AUSAID’S CONTRIBUTION TO FOCUS AREA 5
LEADERSHIP, PARTNERSHIP AND COORDINATION
EVALUATION OF THE AUSTRALIAN AID PROGRAM’S CONTRIBUTION TO THE NATIONAL
HIV RESPONSE IN PAPUA NEW GUINEA, 2006-2010
AUSAID’S CONTRIBUTION TO FOCUS AREA 5
LEADERSHIP, PARTNERSHIP AND COORDINATION
EVALUATION OF THE AUSTRALIAN AID PROGRAM’S CONTRIBUTION TO THE NATIONAL
HIV RESPONSE IN PAPUA NEW GUINEA, 2006-2010
Background and program objectives 2
Leadership, partnership and coordination activities funded by AusAID 4
Support to leadership 4
Support to partnership 4
Support to coordination 6
AusAID’s capacity building approach 8
Funding for FA5 activities 10
Effectiveness of AusAID support for leadership, partnership and
Effectiveness of support to FA5 11
Effectiveness of FA5: national response leadership, partnership and coordination 18
Capacity building approach for leadership, partnership and coordination 23
Gender and GIPA in support to leadership, partnership and
Relevance of AusAID support for monitoring and evaluation 26
Relevance of capacity building approach 27
Relevance of support for leadership 30
Relevance of support for partnership 31
Relevance of support for coordination 33
Supporting international good practice and use of evidence 38
Efficiency of AusAID support for monitoring and evaluation 39
Sustainability and ownership of support 41
Annex 22.1: Summary of evidence against evaluation questions 43
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 1
This annex is part of a set that documents and analyses the evidence of the Australian aid
program’s contribution to the Papua New Guinea (PNG) national human immunodeficiency
(HIV) response. Seven of the eight annexes analyse Australia’s contribution to each focus
area of the PNG National Strategic Plan on HIV and AIDS 2006–2010 (NSP). The eighth
annex analyses evidence related to the Australian Agency for International Development’s
(AusAID) program management. This annex provides the evidence base for findings in the
main evaluation report related to the Australia aid program’s contribution to leadership,
partnership and coordination as part of the national HIV response. It also contains analysis
of AusAID’s approach to leadership, partnership and coordination within its own activities.
The evidence is drawn from primary and secondary documents reviewed by the evaluation
team and key informant interviews.
Each annex first sets out the Government of Papua New Guinea’s (GoPNG) national
response objectives that the Australian aid program is contributing to, and AusAID’s own
aid objectives for how it will contribute to the focus area. It documents the activities
AusAID has conducted between 2006 and 2010 in support of the focus area. The annex then
provides evidence and analysis of AusAID’s contribution to the focus area in relation to the
four evaluation criteria: effectiveness, relevance, sustainability and efficiency. The conclusion
draws together the main findings. At the end of each annex is a set of tables that documents
the evidence sources used to answer each evaluation question and major evidence gaps.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 2
BACKGROUND AND PROGRAM OBJECTIVES
The GoPNG NSP has seven focus areas (FAs).1 The fifth, FA5, relates to leadership,
partnership and coordination of the national HIV response.
NSP FA5 goal: To encourage politicians and leaders at all levels of society to give a high
profile to HIV and enhance coordination of development partners, participation and
The NSP FA5 objectives are:
> To ensure an annual increase in financial commitment and political involvement to the
national response by fostering political and leadership commitment at all levels of society.
> To strengthen existing partnerships and establish new partners on the basis of equality
and mutual respect at all levels.
> To strengthen the capacity of the National AIDS Council (NAC) and its Secretariat to
effectively coordinate the national response to HIV through the implementation of the
NSP, including effective provincial coordination.
The strategies to achieve these objectives include a focus on the private sector and
government agencies, mobilisation of resources for the response, and advocacy to leadership
at all levels including traditional leaders and women.
The PNG-Australia HIV and AIDS Program (HIV Program) set its own objectives and
strategy in support of the NSP FA5 objectives within its 2006 Program Implementation
Framework (PIF)2, which were:
1. To ensure annual increase in financial commitment and political involvement to the
national response by fostering political and leadership commitment at all levels of society.
– Program priority to fund leadership initiatives – Leadership Support Initiative.
– United Nations (UN) priority to support leadership program.
– Program priority to advocate with Government of PNG for increased response to
HIV – advisor inputs, donor partners group inputs, capacity development of NAC.
2. To strengthen existing partnerships and establish new partners on the basis of equality
and mutual respect at all levels.
– Program priority to strengthen coordination mechanisms at national and provincial
– To strengthen the capacity of NAC and its Secretariat to effectively coordinate the
national response to HIV through the implementation of the NSP, including effective
– Program priority to develop and improve capacity of NAC and National AIDS
Council Secretariat (NACS) to act as national coordinating body.
1NACS, National Strategic Plan on HIV and AIDS 2006 -2010, 2006.
2Mooney, Malcolm and Winter, PNG-Australia HIV and AIDS Program: Program Implementation Framework, Annex
D, 2006 p. 114.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 3
3. Program priority to strengthen capacity of Provincial AIDS Committee Secretariats
(PACS) to develop mechanisms to coordinate stakeholders and monitor activities at
provincial and district level.
At the time of the program design in 2006, it was intended that the NAC, NACS and the
National Department of Health (NDOH) would be the main strategic partners of the HIV
Program, with other implementation counterparts being the health sector-wide approach
(SWAp), civil society and private sector partners. As the major donor in the response, the
HIV Program expected to take the lead in developing the capacity of NACS and PACS to
support the national response.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 4
LEADERSHIP, PARTNERSHIP AND COORDINATION
ACTIVITIES FUNDED BY AUSAID
Support to leadership
The HIV Program’s support to leadership in the national response has involved:
> Funding of the Leadership Support Initiative (LSI) until 2009, which targeted members
of Parliament and senior public servants for leadership training and coaching.
> Funding of the Catholic Diocesan HIV Program church leadership program in 20
provinces from 2007.
> Contributions to policy dialogue on the HIV response by the Program Director and
AusAID Minister Counsellor.
The LSI phases five and six have been implemented during the term of the HIV Program,
through the PNG Australia Targeted Training Facility (PATTAF). The LSI’s primary activity
involved delivery of a training module called ‘The Power of Leadership - Making a
Difference,’ supplemented by an international study tour in 2006, training of coaches, action
planning by participants, and follow-up one-on-one coaching after the training. At the end of
phase six in 2009, the LSI core module had been delivered to over 300 participants in 17
workshops from 2006. The HIV Program’s HIV/AIDS Advisor was directly involved in LSI
as a facilitator.
While the LSI predated the NSP, from 2007 it was the HIV Program’s intention to support
NACS to integrate the multiple leadership programs in operation together in line with the
Support to partnership
While support to strengthening existing partnerships and establishing new partnerships in
the national response was not originally a major focus of the HIV Program’s contribution to
FA5, it has assumed increasing prominence in the HIV Program’s priorities since 2006.
The HIV Program’s support to national response partnerships has involved:
> Support to Igat Hope for its role in representing people living with HIV in the response,
through funding and technical support for its operations from 2007.
> Funding to Business Coalition Against HIV and AIDS (BAHA) in 2008 for private sector
leadership workshops and grants for private sector initiatives.
> Support to PNG Alliance of Civil Society Organisations Against HIV and AIDS
(PACSO) to develop its role as a representative body for civil society organisations
(CSOs) in the response, through organisational technical support to define its role in the
response and revise its constitution (funding was allocated for 2010, but had not been
released at time of evaluation fieldwork as it was contingent on PACSO’s annual general
meeting being held to endorse the new constitution).
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 5
> Participation in the Development Partners Forum, quarterly meetings with UN partners
and coordination on specific activities with other donors (such as co-funding of the Asian
Development Bank [ADB]-managed Rural Enclaves Project, funding of UN activities).
More generally, the HIV Program has invested significant time and resources in working
with its funded partners to strengthen the capacity of CSOs to contribute to the national
response. This was not an explicit focus of the NSP objectives, but was recognised in the
program design as being an important component for supporting the response.
Support to CSOs has involved:
> Funding for CSOs to implement their annual activity plans.
> Technical support through advisers’ input, quarterly forums, sponsoring conference
attendance and providing information and tools.
> Organisational capacity building, such as contracting Deloittes to work with Anglicare
StopAIDS on improving its financial management systems.
> Facilitating networking among civil society partners through quarterly forums.
> Facilitating civil society involvement in national response forums and policy dialogue.
The HIV Program has supported inclusiveness in the HIV response through its efforts to
promote a gendered response, and meaningful involvement of people living with HIV.
In addition to its support to Igat Hope, the HIV Program employed a Greater Involvement
of People Living with HIV/AIDS (GIPA) advocacy officer to focus on supporting the
capacity of positive individuals and networks to be involved in the response, and to help the
HIV Program’s funded partners to integrate the GIPA principle into their activities.
The HIV Program has had one to two full-time gender and social development advisors
during its term, supplemented with short-term advisors. Their activities have included:
> Supporting civil society partners in integrating gender through development of tools and
checklists and dissemination of technical information.
> Support to NACS in launching the NSP gender policy.
> Gender training for partners.
> Technical inputs from advisors on national response policies and strategies, including the
National HIV and AIDS Strategy 2011-2015 (NHS).
> A short-term project in 2010, Powerful Voices, which was designed to empower women
in vulnerable situations.
One area where the HIV Program appears to have had limited engagement is support to the
private sector response to HIV. Apart from the funding to BAHA in 2008 and funding to
2007 the Chamber of Mines and Petroleum in 2007 for advocacy workshops, the only direct
support to the private sector response to HIV has been co-funding of the Rural Enclaves
Project under the Health SWAp. Apart from funding, the HIV Program has had some
degree of strategic engagement with the private sector, such as dialogue with Exxon-Mobile
and Oilsearch in relation to the HIV impact of the Liquefied Natural Gas (LNG) project.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 6
Other parts of AusAID have been supporting the involvement of PNG government line
agencies in the HIV response, mainly through advisory support (see Annex 15 for details).
Through its health sector program, AusAID provides financial support through the health
SWAp that goes to supporting the health response at the provincial level, and technical
assistance to the disease control program in the NDOH through the AusAID-funded
Capacity Building Service Centre (CBSC).
Support to coordination
The HIV Program has devoted considerable attention to supporting coordination of the
national response, through participation in NAC, and support to NACS and provincial
Since 2006, the HIV Program’s engagement with NACS has involved:
> Support to NACS staff from the Program Director and advisors related to the annual
planning process, the mid-term review, the NHS development process, the grants
program, the media unit, condom distribution, provincial liaison, information, education
and communication (IEC), communications and monitoring & evaluation (M&E).
> Funding for NACS’ coordination role.
> Funding of an international study tour for NACS staff.
> Placement of advisors within NACS to support financial management, human resource
management, policy and strategic management.
> Funding of the Financial Management Improvement Unit (FMIU) since 2007 to
administer NACS’ recurrent and development budgets, and the Procurement
Implementation Unit (PIU) since 2009.
> Funding of NACS staff in the grants and research units.
> Support to NACS for condom procurement, warehousing and distribution.
The FMIU and PIU have been set up to manage NACS’s finance and procurement
processes, and report to the NAC and NACS director on a monthly basis. The Deloitte staff
work with NACS staff in these units, and are responsible for capacity building of these staff.
Their Terms of Reference require them to develop capacity-building plans for the staff, but
do not specifically capacity-building activities (these appear to be on-the-job training).
The HIV Program’s support for coordination also involves compensation for gaps in
national coordination, which were not apparent at the time of its design. One of these
activities was the funding and management of the procurement and distribution of condoms
when NACS was unable to do so. In 2008, with national condom supplies running out, the
HIV Program through its implementing service provider, Jane Thomason International
(JTAI), funded and procured 45 million male and three million female condoms. When
NACS took no action to distribute the condoms, the HIV Program then arranged for
storage facilities to facilitate distribution and developed a distribution plan. By 2010, only a
small percentage of the condoms had been distributed. At the time of the evaluation team’s
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 7
visit, JTAI was working with PIU to manage distribution of the condoms, again funded by
the HIV Program.
HIV Program staff have also been actively involved in implementation of national response
coordination activities, such as participation in the NSP steering committee and the National
HIV and AIDS Strategy technical working group.
Since the NAC was reformed in 2009, the AusAID PNG Minister Counsellor has been an
active member of the Council.
In 2009, the HIV Program decided to reorient its capacity building support away from
NACS to the provincial level, guided by a Provincial Engagement Strategy (the Strategy).3
The Strategy set out goals of:
> Improved quality, inclusiveness and scope of HIV interventions.
> Strong sub-national government leadership, ownership and support for HIV.
> Better coordination and management of HIV response in the province.
The Strategy was intended to intensify the response in the seven provinces by helping to
resolve parallel coordination mechanisms and empowering provincial governments to
coordinate their responses. For the first phase of implementation, the Strategy identified
seven priority provinces based on high HIV incidence and prevalence (Western Highlands
Province, Eastern Highlands Province, Southern Highlands Province, Morobe) and strategic
geographic locations for the Australian Government (Sandaun, Western Province and
Autonomous Region of Bougainville).
The Strategy set out a large amount of activities to meet these goals. The first sequence of
activities was identified as scoping exercises for the seven priority provinces to obtain
broader perspectives on the HIV response and joint planning at the provincial level under
the leadership of the PACS. With anticipation that the joint planning would result in a
consolidated provincial annual response plan, the next step would be discussions with the
provincial governments and PACS to agree on specific activities and inputs to be provided
by the HIV Program and its partners.
Since 2007, the HIV Program funded a CUSO-VSO project to provide capacity building for
PACS in nine provinces through international volunteers. Going forward, the CUSO-VSO
PACS project was to be redesigned to result in a greater focus on the seven priority
provinces, with the idea that it would become an extended technical support facility for the
program under the Provincial Engagement Strategy (the evaluation team does not know
what the current status of this project is).
The HIV Program still planned to give support to the non-priority provinces in terms of
funding for non-governmental organisation (NGO) partner activities, sharing of lessons
learned from the priority provinces, and strategic engagement at the national level that would
benefit all provinces.
3The HIV Program, Provincial Engagement Strategy: a framework to support efforts to intensify provincial HIV responses,
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 8
The HIV Program’s 2010 annual activity plan set out a large number of activities to
implement this plan, but many of those do not appear to have been implemented. The main
activities undertaken were provincial scoping visits with NACS to five provinces, and
facilitating of stakeholder mapping workshops in some provinces (such as Western
Highlands Province). During the HIV Program’s visits to the provinces, advisors also
conducted visits to NGO funded partners. Since 2009, the HIV Program has also been
coordinating more closely with the Sub-National Strategy program to leverage off its
structures and relationships at the provincial level.
Another area of the HIV Program’s engagement in national response coordination, which
has evolved more recently, is direct engagement with other GoPNG national agencies.
Notable activities have been engagement with Department of Provincial and Local
Government (DPLG) on the service delivery determination and formation of the Provincial
Local Level Service Monitoring Authority (PLLSMA) HIV sub-committee, and technical
support to the office of the Minister for Community Development, Women and Religion to
draft legislation changes related to legalisation of consensual male-to-male sex and sex work.
AusAID’s capacity building approach
The HIV Program’s second outcome area is enhanced individual, institutional and sector
PNG capacity to lead and manage a national response to HIV and AIDS. A theory of change
exercise conducted by the evaluation team with the program staff confirmed that they see
their role as building government and civil society capacity to response to HIV (see Annex
The PIF set out a broad approach to capacity building, focusing on:
> Capacity building with individuals – training approaches to build competencies and
abilities for improved performance.
> Capacity building within organisations – organisational development processes and
technical assistance with program implementation.
> Capacity building within the government and civil society sectors – processes to build
viable networks, partnerships and strong civil society.
There have been a number of approaches to capacity building through the HIV Program,
CBSC and Advisory Support Facility (ASF) advisors, which have taken the following forms:
> Ad hoc technical advice to partners from the Program Director and advisors.
> Ongoing technical advice and support to NACS from advisors based in the organisation.
> Specific technical inputs to activities from Program Director, advisors, and CBSC
advisors (such as the M&E advisor participating in M&E capacity assessments of
provinces, a CBSC advisor being seconded to NACS to write the NHS).
> Short-term funding of organisational support to improve partner’s management systems,
based on organisational weaknesses identified in audits (all partners are subject to audits)
and organisational assessments (conducted for Anglicare StopAIDS and Igat Hope in
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 9
> Ongoing assistance to partners from JTAI – for example, Igat Hope receives support one
day a month on financial management.
> Long-term funding of contracted functions within NACS (such as the FMIU).
> Sponsoring of government and civil society partners to attend international AIDS
> On-the-job training (such as in FMIU).
> Funding of in-line positions – for example, surveillance officer and sexually transmitted
infection (STI) program manager in NDOH, three positions in NACS research unit.
Where advisory support is provided, it appears to be guided by the initiative and style of each
individual. There has been a lot of trialling of different approaches, although the results are
not well documented. Advisors interviewed reported using a range of capacity assessment
approaches (no standard assessment tool was identified), and then responding through
various interventions such as providing technical input into partner activity plans or formal
training. For long-term advisory positions, mentoring and day-to-day support were
important approaches. For both the HIV Program advisors and advisors located within
organisations, building trust and mutual partnerships are seen as critical factors in their
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 10
Funding for FA5 activities
HIV Program funding to the national response for FA5 totalled $10.2 million between April
2007 and September 2010 (Table 1).
Table 1: The HIV Program expenditure on leadership, partnership and coordination, 2007–20104
Funding Area Year ended 31 December (AUD) Year to date ended 30 Totals (AUD)
2007 2008 2009 2010
FMIU 8,426 425,900 585,236 315,407 1,334,969
Support capacity 49,831 156,081 325,310 430,032 961,254
strengthening in NACS
Funding of NACS activities 122,050 21,109 71,884 2,891 217,934
Support national response 364,893 210,647 1,081,507 589,975 2,247,022
procurement and distribution
Fund NACS small grants 519,766 1,000,000 - 696 1,520,462
Fund NACS in-line positions - 41,666 125,700 110,071 277,437
Advisory Support Facility - - 1,174,830 n.d. 1,174,830
advisors in NACS#
Leadership Support Initiative# - - 146,948 n.d. 146,948
Support to other national - - 20,782 204,544 225,326
Support to provinces - 191,964 440,002 380,599 1,012,565
Technical support to civil - 2,074 - 69,287 71,361
Organisational support to civil - 338,773 276,684 53,246 668,703
Gender activities - 16,255 191,985 81,097 289,337
GIPA activities - 20,537 10,572 44,021 75,130
Totals 1,064,966 2,245,006 4,451,440 2,281,886 10,223,278
# LSIand ASF advisors funded through other AusAID sector programs until 2009. These are funded through
channels other than the HIV Program’s imprest account, and are not included in percentage calculation of FA5
funding as comparable budget figures were not available.
This represents ten per cent of AusAID funding for the HIV Program (imprest account and
NGO grants, excluding LSI and ASF) for the period April 2007 to September 2010.
4The HIV Program (2010e) Detailed Expenditure Statement – Imprest Account managed by JTA-ISP. Funding
on HIV 2007-2010. For the month ended 30 September 2010; The HIV Program (2010f) Detailed Expenditure
Statement – Imprest Account managed by JTA-ISP. Funding on HIV 2007-2010. For the 12 months ended 31
December 2009; The HIV Program (2010g) Detailed Expenditure Statement – Imprest Account managed by
JTA-ISP. Funding on HIV 2007-2010. For the 12 months ended 31 December 2008; The HIV Program (2010h)
Detailed Expenditure Statement – Trust Account and Non-Trust Account for period ended 31 December 2007.
The HIV Program (2010) AusAID HIV Sector Performance Report 2009: Annex C.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 11
EFFECTIVENESS OF AUSAID SUPPORT FOR
LEADERSHIP, PARTNERSHIP AND COORDINATION
Effectiveness of support to FA5
Evidence collected by the evaluation team suggests the HIV Program has been relatively
effective in supporting FA5:
> It has made little progress in capacity building of government partners, but has played an
important role in maintaining critical functions of the response.
> It has led in building the capacity of CSOs to engage in the response, directly resulting in
increased access to services.
> It has helped to build Igat Hope as a lead body to represent people living with HIV, but
has had less engagement with PACSO and BAHA.
> It has maintained a focus on gender and GIPA in the response, but is still struggling
(along with its partners) to make this a lived reality in the response.
> It has contributed to building leadership in the response through is Leadership Support
Initiative, with some positive results for individuals but as yet not broader sustained
> It has used policy dialogue effectively to establish itself as a leader in the response,
particularly through the efforts of the Program Director.
The HIV Program’s achievements in relation to FA5 are not all directly related to its original
objectives, but rather have resulted from its adapting and responding to the progress of the
national response. Some significant gaps remain in the HIV Program’s progress in this area,
particularly in promotion of leadership.
Effectiveness of support for leadership
LSI has been the HIV Program’s most direct input into building leadership for the national
response, allowing access over 300 potential HIV champions in politics and national and
One of the target groups included the Special Parliamentary Committee (SPC) on HIV and
AIDS. The managing contractor reported that outcomes from that workshop were the SPC
Chairman arranging for voluntary counselling and testing (VCT) to be available at Parliament
House, a number of articles published in the daily papers and a site visit to high risk sites in
Port Moresby arranged for Members of Parliament (MPs).5
Participants report that action plans have been implemented, and workplace policies
developed. LSI appears to have helped motivate HIV mainstreaming efforts in a number of
5PNG-Australia Targeted Training Facility (2009) Leadership Support Initiative (HIV & AIDS): Activity Completion
Report October 2009.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 12
departments. It has been reported that politicians have been advocating in their electorates,
and individuals advocating to their families and communities.
An example of LSI’s impact on individual participants is:
Since being a participant in the LSI Study Tour in 2006, [the] Deputy Speaker of the
Autonomous Bougainville Government…has become a passionate and forthright LSI
facilitator. [The Deputy Speaker] has become well known for her outspoken views and has
been invited to address a number of follow up activities arranged by workshop participants
in their workplaces.6
The HIV Program has also attributed support to support to the office of the Minister for
Community Development, Women and Religion to develop a submission to the National
Executive Council (NEC) on legislation of decriminalisation of consensual male to male sex
and sex work as an achievement of LSI.
Some factors that detracted from the effectiveness of LSI included:
> Loss of momentum between LSI5 and LSI6 while the Leadership Strategy was being
> No action taken by NACS on implementation of the leadership strategy, which was
meant to guide LSI from 2007.
> The coaching component was underdeveloped, with the contractor reporting it clearly
needs much more development if it is to become an effective strategy for developing
leaders. The experience of the LSI coaching pilots in LSI 5 and LSI 6 has not indicated
the positive benefits that can be achieved from coaching.7
While there were some positive results from the workshops, sustained results of the LSI are
difficult to see. Partly this is because the LSI approach, while having value, needs
complementary conditions and activities to be in place to have a significant impact. One
example is SPC – while LSI was probably helpful for the members in clarifying their role and
solidifying their commitment, there are not other factors in place (for example, funding for a
secretariat) that are necessary for that SPC to fulfil its role.
The specific objective of LSI is unclear; program documents received by the evaluation team
only state that the sixth phase was intended to:
maintain the momentum arising from previous Leadership Support Initiative activities by
providing a strategic focus on activities endorsed by National AIDS Council Secretariat while
NACS is awaiting NAC approval of the Leadership Strategy and an implementation plan for the
It seems the plan was for LSI to contribute to the objectives of the Leadership Strategy.
Since the Leadership Strategy has never been finalised it instead focused on activities and
outputs, rather than being linked to a more strategic approach to leadership.
6 PNG-Australia Targeted Training Facility (2009) Leadership Support Initiative (HIV & AIDS): Activity Completion
Report October 2009. pp 5-6.
7 PNG-Australia Targeted Training Facility (2009) Leadership Support Initiative (HIV & AIDS): Activity Completion
Report October 2009. p 9.
8 PNG-Australia Targeted Training Facility (2009) Leadership Support Initiative (HIV & AIDS): Activity Completion
Report October 2009. p. 4.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 13
If LSI is considered against the PIF’s expected results for political leaders (increased activity
among politicians, policy and leadership of the response, support of NAC, allocation of
increased resources)9, it seems that LSI may have partially contributed to those results.
However, this contribution may be limited given the political environment. Very few MPs
are championing the AIDS response in PNG. The Chairman of the SPC had made public
statements on HIV and AIDS in the past, but recently few statements are read or heard in
the PNG media. The SPC has not been given any funds by Parliament to conduct campaigns
within and outside of Parliament.
Overall, it appears the LSI has not been an effective intervention to support the NSP FA5
objective for promoting leadership of the national response.
While LSI has been the main aspect of the HIV Program’s support to leadership, there have
been some achievements from other activities in this area. The Catholic HIV/AIDS Office
has reported that the leadership training for pastors and their wives has been an important
pre-requisite to enable the start-up of HIV prevention activities in Catholic communities.10
The HIV Program has also had the opportunity to influence leadership and policy through
strategic engagement and dialogue. It has contributed to policy dialogue on the HIV
response through the Health SWAp strategic engagement by the Program Director, and
official governance forums such as high-level officials meetings.
The HIV Program Director is highly respected and seen by stakeholders to be one of a
group of individuals who have had a substantial influence on the directions of the response.
[The Program Director] is very respected and has done an excellent job. She is the ‘go to’ person.
[The Program Director and some other individuals] have influence at the top level….their voice
carries a lot of weight.
Without [The Program Director] there would have been nothing. She has driven many initiatives.
She is good technically and understands the politics….it’s not just an individual effort, but without
her it wouldn’t have happened.
Another important avenue is AusAID’s position on the NAC, as a representative of
development partners. Stakeholders report that AusAID’s Minister Counsellor is an active
member of the NAC.
The Health SWAp provides a substantial opportunity for influence, but has been under-
exploited. This appears to be a combination of the immaturity of the SWAp structures, and a
lack of interest (until recently when the Minister Counsellor made moves to address this) in
pursuing support for the HIV response through AusAID’s health program.
AusAID has also reportedly been working at senior officials level in bilateral forums to
advocate on the HIV response, but as yet has had limited success moving this to the
ministerial dialogue level. However, with an implementation schedule being developed for
9 Mooney, Malcolm and Winter, PNG-Australia HIV and AIDS Program: Program Implementation Framework, 2006. p.
10 Key informant interview during civil society case study: A Kenyon & E Rudland, Papua New Guinea-Australia
HIV and AIDS Program: Civil Society Engagement. Case Study Report, 2010.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 14
HIV and health as part of the PNG-Australia Partnership for Development, this is seen as a
good opportunity to strengthen policy dialogue on the response.
While there have been some important achievements in terms of leadership promotion,
over-reliance on LSI as a mechanism for reform, the lack of use of key opportunities such as
the health SWAp, and limited attention to building a complementary and coordinated set of
interventions means that AusAID’s effectiveness in this area has been limited.
Effectiveness of support for partnership
The HIV Program has contributed to building partnership through coordination bodies,
primarily in its support for Igat Hope. The HIV Program has provided Igat Hope with core
funding for its operations, technical support from the program’s advisors (such as gender,
GIPA), organisational capacity building, and support from the HIV Program activity
Independent Review Group on HIV/AIDS (IRG) assessments have noted growing progress
in Igat Hope’s ability to represent networks of people living with HIV in the response, with
its first national conference in 2008, and culminating in Igat Hope’s role in the response
being officially endorsed in 2010, and Igat Hope starting to move towards being a
coordinating body. The HIV Program is not the only donor supporting Igat Hope, but has
been an important contributor.
The HIV Program has provided more limited support for the other coordination bodies.
Funding for PACSO budgeted for 2010 was conditional on PACSO holding its annual
forum. However, the HIV Program has facilitated technical assistance for PACSO to clarify
its role and bring stakeholders together to arrive at a consensus on how to go forward. This
was seen by stakeholders as very useful, and has resulted in a consensus on PACSO’s role
and a resolution that it will be funded by NACS and member’s fees. This provides PACSO
with a good opportunity to move forward in its role.
Meanwhile, the HIV Program has been a quasi-coordination body for the civil society
response, which is recognised and appreciated by most stakeholders. Funding for civil
society partners has formed more than half of the HIV Program expenditure, and support to
civil society is currently the major focus of the HIV Program’s advisors and activity
In the absence of effective support structures within the national response, the HIV Program
has been critical in facilitating the civil society response.11 HIV Program-funded partners
deliver a significant proportion of prevention, testing, treatment and care services across the
country. A particular achievement that can be attributed to the HIV Program’s support for
civil society is the expansion of access to VCT since 2006.12
While the evaluation team was not in a position to assess the degree of capacity building in
CSOs since 2006, the positive results of the HIV Program’s efforts are more apparent here
11 Kenyon & Rudland. Papua New Guinea-Australia HIV and AIDS Program: Civil Society Engagement. Case Study
12 The HIV Program, Quantitative Evidence of Progress 2007-2008, 2009.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 15
than its work in the public sector. A case study of the HIV Program’s civil society
engagement in 2009 assessed that it had been relatively effective in achieving its goals
(identified in a retrospective theory of change) of:
> Increased involvement of CSOs in the response.
> Increased institutional and technical capacity of CSOs.
> CSOs integrate a gender sensitive approach into their activities.
> Good partnerships between CSOs to align, share information and lessons learned.
> Increased involvement of people living with HIV and other vulnerable groups in the
> Contribution of CSOs to the national response widely recognised and supported by
government, donors and the private sector.
> Civil society actors involved in a SWAp and policy dialogue with government.
The HIV Program has been most effective in involving civil society partners in the response
and promoting partnerships within civil society. It has been less effective in promoting
integration of a gender-sensitive approach and improvement of people living with HIV in
partner’s activities. It was not within the scope of the case study to measure improvements in
partner’s technical and organisational capacity, although it affirmed the value of the HIV
Program’s activities in these areas.
This evaluation has verified most of the findings in the case study. However, it included a
wider group of perspectives on the civil society response and notes that the case study’s
finding that the HIV Program’s support for civil society is well aligned in the national
response is qualified by negative perceptions in this area. While the HIV Program has
appropriately arranged its funding for civil society partners through the NSP planning
process, and ensures that partners are contributing to the NSP FAs, there is a perception
among other stakeholders of a ‘closed club’ between the HIV Program and its funded
The HIV Program has had limited contributions to coordination of the private sector
response via BAHA. However, it is noted that BAHA is a capable organisation with other
The HIV Program has been proactive in engaging with other development partners in the
response, such as setting up coordination meetings with the UN agencies. Stakeholder
feedback suggests that donor coordination in the HIV response is relatively effective, with
good relationships and a desire to cooperate. However, there are still areas of overlap
between partners and not always the level of consultation and information-sharing that is
Overall, the HIV Program’s support to partnership in the national response is one of its
major achievements, particularly in relation to its support of civil society partners, even if
there is room for improvement in some areas.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 16
Effectiveness of support for coordination
Capacity-building and capacity substitution is the HIV Program’s major mechanism for
support to national response coordination. Initially, the emphasis was on capacity building.
The HIV Program planned to develop a capacity development plan in 2008, which would
outline specific targets and inputs. However, this did not occur. Instead, it appears that
capacity development approaches evolved in a range of ways, based on the efforts of
individual advisors, and specific organisational interventions where needs were identified
(such as support to Anglicare StopAIDS in strengthening its financial management systems).
Over the course of the last four years capacity substitution also emerged as an approach,
such as funding of the FMIU.
Ongoing engagement by the Program Director and advisors with NACS and other
government partners has been the main way that the HIV Program has supported this FA5
objective, and sought to build capacity of its partners. In its 2009 annual performance report,
the HIV Program stated that:
Although time intensive, AusAID’s contribution can be directly attributed to the program
model, whereby the team is actively engaged daily on strategy and policy dialogue with the
NAC Secretariat, GoPNG agencies and partners, and simultaneously facilitates quality
service delivery through application of GoPNG policy in partner activity plans.13
In particular, the NACS Director expressed strong appreciation for the close one-on-one
support he receives from the Program Director.
Identifying the specific achievements from the HIV Program’s capacity-building approach is
difficult, particularly for support to the public sector. In the case of NACS, gains in capacity-
building have been slow and difficult to sustain, due to organisational issues.
Where the HIV Program has been clearly successful is through capacity substitution, which
has played an important role in keeping certain functions of NACS in operation. These
> The FMIU, which the IRG has praised for normalising financial management in NACS.
> The PIU, which has filled critical gaps in procurement of anti-retroviral (ARV) drugs with
the funding from the PNG Government after the end of the Global Fund to Fight AIDS,
Tuberculosis and Malaria (Global Fund) Round 4 grant, and implementing condom
> Funding of the Research Coordination Unit, with staff recruited on a contract basis rather
than as public servants, facilitating achievements in the areas of social and behavioural
> Managing the logistics of condom and IEC procurement and distribution through JTAI.
> Providing funding and technical leadership for the NHS development process.
The HIV Program has also helped to keep the core coordination structures of the response
operating, through its involvement in the NSP Steering Committee and technical working
group. The major achievements from its technical support to NACS appear to be the
13 The HIV Program (2009) HIV Annual Sector Performance Report April 2009, p. 6.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 17
development of the national response policy framework. In many cases this is from direct
technical input rather than capacity building. Similarly, AusAID advisors recruited through
the CBSC program provided major technical inputs into writing the new National HIV and
AIDS Strategy 2011–2015 and the Global Fund Round 10 proposal.
AusAID has also maintained between two and five advisors based in NACS since 2007,
through the Advisory Support Facility (now the Economic and Public Sector Program). ASF
advisors have been placed to support strategic management, financial management,
procurement, and grants management. Reports from ASF indicate that advisor inputs have
been important in developing basic management systems within NACS after the withdrawal
of the National HIV/AIDS Support Project staff and systems. This has included building up
human resource policies and systems and financial management systems, setting up the
grants committee and research advisory committee, and supporting condom procurement.
More recently, ASF has facilitated the transition from a manual to computerised payroll
system which has resolved a lot of inappropriate payments. However, completion reports
from previous ASF advisors all show limitations in the degree they have been able to
complete their workplans, particularly in building staff capacity, due to organisational
management and culture within NACS.
The FMIU has had a capacity-building role as well as implementation role, but has been
unable to fulfil this due to significant issues of staff absenteeism, under-performance and
JTAI handed management of condom distribution back to NACS in June, but
underperformance of the logistics officer meant that PIU has had to take this on. This was
necessary as some PACS had not received condoms for the preceding six months.
Overall, it appears that sustained achievements from the HIV Program’s investment in
capacity building of NACS are limited. The 2009 review of the HIV Program said:
There is a strong perception among stakeholders that NACS has absorbed too much of the
Program’s management focus, resources and policy effort, despite the scaling down of this
support in 2008. Over the last three years resourcing to NACS from all sources has
increased, while performance has deteriorated in the near unanimous views of stakeholders.
Now NACS’s poor performance is seen as the responsibility of the AusAID Program and it
reflects on Australia’s ability to engage more broadly, a problem recognised by Program
HIV Program staff expressed frustration that they could not demonstrate solid achievements
from the work to build NACS’s capacity. NACS middle-management staff are also frustrated
by the situation, with a number feeling left out and marginalised by the capacity substitution
systems. However, it was clear to the evaluation team that AusAID’s support is highly valued
by the NACS Director. A major factor in the inability of AusAID’s efforts to make any
progress in NACS has been the difficult context where NACS was without a permanent
director and oversight from NAC for two years, in the context of a restructuring process.
The HIV Program clearly hoped it would be able to make better progress through its
provincial engagement, which became a priority in 2009. It has had some important
14 J Mooney. & K Wheeler, Review of the Papua New Guinea-Australia HIV and AIDS Program, 2009. p. 14.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 18
successes in facilitating provincial responses, with AusAID advocacy leading to inclusion of
HIV as a provincial responsibility in the service delivery determination. Through the Health
SWAp, AusAID has contributed to funding that had kept the provincial health responses to
HIV going. However, the HIV Program has made less progress in implementing its
Provincial Engagement Strategy. The Program had only started to implement its initial
activities in the Strategy when it was asked by NACS to pull back on its provincial
More progress has been made on supporting stronger decentralised HIV responses through
national processes, through engagement with the DPLG and National Economic and Fiscal
Commission. Support from the HIV program has contributed to inclusion of HIV as a
provincial government responsibility in the Service Delivery Determination, work on policy
to phase transfer of ownership of PACS to provincial administrations, and
institutionalisation of an HIV working committee under the PLLSMA.
Effectiveness of FA5: national response leadership, partnership and
Assessments from the IRG and the NHS situation analysis show that, while there has been
some positive progress, substantive progress in FA5 has been limited. As of 2010, the NHS
said of the systems of the national response:
While there have been significant achievements in a number of areas in the national response
to HIV and AIDS, overall progress has been too slow and has not been keeping pace with
In this context, the HIV Program’s contribution to FA5 has been important in making
progress in these critical areas. However, the effectiveness of its contribution has been
hampered by other factors hindering progress.
Effectiveness of national response leadership
Substantive progress in achieving the NSP’s objective on leadership appears to be missing.
The National Leadership Strategy (NLS) was drafted in 2007 by a United Nations
Development Programme (UNDP) consultant and set out an approach to achieve the FA5
strategic objective. The NLS was designed to bring together the uncoordinated efforts on
leadership promotion into a coherent approach, including a common methodology.
However, the NLS has not been finalised or implemented in a coordinated manner.
Three leadership programs have been in operation: the Asia Pacific Leadership Forum
(United Nations Program on HIV/AIDS [UNAIDS]) from 2002, the UNDP Leadership
Development Programme (LDP) from 2004, and the LSI (AusAID) from 2004.
Between them, the three programs have targeted similar groups (politicians, bureaucrats,
public sector leaders), although LDP has also more broadly targeted non-government
leaders. LDP and LSI both use coaching approaches, and LSI has utilised coaches trained
15 NACS, Papua New Guinea National HIV and AIDS Strategy 2011-2015, 2010. p.22.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 19
under LDP. Common problems to the three programs have been lack of sustained follow-up
after the initial training.
As presently organised, the existing AIDS related leadership approaches…operate almost
independent of each other, with no central co-ordination. Instead, various development
partners involved in these programmes decide on their target groups and roll out
programmes based on their areas of focus and in response to NACS intermittent requests.
This uncoordinated process leaves little or no opportunities for synergies and concrete large-
scale results to be recorded.16
The NHS assessment notes that overall the leadership response to HIV has been
disappointing, particularly in recent years. Central government agencies and provincial
governments rarely prioritise HIV in their planning and budgeting processes. Local
leadership initiatives have been limited, but there are a growing number of activities targeting
community leaders and village elders, who can be important agents of change.
The IRG has also raised concerns that the concept of leadership is too limited, focusing on
organisations and workplace issues rather than formal and informal leaders at all levels.
Rather than the ‘strategic advocacy’ envisioned in the NSP, activities have focused on
workshops and training, and there have been poor links between leadership programs of the
Asia Pacific Leadership Forum, UNDP and AusAID.
In May 2010, the IRG warned:
Nationally and locally there continues to be a poor understanding by leadership that business
as usual will not suffice given the severity and impact of HIV, especially within the context
of major development activities such as the LNG project. This absence of visionary
leadership is further reflected in the need for more support and champions at the family
Mobilisation of resources for the response is one of the strategic areas under FA5. The IRG
notes a sharp contrast between provinces that have made HIV a priority and those who have
not. A major issue in national support to the provincial responses has been the lack of flow
of funds to provincial governments. The NACS small grants program has also not been
effective in getting funds to community and grassroots organisations.
The service delivery determination, finalised in 2010, is a positive step forward in establishing
the role of provincial governments in the HIV response. However, IRG highlights the
continued absence of an effective mechanism for channelling financial resources to
provinces, and has suggested consideration of HIV function grants.
Effectiveness of national response partnership
Progress on a national response partnership has been varied. The IRG has continually noted
that BAHA has provided strong leadership in the private sector, and that implementation
progress in the response is resting on faith-based organisations and private sector initiatives.
16 NACS, National Leadership Strategy (2008-2012) for Implementing the National Strategic Plan. Final draft April 2008,
17 P Aggleton, et.al. Independent Review Group on HIV/AIDS report from an assessment visit 22 April – 5 May 2010,
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Initiatives to support better partnerships in the response, such as coordinating bodies like
PACSO, have made slow progress. PACSO was created in 2007 with funding from the
Global Fund to act as a voice for civil society in the response, and to coordinate civil society
partners. However, PACSO had difficulty establishing itself, with donors unwilling to
provide funding until it demonstrated some capacity.
PACSO has reported that its activities to date have involved liaison and networking with
local and international agencies, participation on committees, presentation at workshops, and
extensive networking with stakeholders. It has run ad hoc workshops to build NGO capacity
with funding from the UN and the Global Fund. By 2010, 618 organisations expressed
interest in joining. Members tend to be informal village groups, some formally engaged with
international non-governmental organisations (INGOs) as volunteers.
In its 2010 assessment the IRG noted some positive developments in PACSO’s new
constitution, Igat Hope’s moves to become a coordinating body, and the formation of the
PNG Christian Leaders Alliance on HIV and AIDS.
The inclusive consultation process for the NHS has also been widely praised. Generally,
however, inclusiveness in the HIV response remains a major gap. The IRG has noted a lack
of involvement in decision-making from women, people living with HIV and youth. While
there is some grassroots leadership emerging from local groups of people living with HIV,
these require considerable support to become established organisations.
The NSP situation analysis also highlighted the continuation of stigma and discrimination as
major barriers to an effective response and slow progress of integrating gender into program
implementation. It noted that the level of positive peoples’ involvement in the response has
rarely gone beyond being a target audience or the beneficiary of services, with very few
positive people meaningfully involved as planners, service deliverers or decision makers.
Effectiveness of national response coordination
Key achievements in national response coordination include:
> Expansion in the number of partners in the HIV response.
> Formalisation of the NSP planning process in 2008 to establish a coordinated and quality
controlled process for annual submissions from government agencies, provincial bodies
and CSOs to seek funding in line with NSP FAs.
> Consolidated annual budget submissions for the national response through the PNG
budget process (excluding line agency funding).
> Issuing of guidelines for managing and coordinating provincial and district responses
were issued in 2008, to outline the role and responsibilities of PACS, provincial
governments and other stakeholders in provincial responses.
> The re-establishment of the NAC in 2009 followed by regular meetings.
> The appointment of a permanent NACS director in May 2010.
> Completion of national response policies: the National HIV Prevention Strategy 2010–2015;
Strengthening PNG’s Decentralised Response to HIV and AIDS (2009); the National Research
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 21
Agenda for HIV and AIDS in PNG 2008–2013; and the National Gender Policy and Plan on
HIV and AIDS 2006–2010.
However, the same period has also seen a long gap in effective coordination of the response.
Two years without strategic direction and oversight from NAC and the continually under-
functioning Secretariat have meant national coordination remains problematic. During that
period the NSP Steering Committee appears to have been the main body keeping national
coordination going, but even that met irregularly and often without a quorum.
In 2009, the IRG assessment was that: ‘On balance, it appears that any current progress
being made in responding to the epidemic is being made in spite of NACS rather than as a
result of its efforts.’18
The IRG sees the FMIU as a very positive development in financial management of NACS.
Otherwise, the IRG advocates for NACS to become a leaner and more strategically focused
organisation, with functions it has not done well at (such as grants management) moved out
A particular area of coordination that has suffered has been the public sector response, with
the National Joint Coordinating Committee never formed (despite it being approved by
NEC in 2004) and erratic progress in implementing workplace policies and HIV activities
among the national-level government agencies. In particular, the poor relationship between
NACS and the NDOH has been a major issue for the response. The IRG continues to
urgently call for leadership at highest levels of government.
The NHS situation analysis pointed to growing ownership of the HIV response in provinces,
although provincial leadership remains weak. Achievements are being made in provinces
where there are champions, however, this is despite rather than because of a coordinated
effort to achieve FA5. PACS require more capacity building support.
The 2008 PACS guidelines included a situation analysis of coordination issues in provincial
responses, as follows:19
Stakeholder concerns PACS concerns
General lack of support and guidance Frustration about lack of reporting by stakeholders
Failure of PACs to facilitate mechanisms Stakeholders frequently fail to be present at meetings
Failure of PACs to facilitate a forum for the exchange and Stakeholders submit proposals to national agencies without
sharing of information and experiences upon implementation PAC endorsement
PACs limit stakeholder access to vital and strategic information
There is little or no communication relating to response events
and developments in the provinces
Two years later, the evaluation team’s visits to Western Highlands, Sandaun and Madang
provinces showed that many of these concerns remain current, and that the lack of effective
coordination of provincial responses is still a major concern for stakeholders (see Annexes
18 P Aggleton et.al. Independent Review Group on HIV/AIDS report from an assessment visit 23 April – 6 May 2009,
2009. p. 18.
19 NACS, Managing and Coordinating Provincial and District HIV Response: Operational Guidelines for Provincial and District
AIDS Committees, 2008. p. 2.
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The IRG continues to report on a growing stakeholder consensus that the HIV response
needs to be taken down to the community level, a theme the evaluation team also heard
from many sources. The IRG suggests grassroots initiatives would be better supported
through localised small grant programs to get funds managed in each province either by
strong INGO or provincial governments. The evaluation team concurs with this, having
seen multiple examples of community organisations with a strong motivation to contribute
to the response hindered through lack of basic resources.
Looking forward – the NHS
The NHS has identified the following factors holding back the national response that need
to be addressed:
> The low capacity of people, systems and organisations.
> The lack of a robust leadership response at all levels.
> Weak implementation of policy and legislation.
> Poor targeting of interventions.
> Limited funding for the sub-national level.
> Limited engagement of communities.
> A lack of a bottom-up approach informing programs.
The NHS sets out the following goals for systems strengthening: focusing on use of strategic
information, addressing gender inequality, ensuring GIPA, strengthening leadership at all
levels, reducing stigma and discrimination, and building the capacity of people, communities
and organisations to mobilise, coordinate and implement the HIV response at all levels.
To achieve these goals, the NHS sets out 41 strategic objectives (not counting M&E and
research objectives). Of particular interest are objectives to mobilise people living with HIV
to monitor and advocate against stigma and discrimination and to pursue prosecutions under
the HIV and AIDS Management & Prevention Act. There is a significant focus on greater
inclusion in the response of men and women at all levels, people living with HIV, and
mobilisation of communities. There is also a focus on monitoring the effectiveness of
capacity building approaches, developing a National HIV and AIDS Capacity Development
Plan, and moving the majority of technical assistance to the sub-national level.
Decentralisation of the response is a focus, including mainstreaming HIV and AIDS into all
provincial and district plans and budgets and requiring provincial governments to report
PLLSMA on their HIV responsibilities. The NHS aims to improve multi-sectoral
coordination through quarterly meetings of the National Joint Coordination Committee
(NJCC) attended by all key departments.
After four years, the national response is in a situation where there has been good progress
in getting the basic structures of coordination and partnership in place, but the effective
operation of these structures has some way to go. Leadership remains a particular weakness
of the HIV response. In this context, it appears that AusAID’s support has contributed to
limited and erratic achievement of the FA5 objectives. The FA5 goal has only been partially
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 23
CAPACITY BUILDING APPROACH FOR LEADERSHIP,
PARTNERSHIP AND COORDINATION
As capacity building is a core part of support to FA5, analysis of the capacity building
approach is integrated into the evaluation criteria. See:
> Section 2.4: AusAID’s capacity building approach.
> Section 3.1: Effectiveness of support for coordination.
> Section 4.1: Relevance of AusAID’s approach to capacity building.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 24
GENDER AND GIPA IN SUPPORT TO LEADERSHIP,
PARTNERSHIP AND COORDINATION
The HIV Program has been praised for its sustained focus on gender and GIPA in the HIV
response. However, the way that has occurred may not have been the most appropriate use
The activities of the GIPA advocacy officer included support to provincial groups of people
living with HIV to prepare annual activity plans and NAC submissions, work with NGO
partners to integrate GIPA into their plans and activities, and coordination on GIPA with
other development partners. In an internal report to the HIV Program in 2009, the GIPA
advocacy officer warned that a number of partners saw GIPA as a ‘stand alone’ program and
were having difficulty understanding the GIPA principle. 20 The officer also pointed out that
the HIV Program itself was not integrating GIPA well, with insufficient monitoring of GIPA
and a need to undertake high-level advocacy to ensure that GIPA programs are fully funded
by the government and the necessary support is provided to groups of people living with
Stakeholders acknowledge the progress on GIPA has been weak across the board, and seem
to have high expectations of what AusAID should have achieved.
I feel AusAID has shown leadership on GIPA….[but] I think we’ve all done really badly.
It was a façade, [appointing the GIPA Advocacy Officer]. I don’t think she was given support.
The way the Program worked with positive people…its one of the huge failures of the HIV
A 2006 Oxfam report identifies a number of lessons on facilitating GIPA in the PNG
response. For example, some of the barriers to GIPA identified were stigma and
discrimination, ‘charity models’ of working with positive people, unreasonable demands on
employees who are living with HIV, and competition for PLHIV among agencies. Some of
the factors that facilitate GIPA identified were access to antiretroviral therapy and peer
support, use of appropriate selection criteria, a focus on building self-worth, and providing
opportunities to participate at different levels.21
The evaluation team’s fieldwork suggests that many of the barriers to GIPA identified in this
2006 report remain common. Given that there is good knowledge on how to effectively
facilitate GIPA in the PNG context, it appears that insufficient prioritisation and resources
for GIPA within AusAID’s program and in the national response generally is the reason for
While the HIV Program’s efforts to support a more gendered response are appreciated,
substantive progress has not matched the scale of its inputs. A ‘stocktake’ by the the HIV
Program gender and social development advisors in 2010 points out that many of the
20 The HIV Program, GIPA Quality at Implementation Report. 2009.
21 T Leach et.al. The Involvement of People with HIV in PNG’s HIV Response: A Review of the Implementation of the Greater
Involvement of People Living With or Affected By HIV/AIDS (GIPA) Principle in PNG. Final Report to Oxfam Australia.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 25
activities undertaken suffered from lack of follow-up or take-up by program staff.22 Even
within the HIV Program, gender mainstreaming is limited, and ‘working on “gender” is still
seen as an add-on.’ The advisors report that their colleagues are not being held accountable
for integrating gender into their activities. Gender is also insufficiently integrated into
program systems, resulting in the HIV Program’s own strategies, evaluations and recruitment
not role modelling a gendered approach. The gender advisors have placed an emphasis on
supporting integrating of gender in AusAID’s HIV mainstreaming activities in other sectors,
and are now being supported by the leadership of the new AusAID PNG Gender Advisor
and a PNG program gender strategy. However, they point out that gender needs to be made
a corporate priority for all areas.
Some of the HIV program staff have attended the AusAID corporate gender training, but
describe it as very basic. The gender advisor has focused some of her attention on staff by
providing tools and information, but this is only a small component of her role.
Program staff acknowledge that efforts in promoting gender integration need to go much
We’re just scratching the surface, we need massive cultural change.
Gender based violence is a key driver, we’ve struggled to address it.
The gender stocktake also reports limited progress in supporting NACS to coordinate a
gendered response, stating:
In order to map out a strategic working relationship with NACS and to build the capacity of the
NACS gender adviser, it was suggested in 2007 that a more senior and more experienced person
be hired as the senior gender adviser. Unfortunately the recommendations were not taken on
board, as a result of which capacities are still weak in NACS to understand and drive an
engendered national HIV & AIDS response in the country.
As of 2010, the HIV Program is not leading in supporting NACS on gender as UNIFEM
(the UN Development Fund for Women, now replaced by a new entity) has commenced a
capacity-building project to work with NACS on ‘Gender Equality in HIV & AIDS.’
A further issue raised by some stakeholders is that that the conceptualisation of gender by
the HIV Program (and other actors in the response) is too shallow:
When talking about gender, it is reduced to violence against women…gender is just done as a
project, it's not included as a programming concept
Some stakeholders feel the HIV Program has not engaged sufficiently with men on gender
issues, or focused on the dynamics of sexual desire in PNG.
Overall, while the HIV Program should be acknowledged for its significant efforts in this
area, gender and GIPA have remained siloed in program management. There is a need for
cultural change within AusAID before expecting funded partners to master these difficult
programming concepts. In terms of gender, the recent emphasis on gender by senior
AusAID management in PNG may help to address the issues.
22 The HIV Program (2010) Gender and Social Development Stock Take & Lessons Learnt: 2007-2010.
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RELEVANCE OF AUSAID SUPPORT FOR MONITORING
The 2005 discussion paper that informed the HIV Program’s design identified four recurrent
themes in the national response relevant to AusAID’s support of FA5:
> The critical role of NDOH in mobilising an effective response and the urgent need to
mainstream HIV/AIDS and develop HIV/AIDS capacity across all NDOH program and
> The ongoing need to mobilise PNG leaders around the response, including church,
industry and clan leaders from all levels.
> The need for planning, monitoring and evaluation to guide strategy development and the
allocation of resources both nationally and in the provinces.
> The pressing need for national and provincial coordination of the response.23
The HIV Program has responded to all of these issues to varying degrees, with particular
focus on supporting national and provincial coordination, and much less focus on mobilising
an effective health response through NDOH. However, the HIV Program’s ability to
support the achievement of FA5 objectives effectively has been hindered by significant
external factors, including:
> No strategic oversight for the response for over two years while the NAC and a
permanent NACS director were not in place.
> A high-risk counterpart in NACS, with instances of misconduct and financial
> Limited political ownership of the HIV response at the national and provincial levels.
> A weak public health sector.
> Weak coordination capacity at the national and provincial levels (with some notable
> Limited organisational capacity of many civil society partners.
The relevance of a program’s approach comes down to how well it meets the limitations of
its context, and the following assessment of relevance is made on that basis.
Overall, it appears that the relevance of the way the HIV Program has approached support
to leadership, partnership and coordination could be improved. Even within the constraints
of the context:
> AusAID’s approach to capacity-building is hindered by unrealistic expectations of what is
achievable and inappropriate ways of working in some instances, and there is a need to
reconsider whether resources are being used in the most relevant way.
23Mooney, Malcolm and Winter, Scoping of Options and Issues for Future Australian Support for HIV/AIDS in Papua
New Guinea 2005-2010, 2005.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 27
> The approach to supporting leadership had not been managed in a strategic manner,
relying mostly on the contribution of LSI and not fully leveraging opportunities for policy
dialogue across the AusAID program.
> The approach to supporting partnership has been positive in its focus on the civil society
response, with some important limitations: support to the private sector response is a
gap, and efforts for integration of GIPA and gender into programming have not paid off.
> The approach to supporting coordination has had mixed results, with the focus on
capacity-building in the public sector context not always appropriate and under-
exploitation of AusAID’s potential for leverage in some sectors.
One stakeholder’s assessment was, ‘the way AusAID sets up its work mitigates (sic) against
doing good work.’ The evaluation team does not entirely agree with this statement, but
considers that there are ways the HIV Program has approached its contribution to FA5 that
have not been the most relevant and appropriate response. This suggests that there is
potential for AusAID to improve the value of its contribution in this area, even given the
Relevance of capacity building approach
Both stakeholder comments and the NHS situation analysis confirm the importance of
AusAID’s focus on capacity-building. The way AusAID approaches capacity building was a
significant concern for many stakeholders. The evaluation team was impressed by the efforts
of individual advisors to make progress in an extremely difficult environment, but noted that
the burden of making it work is largely left to those advisors. Strategic oversight of the
approach to capacity building, with appropriate risk management, appears to be missing.
The evaluation team is very concerned by the environment that the Economic and Public
Sector Program (EPSP) advisors are working in within NACS, with reports of threats and
intimidation against both NACS staff and advisors arising out of resistance to change.
Overall, the main issues related to AusAID’s capacity building approach are unrealistic
expectations of what is achievable (leading to the wrong goals) and inappropriate ways of
working by some advisors.
Stakeholders interviewed tended to be critical of the way AusAID and its advisors
approached capacity building. The issues raised included that the approach was often not
appropriate for the organisational contexts and the way that Papua New Guineans learn.
Stakeholders also commented that AusAID’s approach lacked tact and sensitivity, with some
advisors being directive and dominating in meetings, and that the approach can be overly
technical rather than focusing on process and relationships.
Early in Sanap Wantaim the concept of capacity building came to the fore, but they had no idea
what they were talking about.
To build capacity at the provincial level you have to do things differently
The model is OK to get results, but how to build local capacity? It’s a gap.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 28
Some concerns were raised to the evaluation team that some of the HIV Program advisors
do not have the right skills for their positions, including a good understanding of how to
apply international evidence in the PNG context. While some individuals were singled out
for praise, several stakeholders expressed negative perceptions of the advisor group.
Advisors not performing attract criticism of the Program and overshadows its achievements.
I’m not sure what achievements have been made by the Sanap Wantaim advisors.
I expect the Sanap Wantaim advisors to provide support and backup for stakeholders, I don’t see
There is also some feeling that the HIV Program advisors are not in the right position to
influence, and should be based within NACS or out in provinces.
It is well recognised that the conditions for effective capacity building is not one-sided.
Capacity building can be sustained if it’s supported from both sides.
The government needs to spell out what help is needed and make sure it happens.
However, in the face of lack of commitment or ability from government institutions to
provide appropriate conditions, AusAID has continued to pursue capacity building
objectives. A review of completion reports of former ASF advisors in NACS shows that all
thought their terms of reference were unrealistic given the organisational context. Advisors
report on going to a lot of effort to achieve the goals they have been set, with limited
success, and feeling tension between achieving the results they have been set and laying the
necessary foundations of relationship building.
Advisors described factors that militate against them fulfilling their roles. Lack of
counterparts is a common problem. In some cases, high staff turnover in the areas advisors
work means they are constantly starting from the beginning with staff. A lack of skilled staff
to work with is a key issue – ‘sometimes you are the capacity’ – as is lack of management of
underperformance. This leads to advisors feeling they have to step in to keep certain things
happening. Even when advisors do not want to step out of their agreed role, sometimes
pressure from their counterparts to act as implementers makes this difficult. Advisors
recognise that building trust and relationships plays an important role in their ability to
For advisors across different organisations there was a sense that they were limited in the
degree they could build capacity, but were needed to ‘keep the balls in the air.’
We’re not achieving what we’re here to do, but we do achieve something, I worry what the
organisation would do without us.
We change our role on a daily basis.
This in particular has created negative perceptions among some of the NACS staff about the
ASF/EPSP advisory support: ‘when they leave, they leave nothing behind.’ Other
stakeholders also expressed doubts about whether AusAID’s support has achieved anything,
for example: ‘I have a strong feeling that AusAID is not in anyway building the capacity of
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 29
In relation to NACS, stakeholders also noted that AusAID’s capacity building does not take
into account the negative effect that large differences in remuneration between the NACS
staff and AusAID’s advisors has on the motivation of some NACS staff to work
constructively with the advisors.
Some advisors talked of the need to focus on systems strengthening rather than working
with counterparts, while others feel that instability in their counterpart organisations means
that specific capacity building is not feasible.
There is no consensus on the best way to set up advisors within PNG government
organisations. Some people the team interviewed were adamant that in-line managerial
positions are the only way to make an influence. Others think that being in-line would make
their role more difficult where the organisational culture is not conducive to achieving
results. Basing support on in-line positions can also create significant issues for sustainability.
If [the STI program advisor] goes, the STI program in the country will collapse.
Some advisors suggested that clarifying roles might mean recognising that capacity building
is not an appropriate aim in some circumstances, and that institutional strengthening is a
more realistic goal.
A 2009 evaluation of the CBSC program identified the difficulty of strategising for capacity
building in the PNG environment, and importance of building good working relationships
and trust, and a focus on process to influence the complex political, social and cultural
dynamics within organisations.
In line with international applied research supported by AusAID on capacity development, CBSC
has proved that capacity building does not occur through planned approaches but rather emerges
in an often ‘messy’ way. CBSC struggled, and failed, to develop an overarching strategy for
capacity development in NDOH but support has become strategic. This is more tangible at
national level, where support is more intensive, than provincial level. It has also become clear that
‘pure’ capacity building, in the absence of resources for infrastructure and human resource
development has minimal impact on service delivery.24
24 S Emmott et.al., The Capacity Building Service Centre in Papua New Guinea: Independent Evaluation Report, p. i. 2004.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 30
Box 1: CBSC lessons on capacity building in PNG
Focus even more strongly on ownership because change is fundamentally political.
Approach capacity development as a process of learning and experimentation rather than as
Take a more evolutionary approach to design – be clear about the desired direction of change but with
space for adaptation.
Invest more in understanding the political, social and cultural context.
Conduct capacity diagnostics from a perspective of strengths rather than weaknesses.
Be prepared to accept a higher degree of risk and failure in order to encourage innovation and learning.
Be more realistic about the scope of external intervention – external partners are marginal actors
compared with the influence exerted by underlying domestic processes and forces.
Overall, the CBSC evaluation shows that the factors affecting how to work effectively in the
PNG environment are known. In relation to AusAID’s support for the HIV response, and
particularly its support of NACS, these lessons need greater attention. Moreover, there is a
need to question whether all of the capacity building interventions in place are currently
appropriate, or whether resources need to be redirected until the basic conditions of capacity
building are in place. This was expressed by one stakeholder as follows:
The issue is that the government hasn’t stepped up to the plate to make NACS work properly. We
made a mistake if we say everything can be fixed through some form of technical input.
Relevance of support for leadership
Leadership from NACS was fundamental for the success of the National Leadership Strategy
to address leadership in the national response. In the absence of this, the three leadership
approaches (Asian Pacific Leadership Forum, LDP and AusAID’s LSP) operated almost
independent of each other, with no central coordination. The evaluation team is not aware of
whether the HIV Program proactively attempted to resolve this situation. In any event,
AusAID has contributed to a situation where lack of donor harmonisation has hindered
progress towards the FA5 leadership objective.
While AusAID has made important contributions in policy dialogue regarding the HIV
response, this has been a limited focus with no specific resources allocated, no
corresponding program objectives, and no reporting on progress. This suggests much greater
value could be attained from a sustained approach.
More broadly, it appears that the HIV Program has given insufficient attention to this area of
the national response. This is a major oversight, given that active leadership at all levels is
essential in an effective HIV response. Many of AusAID’s efforts in other areas are hindered
by limited leadership within the response.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 31
Therefore, it is the evaluation team’s opinion that the promotion of leadership should have
been, and still should be, a key priority of AusAID’s contribution to the national response.
This needs to go far beyond funding of a stand-alone project to encompass a sustained
policy dialogue and advocacy approach. AusAID’s health, sub national strategy and
democratic governance programs have a critical role to play in supporting the HIV Program
through leadership promotion in their respective areas of focus (respectively public health
sector, provincial governance, and non-state governance). Support for leadership would be
most effective in building on initiatives that have been championed by particular leaders at
the national and provincial levels. The current environment may be more conducive to
strengthening areas of existing leadership further. The IRG team leader suggests there may
have been a recent change in attitude in this area, with the development and endorsement of
the NHS signalling a stronger sense of ownership by key stakeholders.
Relevance of support for partnership
The HIV Program’s support for the civil society response is recognised as one of its major
achievements. There is no doubt that supporting civil society’s role in the HIV response is a
highly relevant contribution to the HIV response. This is discussed in detail in the 2009 case
study evaluation of the HIV Program’s civil society engagement.
This evaluation confirmed the findings of that case study. The direct relationships and
support provided to civil society partners are appreciated, particularly in the context of weak
The HIV Program’s approach to creating mutual partnership-style relations with its partners
is also a highly appropriate part of its approach, and the evaluation team endorses the focus
on relationship maintenance and mentoring.
However, the wider scope and access to stakeholders of this evaluation has uncovered some
> Currently, the HIV Program is fulfilling a role in coordination of civil society that would
normally otherwise be held by national stakeholders if there was capacity – such as NACS
and PACSO. This remains appropriate in the short-term, but attention needs to be given
to transitioning the focus of the HIV Program’s support for civil society to building a
sustainable national coordination mechanism.
> The HIV Program’s direct relationships and well-resourced support for civil society
partners have led to perceptions by other stakeholders of a lack of transparency of the
HIV Program’s support and lack of accountability of funded partners to the national
response. Issues around lack of funded partners’ reporting to PACS and NACS was
raised from numerous sources. The evaluation team also heard concerns from several
senior government stakeholders about a perceived lack of efficiency of civil society
funding. For example, ‘little NGOs are very well looked after, but have small
> Avenues for influencing are the direct relationship between the activity manager and civil
society partners, the quarterly forums where information is shared on good practice and
the HIV Program provides feedback, and the quality-at-implementation peer review
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 32
meetings. However, this has meant the HIV Program has had limited influence in moving
partners away from less effective activities such as mass awareness, and to move into
remote areas of the country. With a few exceptions, the funded civil society partners are
located where they wish to work, not necessarily where the greatest needs of the response
are. This has led to clustering of services in urban areas and duplication.
Where partners are located is down to operational regions, where it’s easy to operate. We
haven’t been able to build a strong case to persuade partners to go to certain areas based on
> The HIV Program has had a tendency to fund the more established organisations. There
is a major gap in support for small community organisations to play a role in local
responses to HIV, particularly with the NACS small grants program not operational since
> There is a need to look at alternative delivery models for civil society to overcome
absorptive capacity constraints.
There is an absorptive capacity issue with civil society. Others would dispute this, there is a
culture of more money is better. It will require thinking on service delivery models and how to
realise civil society capacity at local levels.
The civil society case study identified a perception of HIV Program staff that the pool of
available civil society partners is limited. It suggested the private sector might be under-
utilised as a source of partners; this evaluation has confirmed that perception.
The HIV Program has had limited engagement with the private sector compared to its
government and civil society partners. AusAID’s funding contribution to the Rural Enclaves
Project is the only direct support for the private sector response (and reportedly of value).
The main coordinating body for the private sector, BAHA, is at this stage mostly funded
from its business members, and desires to stay that way. However, there appears to be
potential for more strategic engagement of the private sector, both in terms of advocacy for
businesses impacting on the HIV response to fulfil their corporate responsibilities, and to
facilitate access for private sector actors into the response structures.
There are active and motivated stakeholders working on the response in the private sector,
yet it appears to the evaluation team that the private sector contribution is being under-
exploited (especially given government and civil society absorptive capacity issues). For
example, BAHA offered to take over on national condom distribution but was refused
because this was not seen as a sustainable mechanism. The evaluation team disputes this
assumption: BAHA is a capable national stakeholder, and it is clearly more appropriate to be
leading on implementing major functions in the national response that a bilateral donor.
Condom distribution does not necessarily have to be implemented through government
systems, and BAHA may potentially be a solution to one of the functions the HIV Program
took over not because it was part of its objectives, but because it was felt there was no one
else to do so.
As outlined in Section 5, the HIV Program’s focus on promoting gender integration and
GIPA into the HIV response has not worked for the PNG context.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 33
Overall, the HIV Program’s support for partnership has been a very important part of its
contribution to the national response. Moving forward, attention is needed on enhancing the
value of support to the civil society response and providing for a more sustainable support
mechanisms, and putting a greater focus on supporting the private sector response. Gender
integration and GIPA remain outstanding issues, with the current approach of limited
Relevance of support for coordination
The PIF stated that, for NACS,
It would be good to be able to report in early 2008 that NAC and NACS were becoming the
acknowledged effective coordinator on HIV/AIDS. 25
Its desired outcomes after seven years of the HIV Program were for NACS staff to have the
necessary technical and managerial skills to effectively coordinate and monitor the response.
It hoped that after seven years its civil society partners would be ‘viable organisations that
can have technical and organisational capacity to deliver programs.’
These capacity building goals do not appear to have been realistic, even based on
information known at the time. The Functional and Expenditure Review of NACS in 2002 and
the Roles of Government Study commissioned by AusAID in 2005 show that many fundamental
issues in the management of the response have remained unchanged over time, including the
uncertain role of NACS in relation to other government departments, problems in NACS
supporting the provincial response, and serious financial management issues.26
The National HIV and AIDS Support Project (NHASP) seemed to have contributed to this
lack of progress. Despite funding most of NACS staff positions and providing considerable
operational support (including in financial management), NACS gained little from its period
working with NHASP.
The way the HIV Program is currently set up and relates to NACS is a direct response to the
failures of the NHASP model. There is strong feeling both with and outside of AusAID that
the way NHASP worked with NACS was not appropriate. However, the withdrawal of
NHASP from NACS also created a number of problems, which now affects the HIV
Program’s ability to work with NACS effectively.
When NHASP went, everything started falling apart
When NHASP wound down, it left NACS in much worse shape than before
The end of NHASP was a good thing, but it takes 3–4 years to fill the void
A capacity mapping of NACS in 2006 identified a poorly performing organisation with staff
behavioural issues and major deficiencies in financial management, human resource
management, information technology, procurement and logistics, office accommodation,
25 Mooney, Malcolm and Winter, PNG-Australia HIV and AIDS Program: Program Implementation Framework, 2006.
26 AusAID, Role of Government Study Part One: Government Framework to Respond to HIV/AIDS Epidemic
in PNG; NACS, Functional and Expenditure Review of National AIDS Council Secretariat, 2002.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 34
and planning.27 The mapping provided a basis for AusAID’s capacity building to NACS,
particularly through the ASF advisors. The initial ASF advisors placed in NACS
implemented its recommendations to formalise the organisations by instituting processes and
systems, put checks and balances in place, and address staff performance through a code of
conduct and application of sanctions and rewards.
However, from 2007, ASF advisors were reporting difficulties working in a culture of a lack
of accountability, with significant performance and management issues, intimidation and
non-compliance with public service procedures.
These issues were reflected in program reporting. In late 2007, the HIV Program was already
reporting on significant challenges in working effectively with NACS, with engagement
‘exposing the fragility of their system and the inappropriateness of their structures.’28 In
2009, the HIV Program reported that ‘long term investment will be required to enable the
Secretariat to deliver on its mandate to lead the national response, however there is some
doubt regarding whether this could bear fruit over the medium term.’29 In 2010, the HIV
Program even less optimistically reported ‘institutional capacity to manage the response by
government across the sectors and at all levels is an ongoing challenge, and continues to be
beyond the scope of the Program to influence more than incrementally.’30
In the face of these acknowledged problems, there was no apparent change in AusAID’s
approach to supporting NACS, with the important exception of setting up the FMIU. The
HIV Program responded in 2009 by refocusing its primary attention from NACS to the
provincial responses, but otherwise the ASF advisors and other forms of support to NACS
remained in place. The HIV Program staff and the ASF advisors remained guided only by
the broad capacity building approach set out in the PIF, which was never complemented by
contextualised strategies for each target group.
The assessment of the 2009 review of the HIV Program was that:
The Program’s attempts over three years to build NACS’s organisational capacity, and work
through NACS, were extensive and appropriate at the time, given the critical organisational
weaknesses identified the 2006 design document….However,…the review believes that there is
need for a careful realignment of implementation away from unresponsive PNG mechanisms….31
This evaluation team disagrees with the conclusion that the attempts to build NACS’
organisational capacity were fully appropriate at the time, as the factors underlying the
NACS’ underperformance remaining unaddressed (and in many of the ASF advisors’ terms
of references, unacknowledged). The more politically sensitive path of engaging with
GoPNG on the structural issues related to NACS has been mostly not pursued. While
considerable efforts have been made by the Program Director to work through the NSP
Steering Committee to address leadership, governance and management issues, there has not
27 AusAID, National AIDS Council Secretariat (NACS) Capacity Mapping Report, 2006.
28 The HIV Program, 2008 Annual Program Plan, 2007. p. 15.
29 The HIV Program, HIV Annual Sector Performance Report April 2009, p. 8. 2009
30 The HIV Program, AusAID HIV Sector Performance Report 2009, p. 7. 2010
31 J Mooney and K Wheeler, Review of the Papua New Guinea-Australia HIV and AIDS Program, p. 11 and pp.13-14.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 35
been a willingness within the Australian aid program to back up these efforts by holding
NACS to account. This is a disappointment to other stakeholders who do not have the same
potential for leverage that AusAID does. A number of stakeholders expressed concerns that
AusAID has not used its leverage with NACS effectively:
AusAID and the UN have been propping up NACS. If the Program had more understanding of
what’s going on it might be more proactive in expecting quid pro quo from NACs in exchange for
support, [for example] evidence of management meetings or performance appraisals.
AusAID is not using the leverage it’s got, there should be greater conditionality.
Where there were not serious consequences by AusAID for NACS’s corruption, it eroded respect
for AusAID’s engagement with NACS. I couldn’t take that commitment seriously.
The advantage of being separate from NACS was that it allowed the HIV Program the ability
to engage directly with civil society partners and focus on service delivery results. However,
the experimental program model has not been successful in supporting government any
more than NHASP did. At this point AusAID is facing a dilemma. While the program model
has been successful in working with civil society, it has not been successful in strengthening
government ownership and capacity to coordinate the response, and risks leaving a void
behind in the same way NHASP did.
As outlined in Section 3.1, AusAID has played an important role in filling gaps in the
national response coordination through capacity substitution. This is an aspect of its support
that is relevant and responsive to the context, particularly based on the view at the time that
AusAID was supporting an ‘emergency’ response. This has meant that the momentum of the
response is maintained and no doubt has facilitated many of the achievements made against
From the start AusAID support basically laid the foundations of the response, supported
government and over time strengthened civil society to respond to the epidemic.
Both the HIV Program staff and its advisors feel a strong sense of responsibility to keep the
response going. However, the unintended consequence of this is it has made it easier for
other stakeholders not to step up to fill these roles and has placed AusAID in a difficult
Sanap Wantaim has grown to become a proxy for what NACS should be.
There is no incentive for NACS to do anything because AusAID will do it.
There is not one person in NACS that can provide [my non-government organisation] with
support….Sanap Wantaim is better set up to provide support and communicate on a daily basis.
This is reflected in a tendency of both the HIV Program staff and other stakeholders to
confuse the role of AusAID as a bilateral donor in the response and the role of the
government. The evaluation team heard views about failures in the response that are seen as
a responsibility of AusAID, even by NACS staff. There is a need for clarifying what AusAID
is accountable for vis-à-vis the response, and clearly communicating this to other
The HIV Program’s support for NACS over the last four years is based on the premise that
keeping the basic functions running until a point where GoPNG’s reforms resolve the issues
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 36
in NACS. A restructuring process for NACS commenced in 2008, and was still continuing at
the time of the evaluation team visit in October 2010. At that point, many stakeholders in
the national response had lost faith that the restructure would achieve what it is meant to.
While the merits of the way AusAID has supported over the last four years can be debated,
it is clear that at this point in time there is a strong need for a new direction.
There is a view from a number of stakeholders that the HIV Program’s advisors should be
based inside NACS. The evaluation team’s view is that would not be appropriate unless the
situation in NACS changes significantly, but concurs with the feeling that the advisors are
not positioned in the right place at this time.
The HIV Program’s approach to supporting NACS is now being influenced by the broader
advisor review conducted jointly by the Australian and PNG governments in 2010. The
results confirmed the value of advisors when used in a targeted and cost-effective way, but
also recognised that a number of positions were not cost-effective and/or the most
appropriate aid intervention. Out of the 487 long-term advisory positions currently funded
by the Australian aid program, the two governments agreed to phase out one-third of those
In 2009, the HIV Program’s response to the troubles in NACS was an increased focus on
provincial engagement, and engaging with other government agencies in the response (such
as NDOH and Department of Community Development) directly by the HIV Program
rather than mainstreaming support from AusAID’s other sector programs.
The HIV Program’s objective in 2009 for provincial engagement was to facilitate greater
ownership and coordination of HIV responses at provincial level and to target assistance to
provinces and districts in most need. Seven priority provinces were selected.
The HIV Program’s rationale for its approach to provincial engagement included:
> Poor capacity building approaches for sub-national stakeholders, which were dominated
by one-off training activities without follow-up and not linked to implementation of
activities or service delivery.
> Lack of strategic analysis of local HIV epidemics resulting in interventions not being
targeted to the needs and circumstances of each province.
> Stakeholder plans and activities being developed in isolation and unaligned to provincial
priorities resulting in duplication and overlap of activities.
The result was a plan for sustained engagement with stakeholders addressing deficiencies in
strategic analysis, planning and coordination, and focused on aligning program-funded
activities to provincial priorities. The Provincial Engagement Strategy is well-formulated, and
targets the key issues in sub-national responses identified by the evaluation team in its
provincial case studies.
Unfortunately, implementation of the Provincial Engagement Strategy was interrupted
before much progress was made, at the request of NACS. Feedback from some key
32 Australian Minister for Foreign Affairs (2010) ‘Australia welcomes outcomes of PNG advisor review,’ press
release 14 October 2010.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 37
informants suggested the reason for this was that NACS felt AusAID was pushing ahead too
fast on its approach to supporting provincial responses (presumably leaving NACS behind).
Part of the issue was also the lack of alignment between AusAID’s priority provinces and
NACS’s priority provinces, which focus only on high prevalence locations.
This has presented a considerable dilemma for AusAID in relation to ownership and
> Should AusAID be taking the lead in supporting provincial responses, where NACS has
not yet demonstrated a capacity to fulfil this role sufficiently?
> Should AusAID be considering Australia’s strategic interests in targeting its support, or
only follow the direction of GoPNG?
The evaluation team considers that AusAID was proceeding appropriately. Its priority
activities at the provincial level are an essential prerequisite for AusAID to be able
coordinate the contribution of its funded partners in each province, and to ensure that
support is targeted to the greatest needs.
Using Australian strategic interest as a factor in prioritisation of support is also appropriate.
Indeed, it would be a considerable oversight for AusAID not to focus support on Western
province: while it has relatively low reported prevalence, there are substantial HIV risk
factors present and the easy cross-border access into Australia’s Torres Strait is a significant
health risk that Australia must manage. The evaluation team’s visit to Sandaun province (an
AusAID priority province based on strategic interest) and Madang province (not a priority
province) also confirmed the high HIV risk factors in both environments. This suggests that
there are strong arguments for support to a number of provinces beyond those with high
reported prevalence. It is reasonable for a bilateral donor to conduct its own prioritisation
within the broad framework of the government’s national strategy (which does not specify
The need for support to coordination of provincial responses remains great, and this is an
area that AusAID – as funder of many of the NGOs operating in many provinces – has a
comparative advantage. AusAID’s role in the provincial response needs to be negotiated
with GoPNG and endorsed (possibly at the level of NAC) so AusAID can resume these
activities as soon as possible. AusAID’s role should be defined so that it is clear to all
stakeholders that AusAID is not replacing GoPNG in leading coordination of provincial
HIV responses, but rather is doing what needs to be done to make its funded partner’s
contributions most effective.
As already discussed, the HIV Program’s move into directly engaging with other GoPNG
agencies has been successful, and is a highly relevant use of resources. This allows AusAID
to leverage its relationship capital in other sectors in support of the HIV response. The
exception is in the health sector, arguably the most important sector for AusAID to be
focusing. That was certainly the view of the 2009 HIV Program review which saw the health
sector as the greatest potential for scaling-up. It recommended a greater focus on working
through the health system to strengthening primary health care worker’s capacity to deliver
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 38
HIV services, as part of an integrated approach, and to engage through policy dialogue to
influence the health sector’s response to HIV.33
Overall, AusAID has attempted to be responsive in adapting to the PNG context and has
adopted several new strategies to support coordination of the national response. These have
paid off to some degree and have also produced some unintended consequences that have
yet to be resolved. The apparent reluctance to make a significant change in support to NACS
has meant not all resources going into this area of AusAID’s contribution have been well-
used. There is potential for AusAID to be using its leverage in various sectors more
Supporting international good practice and use of evidence
Analysis of international good practice relevant to FA5 is in Annex 14. There is room for
greater use of evidence on what is known is effective in the PNG context (such as GIPA,
capacity building). Capacity assessments of NACS have been the main evidence used to drive
AusAID’s approach in supporting FA5. Otherwise, beyond the international experience that
advisors may have brought to their positions, the approaches seem to have been driven by
experience and intuition.
33 J Mooney, and K Wheeler, Review of the Papua New Guinea-Australia HIV and AIDS Program, 2009.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 39
EFFICIENCY OF AUSAID SUPPORT FOR MONITORING
The evaluation team did not have the data to make a full cost-efficiency assessment of the
HIV Program’s support to FA5.
AusAID’s resources for support for FA5 involve approximately ten per cent of the HIV
Program funds, and time from the Program Director, several of the HIV Program advisors,
and staff from other sector programs. In terms of funds, the majority of resources have gone
to supporting condom and IEC procurement and distribution (22 per cent), FMIU fees (13
per cent), and funding of NACS small grants (15 per cent). Other significant costs have been
support to priority provinces (10 per cent) and support to capacity-building of NACS (9 per
cent). In contrast, technical and organisational support for civil society (7 per cent) and
gender and GIPA activities (3.5 per cent) are relatively small. Funding of the ASF advisors in
NACS was 11.5 per cent in 2009 alone, suggesting that with a full picture of this funding it
would be the major cost in support to FA5.
Support of the FMIU has clearly been good value for money, as it has significantly reduced
the risk of misappropriation and fraud. The investment in condom distribution and setting
up the distribution infrastructure will have good value, provided the existing condoms can be
distributed before expiry and a sustainable system is set up to maintain the measures put in
Of less value has been funding of the small grants (given the IRG has raised concerns about
how NACS was managing that program) and funding of provincial activities which did not
go far enough to show results.
Funding of the ASF advisors in NACS has clearly had value in helping to keep basic
coordination functions operating, but in terms of investment in meaningful outcomes has
had negligible value for money.
During the evaluation team’s visit, concerns were raised by stakeholders that those resources
are not being used as effectively as they could.
A lot of donor funds are spent around urban areas, a lot of conferences.
Donors are funding NGOs without requiring integration.
The AusAID program across the board, without it there would have been no development, but
there has been a lot of waste.
I’d like to see more investment in the quality of programs, not expansion….so much work is
wasted and poor quality…[AusAID] never checks if capacity-building is successful.
The Program has done things such as funding expensive provincial planning…it’s billed as a
NACS event, but NACS does not do anything. If NACS had to operationalise based on
government funding it’s wouldn’t be able to leave Port Moresby.
If AusAID kept up the level of funding, but focused on critical things, it would change the
trajectory of the response.
Stakeholders also clearly expressed the view that resources are not the primary need in the
response at this stage.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 40
Money is available, but it is the thinking behind the program that is a problem; either a lack of
capacity, money determining where people are, and constant change of consultancies.
Resources are a minor part of it, resources are everywhere, but need technical support to use it for
the best purposes and coordination to get the response right.
Overall, the mixed results from AusAID’s contribution to FA5, some of which can be
attributed to management decisions, suggests that full value of the investment in this area has
not been realised and that focusing on using existing funds more effectively and efficiently
needs to be a priority.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 41
SUSTAINABILITY AND OWNERSHIP OF SUPPORT
In general, the HIV Program’s approach to building capacity of government and non-state
stakeholders in the national response is aimed at long-term sustainability. The assumption is
that, eventually, national stakeholders will be able to fund and implement the national
response without major donor inputs. This may still be a valid assumption, but certainly not
within the timeframe of the current program.
Factors that detract from sustainability are both within and outside of AusAID’s control.
Outside AusAID’s control are the actions (or non-actions of its partners), such as issues that
have limited the functionality of NACS, and the slow progress in political leadership of the
response. The HIV Program has attempted to address some of these factors through its
activities, as set out above, but has little control over the progress. Within the HIV
Program’s control is the way it has set itself up and interacts with other stakeholders as a
major player in the HIV response.
As already discussed, areas of AusAID’s contribution that require attention in terms of
sustainability and ownership are: use of in-line technical support in NDOH, perceptions
around capacity substitution interventions in NACS and support of civil society partners,
AusAID’s coordination role for civil society partners and the use of stand-alone projects as a
primary intervention (LSI). There is a need for AusAID to be realistic about the likelihood
that the current approach supporting NACS of having sustainable results. There is also a
need for AusAID to take care in clarifying and obtaining endorsement for its role as
appropriate to a bilateral donor (such as in provincial engagement).
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 42
1. Support to FA5 has been a major part of AusAID’s contribution to the national HIV
response, with AusAID the main donor supporting the national response coordination
functions. This has accounted for around ten per cent of the HIV Program expenditure.
2. The HIV Program has been relatively effective in supporting FA5, particularly in relation
to helping to build national response partnerships, maintaining critical functions of the
response, and establishing AusAID’s reputation as an important ‘voice’ in the response.
These achievements are in the context of slow progress towards FA5 objectives overall.
The HIV Program’s approaches to promoting leadership, gender and GIPA have had
3. AusAID has been successful in supporting a stronger civil society response, but has made
little progress in capacity-building of government partners. Capacity substitution has
become a more effective and relevant intervention than capacity building.
4. Major gaps in AusAID’s support for FA5 have been engagement with the private sector,
utilisation of the health SWAp to support the HIV response, and using the leverage it has
available. Provincial engagement, which has stalled, is a critical area of AusAID’s
contribution that needs to be restarted.
5. Based on the level of investment compared to meaningful outcomes, the value for money
for support to FA5 has been marginal. There is a need for attention to more efficient use
and allocation of resources.
6. Sustainability of these interventions could be improved, particularly by focusing on a
complementary package of interventions towards objectives, and addressing perceptions
held by other stakeholders about AusAID’s role in the response and what it is
7. Areas for the HIV Program’s attention in support to leadership, partnership and
coordination under the NHS are:
a. Greater prioritisation of promotion of leadership at all levels, particularly through
sustained policy dialogue.
b. Provincial engagement as a priority, based on an agreed role for AusAID.
c. Clarification of realistic objectives and strategies for supporting coordination of the
d. Attention to transitioning coordination of civil society partners to a sustainable
national mechanism with continued focus on enhancing quality and relevance of
funded partner’s activities.
e. Greater focus on strategic engagement with the private sector.
f. Program staff knowledge, attitudes and skills for full integration of gender and GIPA
concepts into programming.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 43
ANNEX 22.1: SUMMARY OF EVIDENCE AGAINST EVALUATION QUESTIONS
Evidence sourced from document analysis (see list of references), provincial visits, and 40 key informant interviews in Canberra, Port Moresby and selected
provinces (where relevant information raised as part of broader-focused interview).
Question Evidence Evidence gaps
What activities has the HIV Government priorities: goals, objectives and strategies outlined in HIV/AIDS National Strategic Plan (NSP) 2006–2010 and National HIV and AIDS Strategy
Program funded? (NHS) 2011–2015, NSH implementation plan.
Program priorities for support to Focus Area (FA)7: outlined in Program Implementation Framework.
Activities: the HIV Program annual activity reports (2007 to 2010) outlines activities and inputs for FA5 related activities each year, Leadership Support Initiative
(LSI) activity completion report, the HIV Program report on LSI outcomes, the HIV Program gender stocktake 2010, Financial Management Improvement Unit
(FMIU) TOR, Procurement Implementation Unit (PIU) TOR, JTAI condom distribution reports, Provincial Engagement Strategy, key informant interviews.
What has not been funded? Gap analysis of funding against priorities (relevance analysis). HIV stakeholder mapping 2004.
What has been the scale of Budget for support to FA5-related activities in annual activity plans. Actual spending in financial reports (spending through imprest account and civil society
funding? partners grants) and in sector performance report.
Question Evidence Evidence gaps
What have the different All – sector performance reports, the HIV Program 2009 review. Degree of capacity
interventions achieved (by Leadership: LSI Activity Completion Report, NACS National Leadership Strategy (draft), the HIV Program report on LSI outcomes. Evidence on policy dialogue built in NACS and
NSP and Program priority through key informant interviews. civil society through
area)? Partnership: ODE 2009 civil society case study, IRG assessments of NHS progress, PACSO constitution, PACSO way forward meeting record, Quantitative AusAID support.
Evidence of Progress 2006–2008, key informant interviews.
Coordination: the HIV Program annual activity plans and annual performance reports, Anglicare StopAIDS joint organisational assessment and organisational
development plan 2008, Igat Hope joint organisational assessment and organisational development plan 2008, ASF advisor completion reports, EPSP advisor
progress reports, Deloitte (FMIU and PIU) monthly reports, October 2010 press release on outcome of PNG advisor review, key informant interviews.
How have these achievements Primarily based on IRG assessments (2007–2010) and situation analysis in NHS. Also draws on: National Leadership strategy, PACSO way forward meeting Do not have views
contributed to NSP record, PACS guidelines, provincial case studies, NHS and NHS implementation plan, NSP planning guide, NACS 2009 national response budget, key informant from other major
achievements? interviews. bilateral donors.
To what extent and in what Analysis based on activities and achievements against: original objectives (Program Implementation Framework), other apparent objectives (current practice),
ways has the HIV Program high level goals that the HIV Program is contributing to (NSP and NHS).
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 44
Question Evidence Evidence gaps
been effective in achieving its
What have been the main As outlined in – activities funded, achievements of interventions, relevance to PNG context.
strategies and approaches
taken by the HIV Program to
ensure ways of working are
effective for building capacity?
What have been the main HIV Program 2010 gender stocktake and implementation strategy, PNG program gender strategy, key informant interviews.
strategies and approaches
taken by the HIV Program to
ensure ways of working are
effective for gender
What have been the main GIPA Quality at Implementation (QAI) report, 2006 Oxfam report on GIPA progress in national response, key informant interviews.
strategies and approaches
taken by the HIV Program to
ensure ways of working are
effective for inclusion of
people living with HIV and
Question Evidence Evidence gaps
To what extent are AusAID’s General & Leadership: 2005 program design discussion paper, 2006 Program Implementation Framework expected results, context discussion in annual activity
program priorities relevant for plans and sector reports, drawing on evidence used for effectiveness assessment compared to contextual analysis (FA5 context/progress and key informant
the PNG context and why? interviews).
Capacity building approach: observation of working environment in NACS, NDOH, and PACS, key informant interviews, CBSC evaluation report.
Partnership: 2009 Office of Development Effectiveness civil society case study, key informant interviews.
Coordination: NACS 2002 review, 2005 role of government study, 2006 NACS capacity mapping, ASF advisor completion reports, EPSP advisor monthly reports,
Deloitte (FMIU and PIU) monthly reports, the HIV Program sector performance reports, the HIV Program annual activity plans, the HIV Program 2009 review,
Provincial Engagement Strategy, key informant interviews.
Are the interventions and Available evidence identified: NACS 2002 review, 2005 role of government study, NACS 2006 capacity mapping, Joint Organisational Assessments for Anglicare
approaches evidence and StopAIDS and Igat Hope, CBSC evaluation, 2006 Oxfam GIPA review, the HIV Program 2009 review.
AUSAID’S CONTRIBUTION TO FOCUS AREA 5 LEADERSHIP, PARTNERSHIP AND COORDINATION 45
Question Evidence Evidence gaps
contextually informed? Use of evidence: in some cases identified actions resulting from reviews (various sources). For example, ASF advisor reports show activities consistent with
NACS 2006 capacity mapping. Joint Organisational Assessments resulted in financial management support for both organisations. Otherwise, no apparent action
– such as when actions resulting from 2006 NACS mapping not resolve organisational issues and risks, no apparent change in strategy for advisor support.
What is the current See analysis in annex 14.
international evidence on
specific areas and how has
this been applied in the PNG
context? Has this application
Question Evidence Evidence gaps
Is the AusAID Program managed and Resources for M&E activities identified through financial reports. Value for money analysis based on conclusions of relevance/effectiveness/efficiency Cost-effectiveness
implemented efficiently? analysis. Also informed by stakeholder perceptions of efficiency from key informant interviews. analysis not in
To what extent does this model conform Alignment, harmonisation, mutual accountability – see effectiveness and relevance analysis. Ownership – see sustainability analysis. Managing for
with the global and PNG aid effectiveness results – covered in relation to discussion of program objectives.
Sustainability and Ownership
Question Evidence Evidence gaps
To what extent are AusAID’s program approach and activities sustainable and facilitating Conclusions based on consideration of activities funded, effectiveness and relevance analysis.
national ownership of the HIV response?
How has the HIV Program facilitated or hindered longer term sustainability and national As above.
ownership of the HIV response?