organisations contribute substantially to the prevention of HIV infections and to the treatment, care and support of people living with HIV. The BMZ will therefore continue to cooperate closely with non-governmental organisations in partner countries and in Germany.
