US embassy cable - 05AMMAN4889

UNCLAS SECTION 01 OF 03 AMMAN 004889 
 
SIPDIS 
 
STATE for S/GAC 
STATE PASS USAID for GH/MMiller 
HHS for Global Health/Steiger 
 
SENSITIVE 
 
E.O. 12958: N/A 
TAGS: TBIO, SOCI, KHIV, EAID, JO 
SUBJECT: Jordan Supports Global Fund Phase 2 Renewal 
 
Ref: State 103678 
 
1.  Summary: Post recommends reftel Phase 2 renewal of 
Jordan's grant under the Global Fund to fight HIV/AIDS in 
Jordan.  The Global Fund grant has been utilized effectively 
and complements efforts made by the Government of Jordan 
(GOJ) and other donors to combat HIV/AIDS.  Jordan's Country 
Coordinating Mechanism has a wide variety of participants 
and does an excellent job of coordinating and involving all 
partners.  USAID was recently added to the Country 
Coordinating Mechanism.  End summary. 
 
Very Good Results in Several Areas 
---------------------------------- 
2.  Jordan's grant under the Global Fund is JOR-202-G01-H- 
00.  Phase 2 would be for $705,300.  Based on Jordan's 
effective performance so far in meeting the goals 
established for this grant, post recommends that the Global 
Fund continue to fully fund this project. 
 
3.  Jordan's HIV/AIDS program has achieved very good results 
in the following areas: 
1) increasing information, communication and Voluntary 
Counseling and Testing (VCT) throughout Jordan and 
especially for vulnerable groups; 
2) establishing an HIV/AIDS surveillance system that 
includes high-risk behaviors; 
3) improving care and support of people living with 
HIV/AIDS; and 
4) maintaining a high level of blood safety, and exercising 
infection control in health care settings. 
 
USAID and Contractor Have Complete Access 
----------------------------------------- 
4.  USAID has contracted with the NGO Family Health 
International (FHI) to provide technical assistance to 
Jordan for the implementation of the Global Fund grant.  FHI 
has a seat on the Country Coordinating Mechanism and has 
been able to closely monitor the implementation of the 
Global Fund grant. 
 
Global Fund Fills Gaps, Addresses Needs 
--------------------------------------- 
5.  Post feels Jordan's Global Fund National Plan is 
appropriate for its situation as a country with a low 
prevalence of HIV/AIDS.  In particular, the Global Fund 
grant provided treatment for people living with HIV/AIDS 
that would otherwise not have been available, and thus 
effectively filled gaps in Jordan's National Strategy. 
 
6.  The Global Fund grant was implemented region by region, 
as planned, over the last eighteen months and now addresses 
most, but not all, of the planned target groups.  One 
hundred percent of the people living with HIV/AIDS are 
covered by anti-retroviral treatment, and an adequate supply 
of safe blood has been maintained.  Jordan's capacity to 
implement the grant has improved during the grant period in 
part because of the Global Fund's technical requirements, 
administrative requirements and overall guidance.  Jordan 
has implemented its program in a timely manner and has met 
its performance requirements. 
 
Country Coordinating Mechanism - Broad Based, Effective 
--------------------------------------------- ---------- 
7.  The Country Coordinating Mechanism (CCM) successfully 
fosters coordination and cooperation between the Government 
of Jordan (GOJ), international donors, NGOs and the private 
sector.  The Secretary General of the Ministry of Health 
heads the CCM, which has been expanded over the last six 
years to include several government ministries, NGOs 
including USAID-contractor Family Health International, the 
Chair of the UN Theme Group on AIDS, the World Health 
Organization representative, the private sector and, 
recently, USAID.  The CCM meets at least four times a year 
and ad hoc as required.  Post feels that the CCM plays an 
active and positive role in coordination, oversight, policy- 
making and outreach on HIV/AIDS, and that governmental 
bodies play an important but not overwhelming role in the 
CCM. 
 
8. The Ministry of Health, as Principal Recipient, can 
request organizations and sectors involved in HIV/AIDS to 
nominate new members to the CCM.  Organizations can also ask 
to become members of the CCM, and those requests are usually 
approved if the organization is making a real contribution 
to HIV/AIDS work. 
 
9.  Post evaluation is that private sector participation, 
through the Jordan Medical Association, in the CCM is 
adequate but post feels that this aspect of the CCM could be 
enhanced.  The CCM encourages and welcomes private sector 
participation but these efforts have borne little fruit so 
far.  At a recent consultation on the National Strategy, 
participants identified expansion of private sector 
participation in the National Strategy as a priority goal. 
The private sector becomes more involved when individual 
projects are implemented. 
 
10.  A complete list of the organizations on the CCM 
follows: 
-- Ministry of Health (multiple departments) 
-- Red Crescent Society (NGO) 
-- UN Relief and Works Agency (UNRWA) 
-- Jordan Association for Family Planning (NGO) 
-- University of Jordan (multiple departments) 
-- Royal Medical Services (government) 
-- National Blood Bank (government) 
-- Jordan Medical Association (private) 
-- IMPACT project/Family Health International (NGO) 
-- Jordan Food and Drug Administration 
-- USAID 
-- Jordan University for Science and Technology 
-- World Health Organization 
-- Jordanian Thoracic Association (NGO) 
-- Jordan Anti-TB Association (NGO) 
-- Annoor Sanatorium (NGO) 
-- Al-Basheer Hospital (government) 
 
Political Support Strong - Ready to Face Sensitive Issues 
--------------------------------------------- ------------ 
11.  There has been strong political support from both the 
Ministry of Health and from the Palace for combating 
HIV/AIDS and keeping Jordan a low prevalence country.  The 
CCM recently convened a large stakeholders meeting to 
solicit feedback on a draft National HIV/AIDS Strategy 
Action Plan developed through widespread consultation with 
stakeholders.  The Minister of Health will submit the final 
version of the Plan to the Prime Minister.  The top-level 
approval by the Prime Minister for the National Action Plan 
is seen as formalizing the political support needed to 
publicly address socially sensitive issues such as stigma, 
male-male sex and discrimination against people living with 
HIV/AIDS. 
 
Weaknesses Exist but Are Known and Being Confronted 
--------------------------------------------- ------ 
12.  While Jordan's capacity for combating HIV/AIDS is 
imperfect, post feels that the CCM has done a good job in 
identifying weaknesses, creating plans for correcting those 
weaknesses, and implementing those corrective measures.  For 
example, the CCM identified Monitoring and Evaluation (M&E) 
of HIV/AIDS as an area that needed strengthening.  As a 
result, USAID through Family Health International is 
assisting the GOJ in developing a high-quality M&E plan. 
Jordan had sufficient levels of technical expertise to 
implement its National HIV/AIDS Strategy Action Plan. 
Jordan also has placed a high priority in its work to date 
to strengthen its human and technical capacity to combat 
HIV/AIDS. 
 
Success Stories: VCT, Peer Education 
------------------------------------ 
13.  Jordan has had successes already in its work on 
HIV/AIDS.  Specifically, with assistance from USAID, Jordan 
established Voluntary Counseling and Testing (VCT) Centers 
in Amman and four other locations around Jordan.  USAID also 
supported a successful peer education program at two 
Jordanian universities.  Both the VCT centers and the peer 
education programs were an active collaboration between the 
Global Fund, the Ministry of Health, USAID and Family Health 
International. 
 
Post Has Good Internal Capacity, Cooperation 
-------------------------------------------- 
14.  Post has good internal capacity in its USAID offices on 
HIV/AIDS issues, and coordinates well between State and 
USAID.  Post management has created an Embassy HIV/AIDS 
committee headed by the DCM.  Working level members of the 
committee are currently developing a post-specific HIV/AIDS 
plan based on best practices from other embassies. 
 
15.  Embassy contacts for further information about Jordan's 
work on HIV/AIDS are Mr. David Piet (dpiet@usaid.gov) and 
Dr. Salwa Bitar Qteit (sqteit@usaid.gov). 
 
16.  Post acknowledges reftel heads-up on a short-fuse 
action request expected at the beginning of July to review 
Global Fund scorecard. 
 
HALE