BackgroundThis implementation plan for the National HIV/AIDS Strategy 2005-2008 (the Strategy) was developed by the Department of Health and Ageing in consultation with the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis (MACASHH), the Intergovernmental Committee on AIDS, Hepatitis C and Related Diseases (IGCAHRD), and other key stakeholders.
In August 2005, MACASHH and IGCAHRD members together with other stakeholders, including key advisory bodies, State and Territory Governments, researchers, community based organisations, experts from relevant medical specialities, general practitioners, and people living with HIV/AIDS, convened for a joint MACASHH and IGCAHRD Strategy Implementation Forum (the Forum). Comments received during the consultation process have guided the development of the implementation plan. The agreed implementation plan was endorsed by MACASHH in December 2005.
Purpose of the Implementation PlanPerformance measures and targets are essential for evaluation of this Strategy. Systematic monitoring and evaluation across all jurisdictions will ensure that activity contributes to the overall objectives and priorities of the Strategy and will provide an accountability mechanism for use by all levels of government. The implementation plan will assist with the monitoring and evaluation of the effectiveness of the Strategy to ensure activities are informed by the best available social and epidemiological evidence.
In particular the implementation plan will:
- Assign clear responsibility to lead and partner agencies;
- Define key performance indicators to measure the success of the Strategy; and
- Identify linkages among related implementation plans.
The Department of Health and Ageing is responsible for developing and coordinating the evaluation of the actions identified in the implementation plan. The IGCAHRD and MACASHH are responsible for guiding and informing the development of the implementation plan, as well as completing a number of activities associated with it.
Community based organisations represent priority target groups, and are responsible for input into policy and education program development. These organisations also deliver peer support services and education initiatives to priority target populations.
Other organisations may be involved in various aspects of the implementation of the Strategy. Such organisations often have a specific role to play in implementation, whether with a priority target group, service delivery or development of policies and programs.
Guiding principlesThe guiding principles underlying the Strategy are intended to provide a framework for collaborative consensus building, focusing on common goals, a shared commitment to evidence-based policy and programming, and role delineation based on strategic planning. The principles enable policies and programs to adapt effectively to changing social and policy contexts and improve the reach of these policies and programs. Australia’s approach to HIV/AIDS will continue to reflect the UN Declaration of Commitment which commits government to strengthening national strategies through participatory approaches that promote the health of the communities and support efforts to prevent and minimise harm related to drug use.
Leadership and Non-Partisan Response
- The MACASHH and its Subcommittees should meet three to four times per year, in order to progress items on their workplans as well as advise the Australian Government Minister for Health and Ageing on all aspects of the response to HIV/AIDS, including the implementation of the HIV/AIDS Strategy.
- The Parliamentary Liaison Group (PLG) should be re-established, and should meet quarterly.
The HIV/AIDS Partnership
- The HIV/AIDS partnership should continue to be strengthened in all areas. All partners have a responsibility for ensuring this occurs.
- Build the capacity of community based organisations to continue their key leadership responsibilities, and ensure involvement in decision making and policy formulation.
- Make use of the HIV Partnership Scorecard to ensure the partnership is maintained in a constructive way. This assessment tool could be used in a review of the HIV/AIDS partnership in Australia.
Centrality of people living with HIV/AIDS (PLWHA)
- The overriding importance of the participation of PLWHA in policy and program development should continue to be ensured, in all aspects of implementation. This includes in the development of prevention education programs, the development of policy addressing changing care and support needs and approaches aimed at improving the health of PLWHA.
The Enabling Environment
- Work to reduce discrimination against PLWHA and affected communities.
- Consult with community organisations to ensure comprehensive involvement in sustaining a supportive social and policy environment.
- Maintain the whole of government response through mechanisms such as the re-establishment of the PLG and regular updates between Australian Government agencies.
- Support a social, legal and policy environment that encourages health education and promotes access to appropriate health services.
Health Promotion and Harm Minimisation
- Australia’s approach to HIV/AIDS will also continue to be set within the overall framework of the Ottawa Charter for Health Promotion. Harm minimisation will continue to be the basis of Australia’s public health response to the transmission of HIV (and other blood borne
- viruses) through injecting drug use. The principle of harm minimisation supports access to any necessary and proven technologies, including new and safer injecting equipment and condoms.
The role of lead and partner agenciesThe Implementation Plan assigns responsibility for action by both lead agencies and partners. For the purposes of this plan a ‘lead’ agency has a leadership role and is responsible for initiating, coordinating and progressing action. The lead agency may not necessarily be the funding body. In some cases they may be responsible for undertaking the majority of the action. A ‘partner’ agency is responsible for assisting and supporting the lead agency to achieve the outcomes of the Strategy. Responsibility is generally assigned to national organisations unless a jurisdictional agency has whole or part responsibility for action.
Community Based OrganisationsThe Implementation Plan frequently lists community based organisations as partners or lead agencies. When used, the term ‘community based organisation’ refers to national or State and Territory based bodies representing priority target groups. Including the term ‘community based organisations’ does not exclude other organisations from being involved in and contributing to the implementation of the Strategy.
Involvement of Other OrganisationsOther agencies not already involved in the Partnership may be engaged in the implementation of the Strategy. Other agencies include Commonwealth/State/Territory Departments other than Health Departments, community based organisations and professional organisations. Responsibility is generally assigned to national organisations unless a jurisdictional agency has whole or part responsibility for action. It is also acknowledged that there may be other organisations that are not listed in the implementation plan that may be involved in implementation.
Monitoring and evaluationIt is intended that progress with the implementation of the Strategy be reviewed 18 months after release of the Strategy, as well as at the conclusion of the term of the Strategy. The Department of Health and Ageing will oversee the mid-term review, and it is intended IGCAHRD will have significant input into this review. It is expected that through IGCAHRD, all States and Territories will participate in the mid-term review, as well as at the conclusion of the term of the Strategy. MACASHH and its Subcommittees will also be involved in the approval processes for the reviews. All other members of the HIV partnership will be invited to contribute to both reviews.
From the mid term review of the implementation of the Strategy, new and existing priorities will be assessed and the implementation plan adjusted accordingly, as required.
Broad performance indicatorsAn agreed set of broad performance indicators will be used to measure the achievements of the Strategy:
- The number of notifications of newly acquired HIV infection, including exposure category, age, gender and Aboriginal and Torres Strait Islander status, as well as co-infection with an STI. Also, country of birth/language spoken at home, collected where possible.
- The number of new diagnoses of AIDS, including by Aboriginal and Torres Strait Islander status.
- Decreased rates of unprotected anal intercourse reported by gay and other homosexually active men, by casual relationship status.
- Monitor the rates of unprotected anal intercourse reported by gay and other homosexually active men, by regular relationship status.
- Increase in the percentage of needle and syringe program attendees who report having been tested for HIV within the last 12 months.
- Decreasing rates of STIs: chlamydia, gonorrhoea and infectious syphilis,
- An increase in the number of gay and other homosexually active men who have been tested for STIs.
- An increase in the number of gay and other homosexually active men who have been tested for HIV.
- Development of a national minimum data set and data dictionary for HIV/AIDS and Sexual Health Ambulatory Care, for use in States and Territories, to assist in the collection of epidemiological and risk factor data on identified populations such as gay men, sex workers etc.
- Continuous mapping of education activities conducted.
- Decreased number of people with a late HIV diagnosis, including by exposure category, age, gender, and Aboriginal and Torres Strait Islander status. Also, country of birth/language spoken at home, collected where possible.
- Decrease in AIDS diagnosis, including by exposure category, age, gender, Aboriginal and Torres Strait Islander status and country of birth/language spoken at home where possible.
- Decreased rates of late HIV and AIDS diagnoses among people from priority culturally and linguistically diverse backgrounds.