ASAP support to MADAGASCAR : A beneficial learning process Fenosoa RATSIMANETRIMANANA Executive Secretary of NAC.

ASAP support to ASAP support to MADAGASCAR :MADAGASCAR :

A beneficial learning process A beneficial learning process

Fenosoa Fenosoa RATSIMANETRIMANANARATSIMANETRIMANANAExecutive Executive SecrSecretary of NACetary of NAC

Situation of the epidemic ...Situation of the epidemic ...

First First cascasee identified inidentified in 1987 1987

Among pregnant womenAmong pregnant women : : less than less than 1%1%

Among STI Among STI Patients : 0% Patients : 0% from from 1990 1990 toto 1999, 0,64% 1999, 0,64% iin n 2000 2000 and and 0,58% 0,58% iin 2005n 2005

Among CSWAmong CSW : 0% : 0% from from 1990 1990 toto 1996, 0,25% 1996, 0,25% iin 1998 n 1998 and and 1,28% 1,28% iin 2005n 2005

A slow increase of the eA slow increase of the epidpideemimicc among the among the all groups of all groups of population population but we have to act but we have to act

now, tomorow will be latenow, tomorow will be late

Major challenges ...Major challenges ...

How to make visible the How to make visible the invisible ?invisible ?

How to mantain the HIV How to mantain the HIV prevalence rate under 1% ? prevalence rate under 1% ?

How to mobilize resources How to mobilize resources in a context of sensitive in a context of sensitive choice at global level (low choice at global level (low prevalence countries v/s prevalence countries v/s high prevalence countries) ?high prevalence countries) ?

Road towards the victory ...Road towards the victory ...

Strong national Strong national leadership at all level leadership at all level

Evidence-informed and Evidence-informed and results-based response results-based response (three ones in action ) (three ones in action )

Performance-based Performance-based funding funding (accountability)(accountability)

ASAP/GAMET support ...ASAP/GAMET support ...

Fine-tuning the National Strategic Plan with a Fine-tuning the National Strategic Plan with a focus on an evidence-informed response focus on an evidence-informed response ((Where to act ? Act toward whom ? What are Where to act ? Act toward whom ? What are the priorities ?the priorities ?))

Finalization of the Monitoring and Evaluation Finalization of the Monitoring and Evaluation Plan with a focus on a result-based approach Plan with a focus on a result-based approach ((Results, Results, ResultsResults, Results, Results))

Development of the epidemiological profile Development of the epidemiological profile documentdocument ( (to know our epidemic : core to know our epidemic : core driversdrivers ...) ...)

Lessons learned ...Lessons learned ... ASAP is a very useful and easy tool available for countries which ASAP is a very useful and easy tool available for countries which

want to progress : simple procedure, free of charge for countries, want to progress : simple procedure, free of charge for countries, participatory approach respecting national counterparts, high participatory approach respecting national counterparts, high level expertises, stimulation of the commitment of some level expertises, stimulation of the commitment of some partners... partners...

Importance of the strategic information for the planningImportance of the strategic information for the planning and and nnecessity to continuously reorient the interventions according to ecessity to continuously reorient the interventions according to programmeprogramme implementation implementation evidences evidences

Necessity of the response ownership through the involvement of Necessity of the response ownership through the involvement of all the all the stakeholdersstakeholders

Do not waste time in reinventing the wheelDo not waste time in reinventing the wheel : build from : build from successful experiences learned from other countries/communitiessuccessful experiences learned from other countries/communities

Winning Winning is a team is a team effort ...effort ...

I, You, We hold I, You, We hold the key of victory the key of victory

in our hands…in our hands…