The Project is the result of dialogue and consultations between the African Development Bank, government representatives of beneficiary countries, representatives of refugees, internally displaced population, the MRU Secretariat, UNAIDS, UNFPA, UNDP, WHO and Non-Governmental Organizations (NGOs) and Community Based Organizations (CBOs) working on HIV/AIDS among refugees and displaced population in the Mano River Basin countries and Côte D’Ivoire. Although Côte D’Ivoire is not a member of the Mano River Basin countries, it has been caught up in the conflict, which has aggravated population movements in the sub region. Cote D’Ivoire also plays host to a considerable number of refugees. It therefore became evident that the fight against HIV/AIDS in the Mano River Basin sub-region is not realistically conceivable without the participation of Cote d’Ivoire. This project takes into account lessons learned from four other sub-regional initiatives: i) Countries Lying Along Rivers Congo Ubangi and Shari financed by ADF; ii) the Countries of the Great Lakes Initiative financed by UNAIDS; iii) the Countries of the Lake Chad Basin Initiative financed by (UNAIDS/ADF and the World Bank); and iv) The Abidjan-Lagos Corridor financed by the World Bank. It will be implemented within the framework of the Sub-regional Programme to Fight Against HIV/AIDS among the Refugees, Internally Displaced Population and their host communities in the MRU Countries and Côte D’Ivoire.

The overall goal of the project is to support the Mano River Basin Countries and Côte d’Ivoire to meet Objective 6 of the Millennium Development Goals (MDGs), which seeks to stop and begin to reverse the spread of HIV/AIDS by 2015. The specific objective of the project is to prevent the spread of new infections of STI/HIV/AIDS among refugees, internally displaced populations, and their host communities in the Mano River Union Countries and Côte d’Ivoire and to provide psychosocial support to those living with HIV/AIDS.

In order to achieve its objectives, the project will focus on the following three components:

1. Strengthening of the HIV/AIDS/STI prevention, care and treatment
   Activities under this component will improve the prevention, care and treatment of STIs/HIV/AIDS in each country’s selected area (1 per country) through the: i) strengthening of the blood transfusion services; ii) promotion of positive behaviour; iii) promotion of condoms (both male and female); iv) establishment of HIV Voluntary Counselling and Testing Centres; v) strengthening of the syndromic approach to manage STI cases; vi) support to appropriate training to provide medical, psychological and social support to PLWA in the project sites; and vii) monitoring and supervision.
2. Promotion of multi-sectoral and sub-regional co-ordination
   Through this component the project will support advocacy activities with the local, national and the MRU Secretariat as well as the promotion of exchange of information and experiences between member countries and other development partners involved in the fight against HIV/AIDS in the sub-region. Launching workshops in each of the four countries, local awareness seminars and advocacy activities, meetings of stakeholders, as well as updating the UNAIDS website for the fight against HIV/AIDS in the Mano River Basin Countries will also be supported under this component.
3. Project Management
   Resources under this component will provide support to strengthen the management and administrative capacity of MRU Secretariat to effectively coordinate, monitor and evaluate the implementation of the project.

Origin and History of the Project
Almost 70 percent of the people living with HIV worldwide, live in sub-Saharan Africa. The HIV/AIDS prevalence rate has been increasing at an alarming speed and the epidemic has become the leading cause of adult mortality. Several important meetings have been held at both continental and global levels to discuss the issue. As a result, the fight against the epidemic has been identified as Africa’s topmost priority.

Recognizing the devastating effect of the epidemic, African Heads of States met in Abuja in April 2000 and passed the Abuja Declaration that put the fight against HIV/AIDS as the topmost development priority. Subsequent to the Abuja declaration, in June 2000, the UN General Assembly special session on HIV/AIDS (UNGASS) emphasized, among other things, the need for i) the creation of a global fund to fight HIV/AIDS in Africa; ii) the integration of HIV/AIDS prevention, control and support in development activities, and iii) the elaboration of policy frameworks to address HIV/AIDS issues at the workplace. UNGASS brought HIV/AIDS issues to the forefront of the global agenda and Resolution No. 1308 wherein HIV/AIDS was viewed as a world security threat and called countries in Sub-Saharan Africa to urgently integrate HIV/AIDS prevention and management in their development agenda. In response, with the support of UNAIDS, some African countries gradually grouped together and created regional and sub-regional programs to fight against HIV/AIDS and sexually transmitted infections (STIs). Presently, there are four other sub-regional initiatives: i) Countries Lying Along Rivers Congo Ubangi and Shari (ADF support through a Grant of $6.0 million); ii) the Countries of the Great Lakes Initiative (UNAIDS/Global Fund); iii) the Countries of the Lake Chad Basin Initiative (UNAIDS/ADF/World Bank); and iv) the Abidjan/Lagos Corridor (World Bank). The thrust of these initiatives is to carry out co-ordinated regional actions to control and prevent HIV/AIDS and STIs.

Under the leadership of UNAIDS, a broad-based consultative process bringing together senior government officials from the Mano River Union Countries and Côte D’Ivoire, representatives of the displaced population as well as non-governmental key partners involved in the fight against HIV/AIDS in the sub-region was therefore initiated. The results of these consultations have been the articulation of a Sub-regional Programme for the Fight Against HIV/AIDS among the displaced population [refugees, Internally Displaced Populations (IDPs) and their host communities] in the MRU and Cote D’Ivoire. The Bank and the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM) were approached by the MRU with full support of the respective RMCs and the UNAIDS to finance the program. The present ADF proposed project has been conceived to complement activities of GFATM within the framework of the overall program. The project focuses on reducing risk and vulnerability factors with a view to preventing the propagation of new infections among refugees, internally displaced populations’ settlements as well as their host communities. It builds on lessons learned and strengthens partnership in developing sub-regional capacities for disease control in recognition of the link between conflict, mobility and HIV transmission. Its objectives will come on stream over a three-year time horizon (2004-2007). Its focus is the coordination of efforts to reduce the risk and vulnerability to STI/HIV/AIDS among major refugees, internally displaced populations’ settlements as well as their host communities. This initiative will strengthen partnership to develop sub-regional capacities for disease control, and build on lessons learned.

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