Wednesday, 31 July 2013

PrEP and MSM

Landmark PrEP Study Seeks Black Men Who Have Sex With Men

Researchers at universities in three different states will participate in the study.
The HIV Prevention Trials Network has begun the process of screening men for possible involvement in what may be a landmark study.
The study, known as HPTN 073, will be studying pre-exposure prophylaxis initiation and adherence in HIV-negative black men who have sex with men. The study will occur at three of the network’s United States research facilities in Washington, D.C.; Chapel Hill, North Carolina; and Los Angeles. Those involved in the study will participate throughcolleges near the research facilities: George Washington University, University of North Carolina, and University of California, Los Angeles.
For more information tune into a live Twitter chat will be hosted on Wednesday, August 14 at 1p.m. EST on the HIV Prevention Trials Network’s page, @HIVptn, featuring the hashtag #PrEPChat.

HIV Cure......

Scientists Gets $1.4 Million to Search for an HIV Cure

The grants, given by amFAR, are among the largest in the country.
The Foundations for AIDS Research has announced a new round of grants totaling more than $1.4 million that will be given through its program, amFAR Research Consortium on HIV Eradication (ARCHE) to four separate teams of scientists who are breaking ground in new research.

The scientists work at the leading institutions around the world and, with proper funding, are getting closer than ever finding a cure for HIV and AIDS.

“Through ARCHE, amfAR leverages the expertise and innovation of distinguished scientists from across the globe to advance cure-focused research,” amfAR CEO Kevin Robert Frost said in a statement. “Some of the most important recent advances in HIV research are the result of strategic collaborations among amfAR-funded scientists and are a testament to the success of our cooperative approach to research.”

AmFar last round of grantees have shown great success, including Dr. Deborah Persaud and Dr. Katherine Luzuriaga, who functionally cured an infant of HIV earlier this year, and Timothy Henrich who cured two HIV-positive patients through stem cell transplants.

This year, amFAR's $1.4 million in funding will go to researchers in the U.S., U.K., France, Thailand, and Australia. All four expect innovative breakthroughs in the coming years.

One group, led by Dr. Eric Arts, hopes to develop and test a vaccine-like HIV treatment that is specifically made for each patient's virus.

Another research group, led by Dr. Nicolas Chomont, will study HIV persistence in T-cell sublets duringantiretroviral therapy, specifically the subsets of CD4+ T memory cells where HIV mainly resides, and the roles they may or may not play in a potential cure.

A third group, led by Dr. Scott Kitchen, will explore gene therapy using stem cells as a potential cure. They plan to modify stem cells so that they bind directly to HIV; the cells would then mature into a specific type of immune cell that can further kill HIV-infected ones.

The last group, led by Dr. Robert Siliciano, will continue studies on his recent finding that as many 50 cells may harbor viruses. The study will focus on identifying these cells and their properties to determine how the viruses may be induced out of the infected cells so they may be targeted by antiretroviral therapy.


PrEP as a best practice tool in the fight against HIV Infections

Why I'm Taking PrEP — and Maybe You Should Too

Coming out as an HIV-negative, sexually active gay man on PReP.

A month ago, I began taking a blue pill each day, called Truvada.

It's a combination of two of the three antiretroviral medications that form the cocktail used to treat people with HIV. Last year, the FDA approved the prescription of Truvada for the preventing of HIV in people who are uninfected. The term for this is pre-exposure prophylaxis (PrEP).

I'm HIV negative.

My choice to begin taking a highly-potent HIV drug wasn't an easy one. And the decision to come out publicly as someone who's on PrEP is not one that I take lightly.

But the more I learn about PrEP, the more shocked I'm becoming that gay men are not shouting from the rooftops about this potential game changer in the fight to prevent new HIV infections, which we're losing badly.

I'm ready to shout about it.

Here's what helped convince me: Dr. Robert Grant of UCSF, the researcher who led the multinational study on PrEP, was quoted at an AIDS conference as saying that “No one in iPrEx [the PrEP study] acquired HIV infection with a drug level that would have been expected with daily dosing.”

Was this really possible? Whether they used condoms or not, people who took Truvada, as prescribed, were protected from the virus? Before writing this column, I reached out to Dr. Grant to make sure I understood correctly.

While emphasizing that PrEP is still "very new," Dr. Grant confirms that "we have not seen anyone become infected that indicated daily use." He explained that the people in his study were among those at highest risk of becoming positive: gay men whose partners were already positive, and other men who frequently had unprotected sex.

Before I go any further, I do realize that I'm committing heresy. I'm certain there are safe-sex advocates in our community who are reading this right now, and whose heads are about to explode. Am I telling people to pop a pill and go have bareback sex?

I'm not. I am advocating that we look at both the social and medical science, and begin responding accordingly. And I too am angry.

In the past month, eight people I know have told me that they've tested positive for HIV. A couple of them had boyfriends who cheated on them. These friends, who didn't know about PrEP, are now unfortunately among the 50,000 Americans newly infected with HIV each year — one in four of whom is under 24 years old.

Whether we want to admit it or not, safe-sex education has been an epic failure. In a recent national survey, the majority of gay men—58%—admitted to not using a condom the last time they had anal sex. Is PrEp better than condoms? Dr. Grant won't go that far, but here's what he did say in a phoneconversation: "That actual use of PrEp is more effective than saying you'll use condoms and not using them. And that's often the choice people make."

I know I'm not a public health expert, but I can't understand why we're not discussing, in a serious way, getting the most at-risk in our community on this medication immediately. With new and preventable HIV infections happening every hour, is the silence about PrEP among the safe-sex establishment not criminal?

One more statistic: US News reports that if HIV infections among gay men continue to rise at current rates, more than half of college-aged gay men will have HIV by the age of 50. We desperately need a new approach to battling new infections.

To be sure, taking Truvada is not like taking a vitamin. This is serious medication, and unless people take it every day, the protection it offers is greatly reduced. And like all medications, it carries risks and potential side effects—some of which are potentially quite serious. But none of the friends I know who are taking Truvada PrEP have experienced anything abnormal.

And here's as another good thing about Truvada PrEP: You can stop taking it! You can use it at times when you're most sexually active, and stop taking it when you're not having sex. If the side effects are a problem for you, you can simply go off of it.

But if you are HIV positive, that's simply not an option. As of now, you're on it for life. And if you're positive, you have to take another pill, which often causes diarrhea and other unpleasantness. I know this because I've slipped up before, and went on post-exposure prophylactic treatment, which includes all three medications.

There are a few other downsides to the PrEP strategy. If your insurance doesn't cover it, Truvada costs around a thousand dollars per month. But Gilead, the maker of Truvada, is offering assistance (free pills) to qualifying individuals who can't afford it.

You also must get an HIV test before starting Truvada, and between any "breaks" in using it. And, yes, you should continue to use condoms even while taking Truvada to avoid getting other STD's.

I'm now 41 years old, and have been sexually active for at least 23 years. I've lived through the horrific period when AIDS was untreatable. It's a memory that will never go away. But since this disease is no longer a death sentence, our daily fear of it has diminished, and we have become more likely to slip up. That's why the possibility PrEP offers our community is one we need to be talking about. Now.

Michael Lucas is the creator of Lucas Entertainment, one of the largest studios producing all-male erotica. He lives in New York City. This article is the opinion of the writer.

LESSONS TO SHARE FROM POLICY TO IMPLEMENTATION (TOP-BOTTOM APPROACH); A LEAF FROM NYC-USA

What Will NYC's Next Mayor Do About HIV?

Gay Men's Health Crisis hosts all the major mayoral candidates and releases comprehensive survey on their opinions about HIV and AIDS.

GMHC hosted a mayoral candidates forum in New York City on July 23 to bring to light candidates positions on issues ranging from healthcare to youth homelessness as they relate to the HIV epidemic.
The unpredented forum, the first of its kind to ask major political candidates weigh in on issues around HIV, AIDS, and LGBT health, featured six of the 12 candidates who are qualified to appear on the primary ballot. It moderated by Oriol Gutierrez, the editor-in-chief of POZ Magazine.
The 2013 Mayoral Candidate Survey Report was released the same week, detailing positions from five of the mayoral candidates: former city councilmember Sal Albanese, New York City comptroller John Liu, city council speaker Christine Quinn, former city comptroller Bill Thompson, and former U.S. representative Anthony Weiner. The survey was divided into eight sections, including housing, older adults living with HIV, education, and public safety. All but one section asked candidates to state their positions on a variety of issues with an opportunity for comments from each candidate at the end of each section.
The survey showed that all five candidates who completed the survey support measures that would affect the almost 114,000 people living with HIV in New York City. There were some standouts, however, such as Quinn, who supports New York City’s HIV/AIDS Service Administration’s current requirement that clients seek drug counseling in order to qualify for enhanced rental assistance, and Liu, the only candidate to support passing currently proposed legislation that would reform the local police department’s “stop and frisk” policy.
Both the full survey and a one-page summary can be found in PDF form on the GMHC website.

Getting outside the HIV prevention “comfort zone”

KATHMANDU, 31 July 2013 (IRIN) - Despite years of scientific advances in HIV treatment and prevention, more than two million people are newly diagnosed with HIV annually, demonstrating how community-driven approaches to prevention are still needed to curb the epidemic, experts say.

For years evidence has mounted that anti-retroviral therapy (ART) - virus-suppressing drug combinations that are the primary treatment for HIV - can also be used effectively in prevention.

However due to the complications associated with ART procurement, distribution, uptake, adherence, and potential behaviour change in patients (some studies have linked increased risk-taking behaviours in HIV patients post-treatment), a fresh local approach to implementing ART-based prevention programmes is needed, new research argues.

“Research in HIV prevention needs to get out beyond its comfort zone and meet with the people who have very different ideas about what HIV means,” Jim Pickett, the project director for Mapping Pathways, an international research and advocacy project, told IRIN.

Despite international research and policy developments that have boosted awareness and popularity of
what is known as “treatment as prevention”, local-level implementation of it remains murky and piecemeal.

“We talk a lot about the results of science and figuring out how to `make it make sense’ in local contexts. But science is itself a process that should involve communities from the very beginning,” Pickett said.

From efficacy to effectiveness 
According to Mapping Pathways, the ideal approach to implementing treatment as prevention should consider not only the clinical goal of efficacy (works in a lab), but also effectiveness (how to apply the solution in a community).

“I know that if you get anti-retroviral drugs into someone’s blood, they suppress the virus. We have amazing proof of that - it’s a major scientific breakthrough in the history of humankind,” said Linda-Gail Bekker, chief operating officer of the Desmond Tutu HIV Foundation, based in South Africa.

“But now we have to put this together so it works, which means engaging with a wide range of human beings who live very different lives than those of us who run these programmes might imagine,” she said.

Effectiveness requires behaviour change and, therefore, varies across cultures, governments, and communities based on “the firms that produce the drugs, the healthcare clinics that deliver the drugs, the community centres that provide education, and the partnerships developed,” according to Mapping Pathways.

“Human beings will behave like human beings. What does that mean? Well, social sciences have been trying to figure that out for centuries and don’t have one single theory, so why should our HIV programmes?” asked Bekker.

“The notion that in HIV programmes `one size fits all’ has backfired on us and it has been a humbling moment for those of us who work in this field.”

“Local” science 
According to Molly Morgan Jones, a researcher at the international public policy think tank Rand Corporation and lead author of Mapping Pathways’s recent report, the varied applications of science must be taken into account when designing programmes: “Uptake of new ideas or products is contingent on a lot of factors that might have nothing to do with what's created in a lab or recommended by policy experts...

“ART has been around for a while, the innovation at this point is how we are going to use the drugs - a new way of thinking about how communities access, understand, and employ this technology,” she explained.

Development of the Mapping Pathways model relied on research carried out with partners in the US, UK, South Africa and India.

In each of the locations, local stakeholders - including clinicians, researchers, policymakers, the medical industry, patient advocates and coalition groups - interpreted scientific evidence differently, which had “profound” effects on how HIV prevention and care was carried out, the researchers noted.

“Here’s all this science - now what?” said Pickett, referring to the conventional top-down approach to HIV interventions, which often assumes that scientific proof a drug works will be enough to convince patients to use it.

“We need these processes to be local from inception,” he said, echoing arguments from the UN special rapporteur on the right to health that the participation of affected populations in decision-making is key to successful interventions. 

However promising, concerns about putting this theory into practice remain.

The World Health Organization recently published recommendations that call for the number of people enrolled on ART to be increased by up to 25 million worldwide (up from the current 9.7 million). Financing the scale-up while also boosting local buy-in will be a challenge, say analysts.

But, the effort must be made, argued Pickett: “Just because something adds complexity to a methodology or a protocol doesn’t mean it shouldn’t be done - go there, to the places where the results of the scientific endeavour are meant to be utilized, and have a conversation with the people about what it can do, and most importantly, what they need it to do.”

kk/pt/cb
[This report does not necessarily reflect the views of the United Nations]

Ditch Your HIV Pills and Get a Monthly Shot Instead?

Monthly injections have shown to be safer than a daily tablet for men who are taking PrEP to prevent HIV infection.
Johnson and Johnson and GlaxoSmithKline may have come up with an even more convenient way of treating HIV — not with daily tablets but with new monthly injections that at least one study suggests might be even safer.

Though it seems like most patients would prefer pills over needles, a new survey published inNanomedicine has shown that 84% of HIV-positive people would rather have monthly injections. The side effects of injection (versus the newer, popular daily tablets) may be less as well, according to a new trial, especially for HIV-negative people who take pre-exposure medicince called PrEP for the purpose of reducing their chances of getting the virus.

“It’s certainly something that people have great interest in,” Glaxo developer Bill Spreen told Bloomberg about the shots. “There’s going to be a sub-population of patients who select this.”
Daily tablets are a lifelong commitment and have been known to cause long-term damage to the liver, but in the recent trial of 40 HIV-negative volunteers who took the monthly injections, drug levels were sustained above a predetermined threshold that is considered necessary to control HIV for infected patients. These levels remained in tact as long as four months after the shot was injected, according to the results.
Though still in the works, with continuing studies, Glaxo may win U.S. regulatory approval by August and according to economists, could earn more than $1 billion in sales by 2018.

Wednesday, 24 July 2013

Combining treatments for people who inject drugs is the first step towards eliminating hepatitis C

Combining treatments for people who inject drugs is the first step towards eliminating hepatitis C

Hepatitis treatment debuts on WHO Model Essential Medicines List

Hepatitis treatment debuts on WHO Model Essential Medicines List

Report explores the inequity in treatment access for people living with HIV and Hepatitis C co-infection in Canada

Report explores the inequity in treatment access for people living with HIV and Hepatitis C co-infection in Canada

Report explores the inequity in treatment access for people living with HIV and Hepatitis C co-infection in Canada

Report explores the inequity in treatment access for people living with HIV and Hepatitis C co-infection in Canada

U.S. Congress Moves Closer to Lifting Ban on Transplanting Organs From HIV-Positive Donors

U.S. Congress Moves Closer to Lifting Ban on Transplanting Organs From HIV-Positive Donors

Global Experts to Share HIV/AIDS Updates, Trends at July 30 Event in Washington, DC

Global Experts to Share HIV/AIDS Updates, Trends at July 30 Event in Washington, DC

Front-line work of any form among marginalized communities is as challenging as it is life threatening

Between July 1-July 22 2013, Communities around the world have witnessed, heard and been devastated by incidents of brutality, horrific violence resulting in the deaths of many people because of their sexuality or because of their work among sexual minorities or marginalized communities.

On July 1st and 13th in South Africa two different cases in which lesbians were bodily abused, raped and murdered was shared from various media outlets e.g.,http://oblogdeeoblogda.me/2013/07/14/moving-pictures-as-slain-lesbian-laid-to-rest-amidst-controversial-memorial/. On July 13th Dutch tourists were charged for engaging in gay propaganda. On July 15th, the Executive Director of the Cameroonian AIDS organization CAMFAIDS Eric Lembembe Ohena was found murdered in his Yaoundé home. The grotesque experience showed marks of strangulation on his neck. His feet were broken. His face, hands, and feet had burn marks supposedly from an electric cable. This was in different media outlets e.g.,http://76crimes.com/2013/07/16/cameroon-activist-tortured-killed-the-nation-must-respond/.  On July 21 in an anti-gay march of over one thousand people in Haiti, the killing of two gay activists occurred  On July 22 a gender non-conforming 17-year-old attending a party in Jamaica was stripped naked by a crowd, stabbed to death, and dumped in the bushes on the side of the road. Many activists as well as persons working with LGBTIQQ, or those persons of a different gender other than a heterosexual gender are persecuted, tortured and killed.

This experience is not so remote, the author went through a grueling and painful beating for working with marginalized population groups in Uganda. There are many other people who are killed and have no one following up on them. Yet more are working to make change possible. They are doing their work quietly, silently without so much aplomb, outside media cameras and have never attended spaces gaining them international exposure. It is to all these that sponsors, donors and allies should look out to.

The  author was privileged to work with a very dedicated team in reaching out to marginalized communities in Uganda. A nation-wide community diagnosis was carried out into who MARPs were and where they were sustainably engaged in livelihood activities. This was made into a document which is attached.

 BEING PART OF THE SOLUTION in uganda.pdf

BEING PART OF THE SOLUTION in uganda: Advancing and linking HIV, Human Rights and a Development Agenda targeting the MARPs; 2011-2016


                  UNRAVELLING THE MINUTAE OF VULNERABILITY IN UGANDA






                                                                         MARPS IN UGANDA ©
                                                                               AUGUST, 2011

 

CERTIFICATE OF INCORPORATION: 134037
REPUBLIC OF UGANDA


Table of Contents


ACKNOWLEDGEMENTS:

Most at Risk Populations’ Society in Uganda (MARPS in Uganda) would like to extend gratitude to all those who generously provided funds, time and morale support to conduct its activities and a revitalisation (July 2010-August 2011) of key informants through actual visits, meetings and picking a phone call as a means of rededicating efforts to address MARPs issues in Uganda. This document is also developed as the 2011-2016 Strategic Plan. It would not have been possible without such immense input and commitment. 20 volunteers make up the core staffs at MARPS in Uganda it is they who believe in what we are doing and have given undying expertise, diligence and conscientious work towards making this possible. Thomas, Gerald, Grace, Deborah, Diane, Joe, Eddy, Joan,  Mohammed, Martin,  Kwesiga, Hassan, Willington, Jacob, David, George, Sam and our 2 committed drivers of the MARPS in Uganda “ jet”.  In the same breathe we thank Professors Chris Beyrer and Stefan Baral for helping to synthesize MARPs issues and broaden the context within which all MARPs targeting organisations need to explore. A generous grant of USD 188.000 from well-wishers was used to: conduct the revitalisation exercise, travel to attend 3 conferences, facilitation to conduct 3 seminars on sexuality-mainstreaming, purchase medication and SRH commodities that has enabled MARPS in Uganda reach 211, 750 persons with treatment (with 13,700 attendances being MSM; 4000 Young MSM below 24 years and 3200 were 24-35 yrs), conduct 718,650 counselling sessions, pay for office space, utilities, furniture and sundries from 2007-2011. Our earlier efforts were shared mutually with another organisation. We counted on this kind of arrangement but due to internal changes it was curtailed. We are fully registered. We can now contribute towards effective work among the MARPs.

EXECUTIVE SUMMARY:


We invested so much in efforts to capture the topography of MARPs from 2007 to 2011. We are the Most at Risk Populations’ Society in Uganda (MARPS in Uganda) Our enduring pillars are: Contributing to focused prevention programming; Commitment to meet needs of populations most affected by HIV and; Consolidating such efforts through scale up of services . We believe in interfacing at grass-root, we do provide direct services, we want to domesticate the LVCT (Kenya) model to Ugandan environment, we believe there are tiers that are not be defined politically or socially but constitute MARPs. We believe in ground-truthing first because to us visibility is a derived demand.  We clearly state that focused prevention programming targeting MARPs needs scaling up. We believe this has to be based in the broader social-politico environment. We have used 30,000 settings ranging from villages (LCI), Town Councils, Health facilities, Health committees, Ministry departments, Religious entities, to CSOs in order to generate an understanding of programming targeting MARPs. MARPs-defined organisations come in many brands, are taking root and are finally getting direction and defining tuffs. We are a MARPs-targeting organisation, we are looking at the broader contexts, we are a capacity-building organisation, we are a monitoring and evaluation organisation and we are a public health/HIV-AIDS/Human Rights/Development organisation. We are testing and tasting beliefs uttered at Vienna AIDS 2010 (e.g., Vienna Declaration) and want to hear of bigger strides in Washington AIDS 2012.  This is our bold statement made from a tested, tasted background. We at MARPS in Uganda started at first principles. Through anecdotal recollections there is evidence of sexual practices that increase exposure to HIV which explain the disproportionate picture as corroborated from literature review (e.g., UHSB 04/05, Crane Survey 2008, H. Fisher Raymond et al, AIDS Behaviour, 2009) and analysing contexts that fuel vulnerability. We are positing that a paradigm shift to contextualise programmes targeting MARPs is one productive and effective way to address MARPs issues. Contexts that expose one to low knowledge about HIV, deterrents to accessing HIV services, low self esteem and structures within which violence, abuse, discrimination and stigma thrive expose one to HIV infection and have continued to define the following as MARPs:

 -Men who have sex with men         -Commercial sex workers         -Substance Users

-Fisher folk                        –Long-distance truck drivers        -Members of uniformed services

 We see a differential diagnosis and what the treatment plan required will be. Responses to HIV / AIDS counselling, testing and treatment targeting these population groups is much lower. Among MARPs are the key affected populations and populations at a higher risk of HIV. There are those who need an uninterrupted continued supply of ARVs; there are those who need a judicious access to PrEps and PEPs; there are those whose comprehensive knowledge about HIV is so low as to require immediate action; there are those whose misperceptions strongly override as to dare risk exposure to HIV.
Work with MARPs groups will need understanding how they have ramified, how they, therefore, negotiate for sexual intercourse. Unprotected receptive anal intercourse (URAI) is a trend gathered anecdotally  among heterosexual respondents as well as among same sex practicing persons, sharing injections among injecting drug users and peer pressure around multiple concurrent sexual partners should factor highly in programme design that promote inclusion and broad representation of MARPs needs. There are 7 recommendations running as a fabric generated from the solutions and this has been arrived at after generating topography of Uganda MARPs. These thematically include:
1.       Generating needs, giving visibility, ensuring action to address disproportionality characteristic of MARPs and implementing matching redress.
2.      Unravelling structures that fuel vulnerability
3.      Promote trainings that influence change and acquisition of prevention, treatment and care skills
4.     Promote broadening of programmes addressing contexts that reduce exposure to HIV to address disproportionality of HIV prevalence.
5.      Improve spaces of leadership, rights and funding opportunities
6.     Affirmative action towards sexual minorities, sex-workers and substance users
7.      Organisation development
 WHY THIS UNUSUAL BUSINESS:
This business plan gives topography of who the MARPs are. It highlights the challenges in which programming needs to be made. It also posits the 7 themes that need to run in the fabric of all MARPs-targeting programmes. As a lead organisation strengthening information sharing on MARPs issues and being a registered member of Uganda National AIDS Services Organisations (UNASO) we want to be pivotal in tracking of information on MARPs.

THE SYSTEMIC VIEW OF THIS UNUSUAL BUSINESS:
As any organisation also MARPs-related organisations require attendant investment in: organisation development; input and; output in order to have visible impact

WHAT THIS UNUSUAL BUSINESS ADDRESSES:
This business plan addresses:
  1. The Millennium Development Goals overarching targets for improved health by 2015;
  2. Universal Access to HIV Prevention, Treatment, Care and Support, 2011 Road Map;
  3. National Development Plan 2008-2012
  4. Uganda National HIV&AIDS Strategic Plan 2007/2008-2011/2012
  5. ACJ Reference: Human rights, Sexual Orientation and Gender Identity;
  6. The UNAIDS Global HIV Challenge Report - targeting the need for universal access;
  7. The Uganda Modes of HIV Transmission Study - highlighting the need to focus on MARPs
  8. Our own belief statement of contributing, commitment and consolidation using this Strategic Plan 2011-2016
  9. Reflections on the “....expanding and doing HIV prevention better....” theme of the National HIV Prevention Strategy for Uganda: 2011-15.
  10. Protecting Vulnerable LGBT Populations: An opportunity for US Global Leadership
  11. Analysis of rounds 8,9 and 10 Global Fund HIV Proposals in relation to MSM/TG/Sex-workers
  12. Gender Identity and Violence in MSM/TG; Policy implications for HIV services (USAID, 2009).
  13. Technical Guidance on Combination HIV Prevention (PEPFAR, 2011)
  14. WHO Guidelines on HIV programming for MSM, 2011.
  15. Action Group for Health, Human Rights and HIV-AIDS-Uganda report, 2010
  16. The State of HIV-AIDS among MSM/TG In Uganda, Kenya and Tanzania by Nguru, 2010
  17. Promoting the rights of Human Rights Defenders in East  and Horn of Africa, 2008
  18. Engaging MSM in Clinical Setting,2011
  19. Guidelines for the Syndromic Management of STIs in Uganda, 2010
  20. Supporting Community action on AIDS in developing Countries, Alliance Campaign, 2011
  21. Sexual and Reproductive Health (SRH) Choices and Rights for PLHAs in Uganda, 2010
  22. Magnitude, Profile and HIV/STD Related Knowledge and Practices of Commercial Sex Workers in Kampala, Uganda, 2009
  23. The Status of The HIV-AIDS Epidemic in Uganda, 2011.
  24. The MARPS in Uganda 7 thematic areas:
-Generating needs, giving visibility, ensuring action to address disproportionality characteristic of MARPs and implementing matching redress.
-Unravelling structures that fuel vulnerability
-Promote trainings that influence change and acquisition of prevention, treatment and care skills
-Promote broadening of programmes addressing contexts that reduce exposure to HIV to address disproportionality of HIV prevalence.
-Improve spaces of leadership, rights and funding opportunities
-Affirmative action towards sexual minorities, sex-workers and substance users
-Organisation development

WHY THIS SOCIETY NEEDS YOUR SUPPORT:
The Society rallying call is “Contribution, commitment and consolidation”. We intend to be the lead resource organisation on MARPs issues in Uganda. We enjoy:
History of collecting information, establishing linkages for referrals and follow up.
History of having worked with MARPs at a time in Uganda when many organisations were giving this a wide berth.
History of having provided organisation development skills training to sexual minorities, sex-workers, substance users and reformed former in-mates.
Having been key players in generating documentation that led to evidence of visibility of key affected population groups in Uganda.
Having presented 4 papers at international conferences on MARPs in Uganda.
Having pooled together over 1000 resource persons and 3000 key entities in Uganda we can eventually work with to provide visibility to MARPs issues. These informed the way we have done business between 2007-2011
Having provided a space for meditation, self-rediscovery and re-evaluation for 129 persons (since 2007) who were evicted from their homes and abandoned by their families due to their visible same sex orientation.
Running a transitory home that we let out to persons evicted from homes due to their revealed histories of sex-work or same sex practices.




Therefore we need:
Your support to enable us implement this unusual business plan
Your support to enable us empower communities to demand services from grass-root to National level.
Your support to eventually create an indigenous organisation with ability to create durable enduring community structures driving conversation around eradication of HIV, Poverty , violence, abuse, discrimination and stigma.
Your support to solidify the structural entities in which MARPs will have high powered programmes to eradicate HIV
Your support to enable us include; sexual minorities, substance users and sex-workers in efforts to access and demand HIV services.
Your support to run a transitory home.
THE UNUSUAL BUSINESS 2011-2016:
This business highlights our service delivery Systems’ perspectives, inputs, processes, outputs and outcomes set out logically. We are integrating many tried practices, e.g., Comprehensive HIV knowledge,  ABEK (Alternative Basic Education-Karamoja) and BTVET (Business technical vocational education training).
CASCADING INTO THE UNAIDS STRATEGY:
These business outcomes will also be used to monitor progress combined with the “our product” portfolio and normative framework to match the UNAIDS 2011-2015 strategy.
MONITORING THE MONITORS 2011-2016:
Ours is business unusual. Inbuilt information processing mechanisms make this possible: the core meetings, rotating symposia, contract of service, Community anti-stigma diaries and a vision 2030 Road map.  We intend to become an NGO.  All these are opportunities towards visibility, sustainability, reporting, rewarding, recognising, re-visit commitments and give accountability for our actions.


FUNDING NEEDED BETWEEN 2011-2016 (3,770,000,000 (UGX.) /1,639,130 (USD))






COST CENTERS
2011
2012
2013
2014
2015
2016
SUSTAINABILITY
SEE BELOW
SEE BELOW
SEE BELOW
SEE BELOWSEE BELOW
SEE BELOWSEE BELOW
 SEE BELOW
CORE (UGX.)
190,000,000
138,000,000
138,000,000
138,000,000
128,000,000
128,000,000
USD
82,609
60,000
60,000
60,000
55,652
55,652
PROGRAMME (UGX.)
385,000,000
350,000,000
240,000,000
340,000,000
340,000,00
335,770,000
USD
167,391
152,174
104,348
147,826
147,826
145,986
TOTAL (UGX.)
575,000,000
488,000,000
378,000,000
478,000,000
478,000,000
337,050,000
USD
250,000
212,174
164,348
207,826
153,378
151,638

NB. UGX.  1000,000,000 (USD 437,782) IS FOR STARTING UP A BUSINESS VENTURE AS OUR SUSTAINABILITY PLAN





STATEMENT FOR 2007-2010 (432,400,000 (UGX.) /188,000 (USD))






COST CENTERS
2007
2008
2009
2010
TOTAL
CORE (UGX.)
12,400,000
20,000,000
30,000,000
100,000,000
162,400,000
USD




70,607
PROGRAMME (UGX.)
10,000,000
20,000,000
30,000,000
200,000,000
280,000,000
USD




121,739
TOTAL (UGX.)
32,400,000
40,000,000
60,000,000
300,000,000
432,400,000
USD




188,000







RISKS:

We envision the following risks as we conduct or implement our business plan;
  1. Failure for funding will water down all our efforts since 2007. WHAT WE INTEND TO DO ABOUT IT: Prepare proposals in time, prepare our reports in such a way as to be able to provide information but at the same time market ourselves.
  2. We have established a very big following of volunteers among MARPs-related programming organisations, we risk losing them. WHAT WE INTEND TO DO ABOUT IT: We have trained some volunteers in various community improvement skills; some are attached to researching organisations that have activities taking place. This has enabled them earn a living. The trustees themselves have volunteered resources and time to the SOCIETY. They are engaged in regular paying jobs.
  3.  We risk attracting animosity because we have come out strongly to lay bear issues of same sex relations, substance use and sex-work. We are an organisation that brings out sexuality issues in conversation form.  WHAT WE INTEND TO DO ABOUT IT: To mainstream development programmes in the trainings for MARPs-related issues. As the beneficiaries integrate in communities and become contributors to their communities they will galvanise support and opportunities to mobilise others for development. MARPS in Uganda intends to conduct community development trainings in form of short capacity-building courses for communities around critical thinking, development, self esteem and life-planning skills. We intend to engage communities in competitive sports, especially, board-games/snooker that are so popular in trading centers but also allow one to understand men and young males’ judging from anecdotal exchanges shared.
  4. Losing our transitory home which has been used as a refuge for those chased away from their homes due to sex-work, substance use and same sex practices. We have provided this space to 129 school going persons (100 Tertiary/Technical/ university students and 29 secondary school going students). It was possible for all these people to continue with school and completed with qualifications. This enabled us realise how helpful this project has been for these people. It is our hope that in writing this and having revealed our kind of projects it will not be reason for refusing funding us.
  5. If we do not receive funding, all our efforts, all our mobilisation structures, all the people we have reached with self development messages will now look at us as failures. It is good for a prophet to lead by example. All the money we had was invested in our efforts hoping that by end of 2011, we shall have got funding to continue doing work beyond 2011. Even as we produce this report, we do have on-going community-based activities.



DIFFERENTIAL DIAGNOSIS OF MARPs ISSUES IN UGANDA

EASTERN AND NORTH EAST UGANDA CONTEXTS:

Geography, sociology, ideology, biology and eligibility scope:

This is a part lying east of Uganda, with almost 30 districts from Kaboong at the tip, Moroto, Namayingo,  Jinja, Kaberamaido,  Abim and back to Kaboong districts if one were to draw an imaginary triangle.  This block has fertile flat land, giving way to sub-county size rocky hills with ridges used for agriculture, grazing and settlement. These give way to mountain Elgon slopes. It has heavier spells of rains. The social economic activities include: Community markets, community FM radios, an existing and intact Local government structure, VHTs exist, communities engage in seasonal festivities, there are several denominational structures, community cattle dips exist, men meeting points are in all trading centers and in the villages during social afternoons/evenings,  NGOs/CBOs/FBOs structures exist, the police and army barracks are within driving distances, the biggest component of industries is this side, rice growing schemes are vast, cereal crops do well this side, jaggery and wet coffee processing is found in many places, the sub-county headquarters are near roads and more populations are seen in the trading centers at night up to 9pm than during day time.

HOTSPOTS:

  1. Road stop spots
  2. Peer pressure and experimenting with drugs
  3. Peer pressure around unprotected sex, multiple concurrent sexual  partners, stigma for being HIV positive among young people
  4. Brothel based sex-work
  5. Child Sex-work
  6. Proximity of barracks to major urban areas
  7. Proximity of Industrial housing estates
VULNERABILITY
  1. Dry spells leading to poor crop productivity and attendant dependency on sex-work as an income generating activity for sections of populations.
  2. Land-slides leading to massive displacements of many people.
  3. Fisher-folk have depleted fish-stocks in lakes like Lake Kyoga and there is need for alternative income generating activities for these communities to avoid dependency on lakes alone.
  4. Floods in Amuria, Katakwi, Karamoja during rainy seasons and the dry spells lead to unconducive environments for permanency
  5. Land wrangles and fragmentation leading to low productivity and continued search for fertile lands.
  6. Resettlement programmes may fail to conceptualise immediacy of MARPs-related programming.
  7. Salaried workers with disposable cash and the hyper “pay day” sexual activity in most trading centers.

SOLUTIONS:
  1. Mapping of MARPs related needs
  2. Structural interventions to ensure passage of knowledge and skills to improve informed decision-making for communities about HIV-AIDS prevention, treatment and care.
  3. Mainstreaming approaches in other social interventions to avoid stand alone programmes otherwise there is risk of fatigue and mismatched expectations (Popularise ABEK and BTVET methods of education side by side UPE/USE).
  4. Design trainings for individual awareness that improves on informed decisions around HIV/STIs, violence, abuse, discrimination and stigma

NOTHERN UGANDA AND WEST NILE CONTEXTS

Geography, sociology, ideology, biology and eligibility scope:

This is a part lying in the immediate north and north-west of Uganda, with almost 30 districts from Koboko at one corner, Lamwo at another, Alebtong, Apac and back to Koboko districts if one were to draw an imaginary square.  This block has flat land with rocky hills and kopjes with sheer sides forming ridges which are used for agriculture and settlement. They have shorter spells of rains. The social economic activities include:  Community agriculture groups and farm based learning units, Community markets, Artisanry, reconstruction work, Elders’ meetings, community FM radios, an existing and intact Local government structure, communities engage in seasonal festivities, there are several denominational structures, community agriculture groups exist,  men meeting points are in all trading centers and in the villages during social afternoons/evenings,  NGOs/CBOs/FBOs structures exist, the police and army barracks are within driving distances, millet cereals growing schemes are vast, cereal crops do well this side, the sub-county headquarters are near roads and more populations are seen in the trading centers at night up to 2 am than during day time. Schools are open and school going pupils and students need more incentives to keep in classes such as immediate skills development as opposed to learning to pass examinations.

HOTSPOTS:

  1. Road stop spots
  2. Construction work camps
  3. Work related destination points
  4. Peer pressure and experimenting with drugs
  5. Brothel based sex-work
  6. Child Sex-work
  7. Peer-pressure around first sexual debut
  8. Peer pressure around multiple concurrent sexual partners
  9. Recurrence of use of sex as a subjugation tool by former child soldiers.
  10. Design trainings for individual awareness that improves on informed decisions around HIV/STIs.
VULNERABILITY:
  1. Dry spells leading to poor crop productivity
  2. Land wrangles
  3. Resettlement programmes may fail to conceptualise immediacy of MARPs-related programming.
  4. Recurrence of psychological trauma of former  child soldiers
  5. Heavy dependence on Marijuana as a recreational drug.
  6. Schools may fail to have in mind issues of disparities of age/ mismatch of requirements for given classes and incentives for retention.
SOLUTIONS:
  1. Mapping of MARPs related needs
  2. Mainstreaming approaches
  3. Education system should embrace facts such as skills, age and retention issues. This can be by incorporating the BTVET approaches and ensuring extra-curricular activities are awarded scores directly tied to performance and grades at school.
  4.  Structural interventions to ensure transfer of knowledge and skills to improve informed decision-making for communities about HIV-AIDS.
  5. Drug-related risky behaviour needs targeting activities using harm reduction approaches.
  6. Design trainings for individual awareness that improves on informed decisions around HIV/STIs, substance/drug use and life planning skills.
  7. Introduce/mainstream rights education in all MARPs related programmes.

WESTERN AND MID-WESTERN UGANDA CONTEXTS

Geography, sociology, ideology, biology and eligibility scope:

This is a part lying in the immediate West and mid-west of Uganda, with almost 25 districts from Kisoro, Isingiro, Buliisa and Bundibugyo and back to Kisoro districts if one were to draw an imaginary square. It has well made sections of major trunk roads and has enjoyed relative political harmony. It has thriving market areas and economic activities.  This side has flat land with rolling hills forming ridges which are used for agriculture and settlement. This is where one finds the Ruwenzori Mountains.  They have two seasons with shorter spells of rains. The social economic activities include: Community markets, Artisanry, reconstruction work, Elders’ meetings, Youth and women groups, Community agriculture self help groups,  community FM radios, an existing and intact Local government structure, VHTs exist, communities engage in seasonal festivities, there are several denominational structures, community agriculture groups exist,  men meeting points are in all trading centers and in the villages during social afternoons/evenings,  NGOs/CBOs/FBOs structures exist, the police and army barracks are within driving distances, millet cereals growing schemes are vast, banana growing, tea plantations and forestry are a major visible engagement. The sub-county headquarters are connected by roads and populations seem to lead a sedentary stay home life only going to trading centers occasionally. Schools are open and school going pupils and students need more incentives to keep in classes such as immediate skills development as opposed to learning to pass examinations.

HOTSPOTS:

  1. Road stop spots
  2. Peer pressure around first sexual intercourse debut.
  3. Peer pressure around multiple concurrent sexual partners
  4. Peer pressure leading to cross generation un protected sexual intercourse
VULNERABILITY:
  1. Destructive winds leading to destruction of banana plantations and food crops
  1. Land wrangles
  2. Agriculture and social improvement programmes may fail to conceptualise immediacy of MARPs-related programming.
  3. Schools may fail to have in mind issues of disparities of age/ mismatch of requirements for given classes and incentives for retention.
  4. The major trunk roads feeding this arm of Uganda have points of urbanisation (likely brothel-based sex-work prevalence) and mobile men/women with money attending the various markets, employed as construction workers  and settling in this area.
  5. Thriving tourism industry fails to cater for MARPs-related programming.
SOLUTIONS:
  1. Mapping of MARPs related needs
  2. Mainstreaming approaches having agriculture degradation in mind. Projects for forest regeneration should be side by side with agriculture.
  3. Fish-farming projects should be encouraged.
  4.  Structural interventions to ensure passage of knowledge and skills to improve informed decision-making for communities about HIV-AIDS. This should address planning in all sectors.
  5. Education system should embrace facts such as skills, age and retention issues. This can be by incorporating the BTVET approaches that offset unemployment and ensuring extra-curricular activities are awarded scores directly tied to performance and grades at school.
  6. Microfinance and credit facilities to extend to banana and fruit preservation and industries as these are produced in plenty in this region.
  7. Design trainings for individual awareness that improves on informed decisions around HIV/STIs.

CENTRAL UGANDA CONTEXTS

Geography, sociology, ideology, biology and eligibility scope:

This is a part lying in the immediate center of Uganda, with almost 16 districts from Kampala City Authority, Wakiso, Kyankwanzi, Bukomansimbi, Kalungu and Mityana to Mubende.  This block has flat land with rolling hills forming ridges which are used for agriculture and settlement. This is where one finds the largest settlements and Buganda Kingdom.  They have two seasons with shorter spells of rains. The social economic activities include: Cultural galas, Community markets, Artisanry, reconstruction work, Elders’ meetings, Youth and women groups, Community agriculture self help groups,  community FM radios, an existing and intact Local government structure, VHTs exist, communities engage in seasonal festivities, there are several denominational structures, community agriculture groups exist, Ludo/board games/snooker, entertainment centers,  men meeting points are in all trading centers and in the villages during social afternoons/evenings,  NGOs/CBOs/FBOs structures exist, the police and army barracks are within driving distances, millet cereals growing schemes are vast, banana growing, tea plantations, cotton, cocoa, coffee and forestry are a common agro-based occupations. The sub-county headquarters are connected by roads and populations seem to lead a sedentary stay home life only going to trading centers occasionally. Schools are open and school going pupils and students need more incentives to keep in classes such as immediate skills development as opposed to learning to pass examinations.

HOTSPOTS:

  1. Road stop spots
  2. Peer pressure around first sexual intercourse debut.
  3. Peer pressure around multiple concurrent sexual partners.
  4. Violence, abuse, discrimination and stigma for those not conforming as a result of patriarchical structures.
  5.  Migrating Fisher-folk and many landing sites may pose programming problems
VULNERABILITY:
  1. Destructive winds leading to destruction of banana plantations and food crops
  2. Land wrangles
  3. Agriculture and social improvement programmes may fail to conceptualise immediacy of MARPs-related programming.
  4. Competition for land from cultural institutions,  agriculture, settlement and industry
  5. Schools may fail to have in mind issues of disparities of age/ mismatch of requirements for given classes and incentives for retention.
  6. High burden of OVCs.
  7. Drugs and truancy networks among school going communities.
  8. Idleness and redundancy among non-school going communities.
SOLUTIONS:
  1. Mapping of MARPs related needs
  2. Mainstreaming approaches having agriculture degradation in mind. Projects for forest regeneration should be side by side with agriculture.
  3. Fish-farming projects should be encouraged.
  4. Education system should embrace facts such as skills, age and retention issues. This can be by incorporating the BTVET approaches and ensuring extra-curricular activities are awarded scores directly tied to performance and grades at school.
  5. Microfinance and credit facilities to extend to banana and fruit preservation and industries as these are produced in plenty in this region.
  6. Design trainings for individual awareness that improves on informed decisions around HIV/STIs.

SEXUAL MINORITIES AND SUBSTANCE USERS

Geography, sociology, ideology, biology and eligibility scope:


MARPS in Uganda did interact with sexual minorities, substance users, held dialogues around same sex practices and substance (drugs) use in Uganda. The findings are as follows:
  1. Sexual minorities and substance users (use mostly marijuana, valium, alcohol, jet fuel, khat and methamphetamine) exist in all the regions of Uganda.
  2. Persons who have had unprotected anal sexual intercourse in their lifetime exist in all regions of Uganda
  3. Girls/women who have had same sex first sexual intercourse debut as a means of retaining their virginity exist in all regions of Uganda
  4.  Girls and boys who out of Peer pressure around heterosexual relations and have married partners but seek counselling about same sex attraction exist in Uganda.
  5.  Same sex attracted Men and women who have faced violence, abuse, discrimination and stigma for not conforming as a result of patriarchical structures exist in all regions of Uganda, especially Eastern Uganda.
  6. Drug users (Youths, men and women) who have faced violence, abuse, discrimination and stigma for not conforming exist in all regions of Uganda, especially Eastern Uganda.
  7. A number of people who still perceive unprotected anal sexual intercourse (UAI) as a route through which HIV is not transmitted.
  8. Sex-work among same sex persons is prevalent in Uganda. Inter-sexed persons do exist and need programmes to address their issues.
  9. Nearly all same sex attracted persons MARPS in Uganda approached felt unsafe in their communities or schools at one time because of their sexual orientation.
  10. Key leaders and informants in organisations and entities approached by MARPS in Uganda expressed need to be introduced and trained in sexuality, gender, identity and health education to understand how to provide services to sexual minorities and youths.
  11. Same sex attracted communities, sex-workers and substance users expressed need to be given trainings and skills for informed decisions against risky behaviour. They also expressed fear for some organisations capitalising on their identity to seek funding without actually doing interventions with and for them.

VULNERABILITY AND IGNITERS OF HIV AMONG SEXUAL MINORITIES AND SUBSTANCE USERS:

  1. High prevalence of risky behaviours.
  2. Drugs and truancy networks among school/non-school going communities.
  3. Idleness and redundancy among non-school going communities.
  4. Victims of community brutality, evictions and abandonment due to orientation
SOLUTIONS:
  1. Mapping of sexual minorities- related needs
  2. Link substance use to programming among MARPs.
  3. Ability to unravel linkages of substance use, informal sector activities, urbanisation and masculinity inspired peer pressure.
  4. Documenting and presenting needs to policy and programme level actors for action
  5. Empowering organisations or sexual minorities in organisation development and accountability skills.
  6. Ensuring education systems should embrace facts such as skills, age and retention issues. This can be by incorporating the BTVET approaches and ensuring extra-curricular activities are awarded scores directly tied to performance and grades at school.
  7. Microfinance and credit facilities to be extended to MARPs who engage in enterprising work as a means of ensuring social protection.
  8. Design trainings for individual awareness that improves on informed decisions around HIV/STIs.









INTRODUCTION:

Substantial work is being done to expand access to services for the majority of persons in Uganda, thanks to the Government of Uganda that has made sure it provides such a conducive environment.  The conducive environment in a majority of Ugandan districts begins with improved roads, housing, water and livelihoods (RHWL).  Thousands of kilometres of pipes have been extended to urban and rural communities thereby enabling men, women and children access piped clean water. Such scenarios constitute a minimum and critical level at which an adjustment to avoid exposure to avoidable vulnerability and risks is possible. Before one attributes to a given population the term “at risk population” one assumes these basics are in place. At the governance tier, Uganda has provided support to decentralisation and encourages community involvement in decision-making mechanisms. On the third tier is programming that targets improved well-being of all citizenry as entrenched in the Constitution Of Uganda. The familiar aspect to gauge well-being is health. The government of Uganda has put in place holistic services that create the well being of communities.  MARPS in Uganda engaged in a  consultative process involving: Development partners to Uganda, CSOs, NGOs, investigators, clinicians, local government workers, participated in National Consultative meetings on the national HIV Strategy 2011-2016, desk reviews of various resources on MARPs and various interactions have drawn attention to a number of under probed issues faced by MARPs. This has been as a result of actual visits to identified districts, holding conversations with key  community gate keepers/leaders, engaging communities (District, Town Councils, county, sub-county, parish, FBO catchment areas) in community guided conversations on topical issues, investigating/reviewing social calendars and visiting communities to ascertain typology/characteristics in order to understand existing programming, programming that targets MARPs, the community’ understanding of the term MARPs and platforms for making demands to address MARPs issues. The findings include: HIV-AIDS affects certain groups disproportionately; there are gaps in programming targeting MARPs; gaps in matching programming to their needs; a lack of integration and a disharmony in plans to break into communities and generate MARPs’ needs. A gap in programming for MARPs seems to be influenced by the conditional indicative approaches to planning for most local councils and local government structures. Existing programmes targeting MARPs is left to four entities; Development partners (USAID, DFID, Belgium, ICEAID,NORAD, EADB, SIDA, Gtz, DANIDA...) the community groups which address immediately felt needs, CSOs/NGOs/FBOs that are engaged in social development programming and Government semi-autonomous arms and departments such as those in Ministry of Works and Transport, Uganda AIDS Commission, STD/ACP-MoH, Ministry of Education and Sports, Ministry of Internal Affairs, Ministry of Defence, Ministry of Gender, Labour and Social Development  as well as other entities.  Visibility is a derived demand which is influenced by planning and policy.
We at MARPS in Uganda,  have dedicated efforts at improving conscietisation, institutionalisation and structural mechanisms that may entrench programming targeting MARPs as well as engaging communities in dialogues on eradicating situations that create vulnerability and risks. We note low-targeting for most programmes and hopefully this report will help inform on influence of vulnerability, risks and poor access to services as areas that once addressed will help address needs of MARPs. This move towards “eco-programming” will improve the welfare of many. Primary responsibility for MARPs lies with government of Uganda, the secondary responsibility is with individual citizens, third responsibility lies with communities working hand in hand with organisations that have mandates targeting MARPs. Organisations have the duty to help government take seriously MARPs. The gravity of issues faced on a daily basis is such that it is important to pursue means to strengthen protection against vulnerability and risks. The approach is based on; identifying local communities, work towards viable mobilisation with them, inform the leadership mechanism in a given community, generate a stakeholder mapping, share outcomes from community engagements, Generate a social calendar and match this with existing pressing needs, plan action accordingly. This should constitute the normative framework to check both the socio-politico environment and the natural environment that once handled wrongly brings drought and other catastrophes. Catastrophes compound MARPs issues.
We at MARPS in Uganda commend the work of government of Uganda in providing an atmosphere to address MARPs issues. It has been a long, tempestuous journey and not to belabour that history, MARPS in Uganda joined the long queue of organisations helping create visibility for MARPs-related HIV prevention interventions and socio-behavioural risk factors that increase vulnerability and susceptibility. We have realised the devil is in the implementation. Between 2007-2011, we worked with entities whose work or action impacts on MARPs. We intend to approach MARPs issues through providing an interface with public and private entities, with the intention of perfecting understanding of MARPs and improving Uganda’s ability to address MARPs issues between, 2011-2016. We hope that what MARPs want, MARPs will eventually get.

Vision, Mission and Guiding Principles

GOAL: Promote dignity and safety of all persons.
VISION: A society free of discrimination.
MISSION: Involvement and participation by all grass-root and stakeholders in genuinely providing services for all.
VALUES:  Responsibility, transparency, accountability, positive contribution, dignity, peace-building and development.
Guiding Principles:
  • Internal organisation (Meetings, committees, minutes and records).
  • Immediate activities (Organisation set up, health, human rights, income generating activities).
  • Long-term activities (Regional coordination, Constituency coordination and core activities).
  • Partnerships (Resource generation and building, reports, documentation, conferences and Cooperation with other actors).
  • Normative frameworks arrived at after many years of programming targeting MARPs.

Normative Frameworks


  1. Violence Abuse, Discrimination and Stigma (VADS): Contribute to reducing Violence, Abuse, Discrimination and Stigma. Increase effectiveness and appropriateness of the HIV-AIDS response in Uganda.
  2. Transparency and Accountability: MARPS in Uganda is committed to ensuring the structure and function of the beneficiaries, decision making processes and clear use of resources by all. Monitoring of activities will be against these normative frameworks, vision, mission and values. It will actively seek opportunities to share challenges and successes with stakeholders.
  3. Anti-oppression framework: MARPS in Uganda will work to eliminate low targeting within the various structural and systemic cradles of service delivery. Symposia on; race, gender, sexuality, identity, orientation, faith, disability, age, legal status and other dimensions of difference will be held in community spaces. The idea is to highlight impact of these and extent of harm they can cause to individual or communities as they respond to HIV-AIDS.
  4. Social Justice: MARPS in Uganda will borrow from a social justice philosophy to inform its work and activities; using practices and tools based on the promotion of human rights and social determinants of health. The interrelatedness of social, economic, political and environmental contexts on HIV-AIDS as realities not to ignore.
  5. Diversity and Inclusion: In doing its work, MARPS in Uganda will support involvement of diverse populations, allies and stakeholders. We are very strong on community-owned/based shared understandings that value diversity through use of practices and language that is non-stigmatizing, respectful and inclusive.
  6. Capacity Building, Organisation and Leadership Development: MARPS in Uganda will use and support individual and community based models to ensure sustainable growth for the future of the society.
  7. Advocacy: MARPS in Uganda will strategically advocate with, and on behalf of beneficiaries on a variety of issues: securing access to micro-finance credit/resources; policy decision-making; scaling up prevention, treatment, care and support; documentation and research.

What has informed our activities from 2007-2011

  1. Contributing technical expertise to the MARPs Network in Uganda, AGHA-Uganda, MARPI and 45 small grass-root CBOs in Uganda.
  2. 180 Town council key persons, 120 Health centers, 1,250 trading centers visited in Uganda to gauge specific services, access by MARPs and generating a social map to inform on interfacing possibilities with MARPs. These have been across the whole of Uganda.
  3. 10 leaders of Local Council I in Bulucheke Sub-county, Bududa District  who shared with us their plight after mudslides and how this leads to destruction of years of investments, practices and to immediate displacement.
    
MARPS in Uganda will pursue the “whole-society” philosophy whereby we shall encourage meeting concerned leaders in their communities to understand their issues and share with them experiences.

  1. 113 Karamoja elders and 22 others from the Water/Sanitation/Hygiene committees, who expressed their undying desire to work with anyone who will enable them, preserve life and their natural environment. Our conversation was around topical issues concerning Karamoja, especially how to return the green cover to keep the land, engaging various forms of work, feed their cattle, families and their fears of landslides.

  1. 12 community leaders near the Uganda-Congo border in Ombaiva Village, Arivu Sub-county in Arua who first intimated on drug-use among communities. This led to an awareness of a very large web of marijuana users who use Ombaiva as the Marijuana destination. We also witnessed first hand experiences of former fisher-folk who now engage in collecting snail shells as an alternative to using Lake Albert resources.
  2. 34 Faith Based Organisations, 112 CSOs and 15 Persons with Disabilities’ Organisations.
  3. 25 newly formed districts’ key leaders, 115 agricultural extensionists at sub-county level, 120 teachers of various schools, and 235 Local Council I leaders to specifically interrogate programming targeting MARPs.
  4. 15,372 women and Youth Groups specifically identified to gauge understanding of MARPs issues in Uganda. These gave insight into a number MARPs issues. This formed basis of the development of the MARPS in Uganda Technical guide to addressing MARPs issues in Uganda.
  5. Identified 42 Police stations/posts and 59 Local Council I Chairpersons visited to gauge community handling of Violence, Abuses, Discrimination and Stigma issues in all 5 Divisions of Kampala. This also formed basis of corroborating stories from town councils on rapid urbanisation and state of housing. The conversations revolved into deeper meanings of inadequate housing, services and job opportunities. It was agreed that the fabric of violence, abuses, discrimination and stigma can only be unravelled once urban centers plan for well being of the dwellers.
  6. 125 key contact famer groups who managed to share with us a linkage in agro-production, environment and use of disposable income after harvests. These enabled us to tap into an on-going Igara tea-growers’ network meeting for tea-growers of Bushenyi, Sheema, Mitooma, Buhweju districts.
  7. 110 Sub-counties across Uganda visited to review plans to address MARPs in their communities. These also provided such opportunities like: identifying/hearing first account stories of inter-sexed persons; to sit in council meetings; get to review sub-county plans and to have an eye-witness account of April-August 2011 dry-spells and their effects to most of East Uganda areas such as Buluguya, Bumufune, Bunanganda, Buwebele, Bushanji and Bumasali (Bunambutye Sub-County) and Bulembera, Buwabula, Bwekanda (Buikhonge Sub-county).
  8. Busia, Malaba, Mpondwe, Katuna and Mutukula border posts communities who helped to gauge understanding of MARPs needs, use of condom dispensers and services provided for sex-workers. The picture below shows an illustration of this.

  1. The support of 25 area Members of Parliament who facilitated talks on comprehensive awareness of HIV prevention, care and treatment for their constituencies.
  2. National Forum for people living with HIV Networks in Uganda, Sexual Minorities, Substance Users, fisher-folk and reformed former in-mates. Key informants from these disproportionately affected populations expressed need to be involved in actual organisation development and as a means of self determination to be trained in organisation development skills which they would in turn use to audit any MARPs interventions. They expressed fear of being used by established organisations which in turn solicit for funding on their behalf but fail to do impacting programmes among them.
  3. 900 mobilisers in the 10 regions we marked out as service areas covering the whole of Uganda. These enabled us interface with; Long distance truckers, sex-workers, mobile men/women with money, substance users, fisher-folks, MSM/Sexual minorities, uniformed services, M-Cycle-Riders. The mobilisers will continue to be our enduring belly-buttons for continued MARPS in Uganda grass-root work even beyond 2011.
  4. 18 fresh agro-products markets’ leaders who shared with us their plights and effects of uncertainties at work and how this in turn affects productivity and earning a wage.
  5. 17 factory based women groups of sorters and errand runners who shared with us their stories around employer-employee relations, fears, uncertainties, lack of social insurance, too much deductions from the meagre salaries without surety to get loans, need for contracts, minimum wages and how this influenced productivity and life planning.
  6. 5 Beach Management Units in Uganda to gauge breaking into fisher folk/landing sites. Through these we managed to hear voices talking of; plights of Lake Kioga fisher folk who have depleted the lake and need to learn newer survival skills; need to have skills in craft making as a means of breaking into tourism attraction for the case of Lake Victoria fisher folk.
  7.  123 Lorry, bus, heavy trucks’ parking guides and members from 125 M-Cycle Stages (BODA-BODA). This gave insight on consequences of non-consensual sexual intercourse fuelled by use of substances. These also gave insight on messaging and practices against unprotected sex.
  8. 152 men only Ludo/board games’ clubs. This enabled MARPs in Uganda trigger off conversation around MARPs’ issues, sexuality, orientation, gender, identity, violence, abuse, discrimination and stigma.
  9. Internet based social networks. These provided deeper insight into key populations.
  10. 142 snooker joints in Kigowa-Ntinda, Kawaala, Rwampara, Lyantonde, Gulu, Arua, Zombo and Kyegegwa. This was an opportunity to engage youths (14-35 years) while at play.
  11. The generous support of well-wishers who provided spaces for intellectual debates and reviews of publications on MARPs in the whole world.
  12. Communities in Karamoja, Katakwi and Amuria who faced imminent floods, displacement and fears of the future. This happened in the last month of our cross-country exploration into MARPs issues in August 2011.
  13. 13 travel tour operator companies. That provided insight into child sex-work along Kampala-Busia/Kampala-Juba /Kampala-Kabale Roads.
  14. 14 meetings with key policy persons in key ministries on: NAADS, social development, health, youth employment and skills development (BTVET). This was arrived at after planning to attend the Arua International Youth Day Celebrations. MARPS in Uganda wanted to explore the environment that would enable it provide support to young Ugandans as means of contributing to the Vision 2030 of Uganda: From a peasant to a modern and prosperous country. Free of poverty, unemployment, discrimination, inequity and exploitation. A world full of creative challenges and opportunities to overcome these challenges.
  15. 72 MSM-only groups, 4 lesbian groups and 10 bisexual-persons groups and other Sexual Minorities’ Health/Well-being initiatives have expressed desire to be trained in skills to enable them move towards self determination, viable health action groups with activity plans to enable them negotiate issues by themselves. This capacity building it is envisioned will create visibility of needs and enable them report their successes without going through host organisations.
  16. 57 MARPs-targeting organisations visited as an experience sharing exercise in Kenya and Tanzania. These enabled us explore context of Geography, sociology, ideology, biology and eligibility scope in which MARPs services are provided in those countries.

MOST AT RISK POPULATIONS’ TARGETING PROGRAMMES IN UGANDA WILL LEARN A LOT FROM KENYA, RWANDA, BURUNDI, TANZANIA AND ZANZIBAR










THE GRIM REALITY IS THAT HIV DOESN’T CARE IF YOU HAVE SEX WITH MEN OR WOMEN.






KENYA AND TANZANIA HAVE MADE LEAPS INTO MALE CIRCUMCISION, SUBSTANCE USERS’ AND MSM PROGRAMMING

PICTORIAL STORY OF CONTEXTS WE NEED TO FACTOR IN AS WE DEVELOP MARPs-RELATED ACTIVITIES:

Long-distance truckers who have to drive over long stretches and rest in various urban or trading centers; the young people who are drawn to urban centres following the employment grail, trappings of the city and a “good” life. The next pictures give the reader a sense of the broad inputs required for one to plan effectively to improve access to HIV services for MARPs. Road construction companies and many other settings bring life to communities that are otherwise found in remote areas. The disposable income is spent in procuring many things including sex. How this is interpreted by the young people or able bodied males is left to one’s imagination. Some areas are so far away, set in undulating hills and access to roads is so difficult. Newer districts have been curved out of older ones. There is need to plan with all these issues in mind if we are to effectively fight HIV in Uganda. More focused organisations have positioned themselves to address the broader contexts. The frontiers have been widened.

 

LONG DISTANCE TRUCKERS, SPECIAL HIRE DRIVERS, SPRAWLING URBANS, CONSTRUCTION COMPANIES ARE POTENTIAL FOR MARPs-PROGRAMMING IN UGANDA

 

 

THESE PICTURES ARE FROM RWAMPARA (RURAL CONSTITUENCY IN UGANDA)

 



COMMUNITY LEADERS, ESTABLISHED WOMEN/MEN GROUPS ARE KEY IN MOBILISATION AND THIS IS WHAT MARPS IN UGANDA WILL USE TO SET FOCUSED PROGRAMMING TARGETING MARPs.

Meetings held in a community-shed. Using these kinds of meetings we were able to generate an understanding of how MARPs-related programmes can cause impact.




Hima Cement Factory in the background. In the foreground is a thriving trading center. Trading centers are a potential for mega-size messages about prevention of  HIV/STIs or even sexuality-related IEC. A quick run through ten simple questions on HIV showed that questions around ABC prevention measures were well answered.  Issues of access to condoms, child-sex-work were raised and need for initiating anti-HIV Clubs were welcome.


This hotel space is run by an organisation concerned with addressing MARPs issues. It was provided to us for 3 days. It was a convenient place for attending to University students and other people. The experiences we shared around HIV, MARPs and Self-esteem were very informative and promising to bloom into one of the few University anti-HIV Clubs in Western Uganda.



University towns are good points for programming around MARPs-related issues.




Housing opportunities and environment sustainability/ regeneration efforts are such programmes MARPs-related programming should link with to address a broader context that fuels exposure to HIV transmission risks. Imagine a hungry trading center with little or no housing facilities, such a scenario fuels exposure to vulnerability and certain sections of the populations are more at risk of being lured into sex-work (unprotected sexual intercourse).



It is possible to work with community-based development programmes, banks and health facilities in order to develop broader programmes targeting MARPs.



Community-Market days are a platform for passing on MARPs-related information to communities.



Community fresh foods’ markets are opportunities for enrolling participation of mobile men/women with money in life planning skills sessions to lessen risk behaviour among mobile communities.


The government of Uganda is providing the best atmosphere, context and environment for realising the need to fight HIV; for stemming the tide of HIV infections; for encouraging community participation in anti-HIV Campaigns; for leadership to be galvanised behind efforts to eradicate contexts in which HIV seems to be slipping the noose of efforts. Thanks to the NRM government MARPs-related programmes will finally have budgets to effect them.

Road networks connecting many parts of Uganda contribute to improved social services’ presence, access and demand. These contexts should be highly considered in planning for enduring durable MARPs-related programmed in Uganda.




Break neck urbanisation has drawn the young persons, adults, men, women from rural settings to the trappings of towns. We reached over 11,000 towns and saw opportunities for programming, messaging and forming anti-HIV clubs. The community radios in most of these small towns is an untapped medium MARPs-related programming should use.




TORORO HOSPITAL, such health facilities have community-learning spaces for training stakeholders and are opportunities for linking enduring prevention, treatment and care services.

MOST AT RISK POPULATIONS’ SOCIETY IN UGANDA (MARPS IN UGANDA) OFFICES,  KAMPALA ROAD ZONE, PLOT 22, LUBAGA DIVISION. ORGANISATIONS NEED TO AFFORD OFFICE SPACE, LOGISTICS AND TECHNICAL RETAINING POWER TO BE ABLE TO CONTRIBUTE, COMMIT AND CONSOLIDATE EFFORTS BREAKING THE BACK OF HIV-AIDS.

WE KINDLY CALL UPON YOUR SUPPORT TO ENABLE US IMPLEMENT OUR BUSINESS COMMITMENTS FOR 2011-2016.
www.marpsinuganda.org;  marpsinuganda.blogspot.com;  P.O.BOX. 27530 Kampala



Where we are going 2011-2016:

MARPs in Uganda will engage in a targeted and strategic investment approach using the normative framework to encourage and invest heavily in community mobilization, collaboration across programme elements and an increased focus on the benefits of a formal-informal sector synergy. We shall intensify work in four investment categories and eight core programmatic activities: Using local government and social structures; procurement, distribution, and marketing of SRH Commodities; revitalising prevention of transmission of HIV; promotion of latest prevention measures; integration of combination HIV Prevention for MSM; promotion of behaviour change programmes; promotion of antiretroviral therapy programmes;addressing violence, abuse, discrimination and stigma; creating an enabling environment at community levels and; establishing synergies with other actors.  With an earlier investment portfolio of USD 188.000 and a fallback position using key contacts from 2007 to date, MARPS in Uganda has continued to evolve, create a structural possibility to reach between 700.000-1,000.000 persons and developed a sleeper ramification covering all corners of Uganda to reach MARPs. We call upon your support please. We want to consolidate our work, we want to have contacted 1,000,000 people with MARPs related information and shared a comprehensive HIV related prevention, treatment and care planned for 2011-2016.






 

MOST AT RISK POPULATIONS’ SOCIETY IN UGANDA STRATEGIES

Our milestones from 2011-2016

ADDRESSING THE PSYCHO-SOCIO-BEHAVIOURAL CONTEXTS THAT FUEL MARPs AND KEY AFFECTED POPULATIONS’ ISSUES IN UGANDA 2011-2016

Our delivery Systems’ perspectives, inputs, processes, outputs and outcomes
Stakeholder
Socio-Political Aspects/Tiers
High Target  Activity
Output
CAOs
District Plans addressing MARPs
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs

Municipal Councils
Municipal Council Plans addressing MARPs
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
Town Councils
Town Council Plans addressing MARPs
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
Urban Trading Centers
Urban Center Plans addressing MARPs
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
MARPs Visibility Marches in urban, Towns and Municipals
Marches through urbans, Towns and Municipals
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs.
3. Action to address issues that fuel violence, abuse, discrimination and stigma
NGOs/CBOs/FBOs
Plans to address Violence, Abuse, Discrimination and Stigma
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
Sub-Counties and Parishes
Sub-County/Parish plans to address issues of MARPs, Violence, Abuse, Discrimination, Stigma, HIV-AIDS, Human Rights, Environment and Development
 Development plans targeting marginalised in the given communities, BMUs plans to mobilise fisher folk, Health education targeting all MARPs and M/E plans as follow up and re-attendance plans
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
4.Addressing livelihoods
Development Partners
Plans to address MARPs/ Key affected Populations
Partnerships, linkages and support
Partnerships that build capacity for durable safety nets against vulnerability
CULTURAL ENTITIES
Plans to address MARPs/ Key affected Populations
Partnerships, linkages and support
Partnerships that build capacity for durable safety nets against vulnerability
HIV-AIDS SERVICES ORGANISATIONS
Plans to address MARPs/ Key affected Populations
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

HUMAN RIGHTS SERVICES ORGANISATIONS
Plans to address MARPs/ Key affected Populations
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

3. PUBLIC HEALTH SERVICES ORGANISATIONS
Plans to address MARPs/ Key affected Populations
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs





PWD ORGANISATIONS
Plans to address PWD  MARPs/ Key affected  PWD Populations
Identified action to address PWD MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs and location of PWD MARPs
2. Identified Action to address needs of PWD  MARPs
3. Legal-Policy level changes targeting issues of PWD MARPs

HEALTH FACILITIES/CENTERS
Plans to address MARPs/ Key affected Populations
Identified action to address MARPs issues, Follow up plans to monitor impact of action, reviews/documentation of best practices.
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs
3. Health Facilities’ action plans to address MARPs issues

SCHOOLS
Access to education by marginalised persons
1.       Equity plans to allow marginalised access education
2.       Education sessions on contexts that bring about MARPs issues.

1.Education Sessions on needs of MARPS
2. Schedules to educate students about Contexts that fuel MARPs issues.

VILLAGE/COMMUNITY MARKETS/FINANCIAL ENTITIES
Plans to address issues of MARPs
1.       Access to markets and equal opportunities provided for less privileged
2.       Ensure engagement of  MARPs in targeted cash transfers
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs
3. Social insurance schemes
SPORTS/RECREATION GROUNDS
Organised recreation and  sports as a means of inclusion of MARPs
Access to spaces and equal opportunities provided for less privileged
Self esteem and opportunities to provide education to young people, men and women while at play.
Truck Stop Spot
Plans to address MARPs/ Key affected Populations
Information about MARPs, plans to involve Truck Stop leaders in promoting information and practices that
Self esteem and opportunities to provide prevention services while in transit.
Hotels/Lodge Owners/ Hospitality Industry
Plans to address MARPs/ Key affected Populations
1.       Hotels and lodges being spaces of dignity
2.       Plans to eradicate violence, abuse, discrimination and stigma
1.Broad based approaches to eradicating violence, abuse, discrimination and stigma
 2.Including  Hotels and lodges as spaces for addressing MARPs issues
Uniformed Services
Plans to address HIV-AIDS, Women, Children and Civilian Liaison issues
Addressing health issues for all improves morale and general well being of forces
Planned well being addressing issues of the forces
MEDIA HOUSES/ Entertainment Industry and Drama Groups
Plans to address MARPs/ Key affected Populations
Providing space and proper information about MARPs and conscientious reporting to avoid violence, abuse, discrimination and Stigma towards MARPs.
1.       Avoiding sensationalising MARPs issues
2.       Partnership in the fight against HIV  by media houses, entertainment industry and Drama Groups
3.       Non-abusive reporting and trivialising of MARPs issues
SECURITY ORGANS
Plans to address MARPs/ Key affected Populations
Providing due diligence, handling MARPs issues and proper information about MARPs and conscientiously to avoid violence, abuse, discrimination and Stigma towards MARPs.
1.       Security organs handling MARPs, especially sexual minorities with dignity.
2.       Police stations having action plans on eradicating violence, abuse, discrimination and Stigma
3.       Security /Armed forces having opportunity for dialoguing around violence, abuse, discrimination and stigma
4.       Rehabilitation and Incarceration centers being spaces that are violence, abuse, discrimination and stigma free.

OUTPUT/OUTCOME MATRIX

Stakeholder
Output
Outcomes
Indicators
CAOs
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
1. Key-Contact/Responsible Persons
2. Plans to address MARPs issues under CAO’s radar
1. Names of district, sub-counties, responsible persons and groups
2. Work plans
3. Reports
Municipal Councils
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
1. Location and livelihood topography of MARPs
2. Plans to address MARPs issues
1. Names of municipalities, responsible persons and groups
2. Work plans
3. Reports
Town Councils
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
1. Location and livelihood topography of MARPs
2. Plans to address MARPs issues
1. Names of town councils, responsible persons and groups
2. Work plans
3. Reports
Urban Trading Centers
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
1. Location and livelihood topography of MARPs
2. Plans to address MARPs issues
1. Names of urban centers, responsible persons and groups
2. Work plans
3. Reports
MARPs Visibility Marches in urban, Towns and Municipals
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs.
3. Action to address issues that fuel violence, abuse, discrimination and stigma
Urban wide awareness drives
Focus days identified to address MARPs issues
NGOs/CBOs/FBOs
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Sub-Counties and Parishes
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
4. Addressing Livelihoods
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Development Partners
Partnerships that build capacity for durable safety nets against vulnerability
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
CULTURAL ENTITIES
Partnerships that build capacity for durable safety nets against vulnerability
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
HIV-AIDS SERVICES ORGANISATIONS
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
HUMAN RIGHTS SERVICES ORGANISATIONS
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
3. PUBLIC HEALTH SERVICES ORGANISATIONS
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs




PWD ORGANISATIONS
1.Disaggregated needs and location of PWD MARPs
2. Identified Action to address needs of PWD  MARPs
3. Legal-Policy level changes targeting issues of PWD MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
HEALTH FACILITIES/CENTERS
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs
3. Health Facilities’ action plans to address MARPs issues

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
SCHOOLS
1.Education Sessions on needs of MARPS
2. Schedules to educate students about Contexts that fuel MARPs issues.

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
VILLAGE/COMMUNITY MARKETS/FINANCIAL ENTITIES
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs
3. Social insurance schemes
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
SPORTS/RECREATION GROUNDS
Self esteem and opportunities to provide education to young people, men and women while at play.
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Truck Stop Spot
Including stop points as spaces for addressing MARPs issues
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Hotels/Lodge Owners
1.Broad based approaches to eradicating violence, abuse, discrimination and stigma 2.Including  Hotels and lodges as spaces for addressing MARPs issues
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Uniformed Services
Planned well being, addressing issues of the forces
Addressing health issues for all improves morale and general well being of forces
Action plans targeting MARPs
MEDIA HOUSES/ Entertainment Industry and Drama Groups
1.       Avoiding sensationalising MARPs issues
2.       Partnership in the fight against HIV  by media houses, entertainment industry and Drama Groups
3.       Non-abusive reporting and trivialising of MARPs issues
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
SECURITY ORGANS
1.       Security organs handling MARPs, especially sexual minorities with dignity.
2.       Police stations having action plans on eradicating violence, abuse, discrimination and Stigma
3.       Security /Armed forces having opportunity for dialoguing around violence, abuse, discrimination and stigma
4.       Rehabilitation and Incarceration centers being spaces that are violence, abuse, discrimination and stigma free.
Programmes and plans to address MARPs issues.
Action plans targeting MARPs














OUTPUT/OUTCOME MATRIX CASCADING INTO THE UNAIDS 2011-2015 GETTING TO ZERO STRATEGY

VISION AND GOALS:
VISION: To get to Zero New Infections
Goals for 2015: Sexual transmission of HIV reduced by half, including among young people, men who have sex with men and transmission in the context of sex-work; Vertical transmission of HIV eliminated and AIDS-related maternal mortality reduced by half; all new HIV infections prevented among people who use drugs
VISION: To get to zero AIDS-related deaths
Goals for 2015: Universal access to ART for PLWHAs who are eligible for treatment; TB deaths among PLWHAs reduced by half; PLWHAs and Households affected by HIV are addressed in all national social protection strategies and have access to essential care and support
VISION: To get to zero discrimination
Goal for 2015: Countries with punitive laws and practices around HIV transmission, sex work, drug use or homosexuality that block effective responses reduced by half; HIV-related restrictions on entry, stay and resilience eliminated in half of the countries that have such restrictions; HIV-specific needs of women and girls are addressed in at least half of all national HIV responses; zero tolerance for gender-based violence
Stakeholder
Output
Outcomes
Indicators
MATCHING TO UNAIDS Outcome Framework
CAOs
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
1. Key-Contact/Responsible Persons
2. Plans to address MARPs issues under CAO’s radar
1. Names of district, sub-counties, responsible persons and groups
2. Work plans
3. Reports
1. Leading the HIV response through enabling transformative commitments, more focused, more aligned and country-owned responses.
2. Ensure greater investment addresses the intersection between HIV Vulnerability, gender inequality and violence against women and girls.
3.Nationally owned sustainable responses, financing diversified, systems strengthened
Municipal Councils
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
1. Location and livelihood topography of MARPs
2. Plans to address MARPs issues
1. Names of municipalities, responsible persons and groups
2. Work plans
3. Reports
1. Plans to achieve universal access to HIV prevention, treatment, care and support and the Millennium Development Goals.
2. Partnerships among people, communities and lower governments
3. Pursuing social justice and human dignity
4. Halt and reverse the spread of HIV.
5. Contribute to the achievement of the Millennium Development Goals.
Revolutionising HIV prevention politics, policies and practices.
Town Councils
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
1. Location and livelihood topography of MARPs
2. Plans to address MARPs issues
1. Names of town councils, responsible persons and groups
2. Work plans
3. Reports
1. Plans to achieve universal access to HIV prevention, treatment, care and support and the Millennium Development Goals.
2. Partnerships among people, communities and lower governments
3. Pursuing social justice and human dignity
4. Halt and reverse the spread of HIV.
5. Contribute to the achievement of the Millennium Development Goals.
Revolutionising HIV prevention politics, policies and practices.
5.Inclusive responses reach the most vulnerable, communities mobilise, human rights protected.
Urban Trading Centers
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
1. Location and livelihood topography of MARPs
2. Plans to address MARPs issues
1. Names of urban centers, responsible persons and groups
2. Work plans
3. Reports
1. Plans to achieve universal access to HIV prevention, treatment, care and support and the Millennium Development Goals.
2. Partnerships among people, communities and lower governments
3. Pursuing social justice and human dignity
4. Halt and reverse the spread of HIV.
5. Contribute to the achievement of the Millennium Development Goals.
Revolutionising HIV prevention politics, policies and practices.
MARPs Visibility Marches in urban, Towns and Municipals
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs.
3. Action to address issues that fuel violence, abuse, discrimination and stigma
Urban wide awareness drives
Focus days identified to address MARPs issues
1. Fostered political incentives for commitment and catalysing transformative social changes regarding sexuality, drug use and HIV education for all, led by PLWHAs, Key affected populations, women and young people.
2.Targeting hotspots
3.Ensure equitable access to high quality, cost effective HIV prevention programmes that include rapid adoption of scientific breakthroughs
NGOs/CBOs/FBOs
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
1. Greater links between ART services and primary health, maternal and child health, TB and sexual and reproductive health services to reduce costs and contribute to greater efficiencies.
2. Nutritional support and social protection services for PLWHAs including OVCs through the use of social and cash transfers and the expansion of social insurance schemes.
3. Social and legal environments that give protection against stigma, discrimination and facilitate universal access
4. HIV-related human rights including the rights of women and girls
5. Implement protective legal environments for PLWHAs, populations at higher risk of HIV infection
6.Ensure HIV coverage for the most underserved and vulnerable communities
7. PLWHAs and people at  higher risk of HIV should know their HIV-related rights and be supported to mobilise around them
8. Movements united, services integrated, efficiencies secured across Millennium Development Goals.
Sub-Counties and Parishes
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Action to address issues that fuel violence, abuse, discrimination and stigma
4. Addressing livelihoods
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
1. Plans to achieve universal access to HIV prevention, treatment, care and support and the Millennium Development Goals.
2. Partnerships among people, communities and lower governments
3. Pursuing social justice and human dignity
4. Halt and reverse the spread of HIV.
5. Contribute to the achievement of the Millennium Development Goals.
Revolutionising HIV prevention politics, policies and practices.
Development Partners
Partnerships that build capacity for durable safety nets against vulnerability
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Platform and support for operational activities and resource allocation for HIV, Human Rights and Development
CULTURAL ENTITIES
Partnerships that build capacity for durable safety nets against vulnerability
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Platform and support for operational activities and resource allocation for HIV, Human Rights and Development
HIV-AIDS SERVICES ORGANISATIONS
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Lead in addressing issues of PLWAs and people at higher risk of HIV
HUMAN RIGHTS SERVICES ORGANISATIONS
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
1.Lead in revolutionising HIV prevention politics, policies and practices
2. Lead in ensuring intersections between HIV vulnerability, inequality and violence

3. PUBLIC HEALTH SERVICES ORGANISATIONS
1.Disaggregated needs and location of MARPs
2. Identified Action to address needs of MARPs
3. Legal-Policy level changes targeting issues of MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
1.Lead in revolutionising HIV prevention politics, policies and practices
2. Lead in ensuring intersections between HIV vulnerability, inequality and violence






PWD ORGANISATIONS
1.Disaggregated needs and location of PWD MARPs
2. Identified Action to address needs of PWD  MARPs
3. Legal-Policy level changes targeting issues of PWD MARPs

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
1.Lead in revolutionising HIV prevention politics, policies and practices
2. Lead in ensuring intersections between HIV vulnerability, inequality and violence

HEALTH FACILITIES/CENTERS
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs
3. Health Facilities’ action plans to address MARPs issues

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Lead in addressing issues of PLWAs and people at higher risk of HIV
SCHOOLS
1.Education Sessions on needs of MARPS
2. Schedules to educate students about Contexts that fuel MARPs issues.

Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Increase awareness on HIV prevention practices in schools and education facilities
VILLAGE/COMMUNITY MARKETS/FINANCIAL ENTITIES
1.Disaggregated needs of MARPS
2. Identified Action to address needs of MARPs
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
1. Access to financial credit as a means of livelihood improvement for all.
2. Nationally owned sustainable responses, financing diversified, systems strengthened

SPORTS/RECREATION GROUNDS
Self esteem and opportunities to provide education to young people, men and women while at play.
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Increase awareness on  and participation in HIV prevention practices in sports and recreation  facilities as an incentive
Truck Stop spot
Including stop points as spaces for addressing MARPs issues
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Increase awareness on HIV prevention practices at truck stop spots
Hotels/Lodge Owners/Hospitality Industry
1.Broad based approaches to eradicating violence, abuse, discrimination and stigma
 2.Including  Hotels and lodges as spaces for addressing MARPs issues
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Increase awareness on  and participation in HIV prevention practices
Uniformed Services
Planned well being, addressing issues of the forces
Addressing health issues for all improves morale and general well being of forces
Action plans targeting MARPs
Increase awareness on  and participation in HIV prevention practices
MEDIA HOUSES/ Entertainment Industry and Drama Groups
1.       Avoiding sensationalising MARPs issues
2.       Partnership in the fight against HIV  by media houses, entertainment industry and Drama Groups
3.       Non-abusive reporting and trivialising of MARPs issues
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Increase awareness on  and participation in HIV prevention practices
SECURITY ORGANS
1.       Security organs handling MARPs, especially sexual minorities with dignity.
2.       Police stations having action plans on eradicating violence, abuse, discrimination and Stigma
3.       Security /Armed forces having opportunity for dialoguing around violence, abuse, discrimination and stigma
4.       Rehabilitation and Incarceration centers being spaces that are violence, abuse, discrimination and stigma free.
Programmes and plans to address MARPs issues.
Action plans targeting MARPs
Increase awareness on  and participation in HIV prevention practices









Our products AND Key components:

1.       GOAL: Uganda’s lead resource with short and long term plans to address MARPs. These will be designed in an integral way right from inception to implementation. We seek to work with livelihood support organisations and link beneficiaries with these organisations.
a)      To provide skills for informed, vocal and capable organisations of PLHIV, Young PLHIV, People in/out of school, Men, women,  MSM, Sex-workers and Transgender to be recognised as partners to advance universal access.
b)      To provide sexual reproductive health commodities, home visits, meetings, supportive counselling, sexuality education and life planning skills to MARPs.
c)       To train organisations, communities and entities in designing programmes and plans to address MARPs issues.
d)      Design and write documents, reports, conference papers and brief as tools to improve on MARPs-related programming.
e)      Ensure a space for comprehensive HIV programme that provides non-judgemental, non-stigmatising and relevant services to MSM, sex-workers and Transgender persons in Uganda.
f)       Ensure that negotiations around violations reported by MSM, SW and TG people benefit from positive and appropriate response from relevant administrative or judicial authorities.
g)      Provide consultancies to organisations around Africa and beyond on MARPs-related programming
h)      Provide briefs and alerts on trends and actions that impact on MARPs.
i)        Update website: www.marpsinuganda.org
j)        Update blog: marpsiunganda.blogspot.com
k)      Solicit for funds through proposal writings and provide trainings to groups thus empowering them to access services, funding and self determination.
l)        Establish a PVC recycling plant making small plastic bottles and containers.
m)    After 10 years (up to 2020) register as an NGO and provide more high up opportunities for leadership thus for the RESUCs and KAPOCs. This will cause a domino effect to prevail along our system. Uganda will in effect have a MARPs-related mechanism helping drive issues that address MARPs related needs in a more visible way.
n)      Provide opportunities to identified 1800 demonstration spaces to generate small scale projects that will improve on well being of beneficiaries.
o)      Establish a MARPs-related CORPs at National, regional, district, Sub-county and community levels.
2.       GOAL: Actual local government plans outlining activities to address MARPs issues. Our rallying call will be based on the disproportionate nature of HIV-AIDS and poverty prevalence. We shall seek to promote inclusion of MARPs as service beneficiaries, mobilise key affected populations and populations at a higher risk of HIV affirmatively to access prevention, care and treatment services.
a)      Negotiate for Young persons’ access to skills development opportunities and credit to start businesses.
b)      Ensure access to comprehensive knowledge of HIV; promote condom use and use of HIV testing and counselling services by young persons.
c)       Ensure linkage with livelihood and development support facilities.
3.       GOAL: Actual CSO/NGO/FBO plans and audits showing and providing visibility for MARPs issues.
a)      Negotiate for access to skills development opportunities and credit for enterprise development.
b)      Ensure access to comprehensive knowledge of HIV; promote condom use and use of HIV testing and counselling services.
4.       GOAL: Effectively mobilised MARPs/Self determined in groups and organisations.
a)      Effectively organised groups or entities registered with authorities.
b)      Groups engaged in anti-HIV and other development pillars.
5.       GOAL: Regularised and harmonised country-specific MARPs activities.
a)      Identified MARPs issues addressed through actual implementation, referral and other redress.
6.       GOAL: Grass-root led MARPs safety nets and activities.
a)      Identify, involve and raise capacity for grass-root led planning and activities.
b)      Establish a resource center with literature on MARPs
c)       Establish a consultancy desk for interrogating contexts around which HIV thrives and engage in improving livelihoods.
7.       GOAL: Documentation on Violence, Abuse, Discrimination and Stigma (VADS) and establishing practices to eradicate them from communities as a form of holistic approach to MARPs issues.
a)      To show through films, plays and print media the social consequences  that may undermine public health systems when law enforcement drives MARPs away from prevention and care services and into environments where the risk of infectious disease transmission (e.g., HIV, hepatitis C & B, and tuberculosis) and other harms is increased.
b)      To engage government (Policy and criminal justice system), development partners and organisations in establishing environment that promotes a drug policy reform, harm reduction and decriminalisation.
c)        Establish a CASE Diary system of documenting hours invested in action towards VADS in Uganda as a means of show-casing engagement by individuals at community level.

8.       GOAL: Reports and newsletters capturing “VOICES” of MARPs. These will as much as possible be developed to capture risk, behaviour, Knowledge, attitude, practices, perceptions, life planning, anxieties and successes.
a)      Research and develop materials
9.       GOAL: Establish a recycling plant for PVCs and an emollient-making industry in Uganda. This will enable us produce lubricants, gels, emollients and recycled- biodegradable PVCs. We hope this will be the contribution MARPS in Uganda can make to improving use of the natural environment and contribute to the employment base in Uganda.
10.   GOAL: Lead in designing and integrating livelihood and sustainability plans to address MARPs issues.
a)      Linkages with NAADS, Poverty alleviation and other measures by government of Uganda to improve on status of communities through organised group activities.



Organisation at MARPS in Uganda Grid:

The core input level

Entity
Trustees
Peer-review mechanisms/UNASO/
UAC/NGOs/CSOs/
District Development office
Government/ development partners
Community development
Other stakeholders
Core team ( core staffs)
  1. Chief Executive Officer
  2. Associate Executive Officer
  3. Young MSM Desk/ assistants
  4. Young persons’ Desk/ assistants
  5. Women Desk/3 Assistants
  6. Gender,Discrimination, Vulnerability and Risks Protection Desk/1 assistant
  7. MARPs Desk/2 assistants
  8. Transport officer
  9. Guard
  10. Volunteer support Programme

core activities:
  1. Daily activities
  2. Budgets
  3. Salaries
  4. Expenditures
  5. Planned activities
  6. Resource mobilisation
  7. Meetings
  8. Conferences
  9. Volunteer placements/attachments
  10. Attachments opportunities
  11. Compete for call for proposals.
  12. Community based attachments for university and higher institutes.
  13. Writing winning proposals or engaging consultancies to that effect
  14. Engage in exhibitions and events around HIV, Human Rights and Development
Gauge alignment and fulfilment of stated vision, mission and objectives

Share regular reports
Conduct specialist trainings to improve critical MARPs-related knowledge and intervention skills.
Gauge alignment with policy and instruments
Capacity building
Mainstreaming MARPs issues
Alignment with development plans
M/E
Capacity building
Mainstreaming MARPs issues
Alignment with development plans
M/E
10 Regional Support  Coordinators/ 1 assistant / 900 mobilisers (Resource persons at community level with MARPs related interventional skills)
Core activities
Establish a regional coordination resource center (VITALS).
Conduct bi-annual meetings with mobilisers (Community owned resource persons)
Conduct assessments, prepare venues for trainings and generate regular reports
Generate contacts and names of all social-political leadership structures in the assigned region.
Establish rapport and opportunities for meetings for conversation around MARPs, violence, abuse, discrimination, stigma, HIV, Human Rights and Development.
Learning and Sharing
Regional specific MARPs issues
Matching with MARPs-related interventions
Conducting value for money support supervisions
Present regional reports and trends
Present regional reports and trends
Present regional reports and trends

Engage in regular rapid assessments to gauge impact of MARPs-related interventions
  1. Knowledge
  2. Transfer of skills
  3. Number of actual planned interventions
  4. Actual implementation
  5. Represent MARPS in Uganda in regional meetings, conferences and events
Present regional reports and trends

Engage in regular rapid assessments to gauge impact of MARPs-related interventions
  1. Knowledge
  2. Transfer of skills
  3. Number of actual planned intervention
  4. Actual implementation
  5. Represent MARPS in Uganda
Key affected populations’ organised Constituencies
  1. Sexual minorities
  2. Uniformed services
  3. Young persons
  4. Sex-workers
  5. Drug users
  6. Men and Women groups
  7. Fisher folk
  8. Truckers

  1. Presentations and testimonials
  2. Meetings as independent organisations

  1. Presentations and testimonials
  2. Meetings as independent organisations

  1. Presentations and testimonials
  2. Meetings as independent organisations

  1. Presentations and testimonials
  2. Meetings as independent organisations

 Figure 1. Systemic view of MARPs in Uganda at work:                                 


Venn Diagram                                                                                                                                                                                                                                                        IMPACT
MARPS in Uganda seeks to cover the whole of Uganda by presenting a three-fold manifest: a core team, 10 regional support and coordination Offices (RESUCOs) and Key affected persons’ constituencies (KAPOCs). We have conducted activities since 2007 (volunteer-work); these have evolved into what is the present day image. We intend to contribute further, commit and consolidate our efforts once supported with finances. The nature of our three-fold manifest enables us to serve, reach underserved areas and constituencies (e.g., sexual minorities). We intend to have a cadre of 900 mobilisers whom we shall train as “Community owned resource persons” (CORPs) as a means of enhancing skills in promoting knowledge on HIV, Human Rights, Development, Violence, Abuse, Discrimination, Stigma and Discrimination at grass-root levels. Presence of skilled CORPs is a resource base that will promote our mission. Central level activities, coordination, leading and overall administration will be run by the core team and are responsible for all core activities. RESUCOs are responsible for generation of regional MARPs issues and establish means of addressing them. The central level authority in conjuction with RESUCOs is responsible for decision making, technical direction, management, and coordination of area activities. At regional levels, the local government structures/NGOs/CBOs/FBOs will be linked to planning targeting MARPs. A particularity of MARPS in Uganda is that it will in conjuction with individuals be able to provide topographical MARPs issues and provide visibility and likely causes of disproportionality of prevalences. This will be basis of implementation of planned activities. The KAPOCs, will be taken through training in organisation development, participatory planning and enable them design activity plans which will be the basis of continued interface, support, evaluation and re-evaluation specific to these constituencies. Annual country-wide symposia will be held to share annual experiences. Quarterly regional rotating symposia (ROSY) will be initiated and implemented to strengthen knowledge and experience sharing. The outcome reports will be authoritative documents equivalent to technical briefs and updated information on MARPs-programming. The ROSYs will be basis for awarding and recognising communities for efforts to promote mission of MARPS in Uganda. These will be opportunities for visibility of critical MARPs-targeting activities. The awards will be in form of a STAR. The stars will be in three categories (Gold, Silver and bronze). Rotating symposia (ROSY) are an opportunity to show-case leadership and possibilities by MARPs. 900 CORPs will be trained in mobilising communities to engage in conversations and planning around eradications of VADS twice a year. This means that 1800 community level spaces will be created specifically for conversation around VADS every year. These spaces will be interactive, be the basis of identifying a grass-root project for beneficiaries, made educative while at the same time provocative and interrogative of VADS. The CORPs will be tiered at national, regional, district, sub-county and community levels. MARPS in Uganda will through use of its continued anti-stigma effort (CASE) diary record hours of engagement to do something about violence, abuse, discrimination and stigma in communities. Figure 2 line arrows depict supervisory and enduring linkages that promote MARPS in Uganda mission. Double pointed arrows show a collaborative oversight by communities and expert organisations/entities. The size is also an indication of frequency of interface. Other bold arrows show flow of activities and information. In working with this model, we do have certain issues in mind; we believe that some points show areas where there may be a break in the chain. We shall as much as possible provide affirmative action to address linkage to the system. We shall provide direct services as a means of redress (e.g., address a situation fuelling stigma which may in turn cause poor access by affected persons at that point). The cloud depicts point of pick up for raw experiences.  The stars depict areas where specific information pick up points are expected. The four pointed square depicts a call out for specific attention to issues such as; drug use and uprooting community-based VADS. At this point we shall always be mindful of a holistic approach to development (social-economic development). We believe this model of service delivery will enable us conduct regular assessments, targeting MARPs at regional, community and individual level, of:
A. Availability of Service Delivery
B. Service Delivery Access, Coverage, and Utilization
C. Service Delivery Outcomes
E. Service Delivery Access, Coverage, and Utilization
F. Organization of Service Delivery
G. Quality Assurance of Care
H. Community Participation in Service Delivery

CONTRACT OF SERVICE {COSE}:

Our Society will encourage a self assessment before members are asked to enrol to the contract of service (COSE) using the approach of tiered contracts:
Gold contract: A life time membership, recognised as life member tier. The package includes life time award to the fight of HIV and Stigma in communities. The cost is USD 150. This member is a trustee and is entitled to “mention/recognition” in all our efforts. This tier entitles one to voluntary participation in community activities but still entitles one to share the rewards.
Silver contract: A voluntary-opt-out membership, with opportunities to proceed to next level. This could be applicable for a group or an individual.  The cost of membership is USD 50. This tier is opportunity for attending all symposia and access materials generated for that purpose. The member also agrees to a memorandum of understanding whose six-way tests must be adhered to.
Bronze contract: A pay-to-be member. This tier attracts USD 10. At this tier a member or group may accumulate work-hours determined by work that intends to eradicate HIV in communities, engaging communities in eradicating violence, abuse, discrimination and stigma for six months calculated using the ‘continued anti-stigma efforts’ (CASE) diary. This work is equivalent to USD 10 and on completion automatically takes one the silver tier.
Copper contract: For corporate companies, education institutes, denominations, cultural/ government institutions and development partners. Subscription is USD 50. This tier is opportunity for attending all symposia and access materials generated for that purpose. The member also agrees to a memorandum of understanding whose six-way tests must be adhered to.
Iron contract: For grass-root community groups and MARPS in Uganda has the responsibility for taking them through organisation development by end of first year of contact failure to do this our relations with the grass-root organisation can be stopped and MARPS in Uganda should not use the name of this organisation or any relations with it in its publications or as illustrations of linkages in any way. On its part also the organisation has to adhere to the six-way test/memorandum.

Mobile Van and HCT Services:

MARPS in Uganda hopes to use community radios and mobile health education vans to promote popular conversation that draws enduring attention to eradicating bad practices and in their place promote life preserving practices.

Transitory Home Services:

MARPS in Uganda hopes to continue providing services of a transitory home for (most especially) school going students with an aim to promote school retention and gaining education qualification. We provide an adherence counsellor and this has enabled us follow our beneficiaries. This in turn has enabled them drop truancy habits, concentrate on learning/study. We are sure we are contributing to responsible citizenship. Since 2007, we have helped 129 school going persons ( By August 2011, we have helped 12 persons).


TRANSITORY HOME WITH: STUDY, SAFE LOCKING, WASH-ROOM-FACILITIES AND WALKING DISTANCE TO CITY CENTER, RUN BY             MARPS IN UGANDA SINCE 2007.
Quad Arrow Callout: VADS
ISSUES
Fig. 2. SERVICE DELIVERY SYSTEM MAP OF MARPS in Uganda

THE CYCLE OF WORK AT MARPS IN UGANDA 2011-2016

USD 1: UGX. 2300 (AUGUST 2011)
GOAL
2011
2012
2013
2014
2015
2016
Lead Support
AMOUNT IN UGX./USD
Uganda’s lead resource with short and long term plans to address MARPs. These will be designed in an integral way right from inception to implementation. We seek to work with livelihood support organisations and link beneficiaries with these organisations.
a)      To provide skills for informed, vocal and capable organisations of PLHIV, Young PLHIV, People in/out of school, Men, women,  MSM, Sex-workers and Transgender to be recognised as partners to advance universal access.
b)      To provide sexual reproductive health commodities, home visits, meetings, supportive counselling, sexuality education and life planning skills to MARPs.
c)       To train organisations, communities and entities in designing programmes and plans to address MARPs issues.
d)      Design and write documents, reports, conference papers and brief as tools to improve on MARPs-related programming.
e)      Ensure a space for comprehensive HIV programme that provides non-judgemental, non-stigmatising and relevant services to MSM, sex-workers and Transgender persons in Uganda.
f)       Ensure that negotiations around violations reported by MSM, SW and TG people benefit from positive and appropriate response from relevant administrative or judicial authorities.
g)      Provide consultancies to organisations around Africa and beyond on MARPs-related programming
h)      Provide briefs and alerts on trends and actions that impact on MARPs.
i)        Update website: www.marpsinuganda.org
j)        Update blog: marpsiunganda.blogspot.com
k)      Solicit for funds through proposal writings and provide trainings to groups thus empowering them to access services, funding and self determination.
l)        Establish a PVC recycling plant making small plastic bottles and containers.
m)    After 10 years (up to 2020) register as an NGO and provide more high up opportunities for leadership thus for the RESUCs and KAPOCs. This will cause a domino effect to prevail along our system. Uganda will in effect have a MARPs-related mechanism helping drive issues that address MARPs related needs in a more visible way.
n)      Provide opportunities to identified 1800 demonstration spaces to generate small scale projects that will improve on well being of beneficiaries.
o)      Establish a MARPs-related CORPs at National, regional, district, Sub-county and community levels.
*
*
*
*
*
*
Funding thru:
UAC/MoH
Or
Solicit
600 MILLION
(UGX.)
260,870 (USD)
Actual local government plans outlining activities to address MARPs issues. Our rallying call will be based on the disproportionate nature of HIV-AIDS and poverty prevalence. We shall seek to promote inclusion of MARPs as service beneficiaries, mobilise key affected populations and populations at a higher risk of HIV affirmatively to access prevention, care and treatment services.
a)      Negotiate for Young persons’ access to skills development opportunities and credit to start businesses.
b)      Ensure access to comprehensive knowledge of HIV; promote condom use and use of HIV testing and counselling services by young persons.
c)       Ensure linkage with livelihood and development support facilities. Actual CSO/NGO/FBO plans and audits showing and providing visibility for MARPs issues.
c)       Negotiate for access to skills development opportunities and credit for enterprise development.
d)      Ensure access to comprehensive knowledge of HIV; promote condom use and use of HIV testing and counselling services.

*
*

*
*

200 MILLION
87,000 (USD)
Effectively mobilised MARPs/Self determined in groups and organisations.
a)      Effectively organised groups or entities registered with authorities.
b)      Groups engaged in anti-HIV and other development pillars.


*
*
*
*

100 MILLION
44,000 (USD)
Regularised and harmonised country-specific MARPs activities.
a)      Identified MARPs issues addressed through actual implementation, referral and other redress.


*
*
*
*

50 MILLION
22,000
 Grass-root led MARPs safety nets and activities.
d)      Identify, involve and raise capacity for grass-root led planning and activities.
e)      Establish a resource center with literature on MARPs
f)       Establish a consultancy desk for interrogating contexts around which HIV thrives and engage in improving livelihoods.
*
*
*
*
*
*

600 MILLION
260,870 (USD)
Documentation on Violence, Abuse, Discrimination and Stigma (VADS) and establishing practices to eradicate them from communities as a form of holistic approach to MARPs issues.
a)      To show through films, plays and print media the social consequences  that may undermine public health systems when law enforcement drives MARPs away from prevention and care services and into environments where the risk of infectious disease transmission (e.g., HIV, hepatitis C & B, and tuberculosis) and other harms is increased.
b)      To engage government (Policy and criminal justice system), development partners and organisations in establishing environment that promotes a drug policy reform, harm reduction and decriminalisation.
c)       Establish a CASE Diary system of documenting hours invested in action towards VADS in Uganda as a means of show-casing engagement by individuals at community level.
*
*
*
*
*
*

120 MILLION
53,000
Reports and newsletters capturing “VOICES” of MARPs. These will as much as possible be developed to capture risk, behaviour, Knowledge, attitude, practices, perceptions, life planning, anxieties and successes.
a)      Research, develop materials and dissemination
b)      Popular version reports, briefs
*
*
*
*
*
*

500 MILLION
217,000
 Establish a recycling plant for PVCs and an emollient-making industry in Uganda. This will enable us produce lubricants, gels, emollients and recycled- biodegradable PVCs. We hope this will be the contribution MARPS in Uganda can make to improving use of the natural environment and contribute to the employment base in Uganda.

*





1000,000,000
440,000
Lead in designing and integrating livelihood and sustainability plans to address MARPs issues.
a)      Linkages with NAADS, Poverty alleviation and other measures by government of Uganda to improve on status of communities through organised group activities.
*
*
*
*
*
*

600 MILLION
(UGX.)
260,870 (USD)
GRAND TOTAL







3,770,000,000 (UGX.)
/1,639,130 (USD)

Cloud Callout: Affirmative inclusion of: MSM/CSWs/
Substance Users responsible for guiding and giving focused direction
THE SOCIETY, BOARD OF DIRECTORS, REGIONAL SUPPORT COORDINATORS AND KEY AFFECTED POPULATION CONSTITUENCIES

Quad Arrow Callout: 900 community owned Resource Persons (CORPS)/ROSYsLeft Arrow Callout: Affirmative action planning effected by Secretariat/Input by Key affected Population Grps.Organization Chart
                                                                                       Organization Chart Uganda Regions are: Central 1,2,3,4, Northern, West-nile, North Eastern, Eastern, Mid-Western, and South-Western.

ROLES:

THE BOARD:  Trustees of the company/SOCIETY, ensures reports are prepared in time for all symposia, approves all plans/budgets, monitors progress, guide the chief executive officer and staffs, ensures adherence to planned activities, lobby for support.
Chief Executive Officer; At a director’s level, is the overseer, Operations Manager advises organisation on MARPs-related trends, ensures adherence to planned activities, lobbies for support, advocates and fund-raiser.
Associate Executive Office:  At a director’s level, Operations Coordinator
Women Desk Officer: Responsible for adding a women perspective to organisation and is responsible to guiding organisation with the help of 3 other staffs
Key affected population Constituency Officer: Responsible for adding a broader gender-bending perspective to organisation and is responsible to guiding organisation with the help of 3 other staffs.
Finance and Administration Officer: Responsible for effecting fiduciary agreements, adherence to contracts, focal point for reward/recognition activity, guides organisation in accountability and procurement protocol.
Space Manager: Responsible for maintenance, reception and ambiance of secretariat/ resource center
Regional Support Coordinators; Responsible for overseeing activities at one of the 10 regions divided as catchment for SOCIETY. Responsible for vetting membership and ensuring contract of services are adhered to. Responsible for generating plans and dates for regional symposia. There will be a national support and coordinating mechanism that trickles into regional supporting the District CORPs, Sub-county/Division CORPs and CORPs at grass-root level. These ones will be allowed to hold regular planned meetings as a means of checking progress. They will be formed into registrable viable organisations and will be encouraged to access Government of Uganda opportunities for improvement. The SOCIETY on its part will provide means of support that will be possible bilateral/trilateral linkages.
CORPS: Community owned resource persons in MARPs-related programming. Responsible for advocating for inclusion/due diligence sensitive to MARPs-related issues.
ROTATING SYMPOSIA (ROSY): These are equivalent to reporting mechanisms on MARPs-related issues. Exhibition points to generate critical targeting addressing MARPs. They are our form of regular general meetings. They are training opportunities in leadership for all MARPs. The trainings in turn will equip beneficiaries with analytical skills to advocate further for inclusion or targeting by either the SOCIETY or other actors. As much as possible the SOCIETY encourages equipping our beneficiaries with skills to lobby and advocate for further self-determination. We shall encourage self sustenance in all our efforts. Our 2030 vision has five pillars and all these have to be fulfilled.
VISION 2030:
  1. To become an NGO that addresses, guides and provides resource-base to eradicate contexts that fuel exposure to HIV.
  2. To engage in a business venture in order to be a self sustaining organisation able to support all its programmes.
  3. To empower all beneficiaries in organisation development skills, proposal writing skills and social-economical development skills for sustenance.
  4. To encourage formation of a country-wide advocacy consortium to eradicate violence, abuse, discrimination and stigma in Uganda.
  5. To link services in a synergic complementing way.

OUR BUSINESS PLAN IN ONE STATEMENT:

To ensure inclusion and participation by MARPs in addressing HIV needs using appropriately felt solutions.






THE LINKAGES BETWEEN CORPs AND REGIONAL COORDINATORS

Pyramid Diagram




THE 2011-2016 BUDGET BREAK DOWN


DESCRIPTION
CORE COSTS (UGX.)
2011
(million)
2012
(million)
2013
(million)
2014
(million)
2015
(million)
2016
(million)
Total After Six years
REMARKS
1.Sustainability plan
1000





1,000,000,000
  1. A PVC recycling plant, plastic bottle plant, emollients/lubricant/jellies/
  2. Vaseline plant.
  3. Equal opportunity employment space
SUSTAINABILITY






1,000,000,000

SUB-TOTAL IN UGX.






1,000,000,000

Office Premises rent
24
24
24
24
24
24
144,000,000
Central and regional offices, including sub-county activities
Fuel, workshops, seminars
14
14
14
14
14
14
84,000,000
Staff transport and staying out of station.
Furniture
24





24, 000,000
Central and regional offices
Running costs
128
100
100
100
50
50
528,000,000
Including Stationery, security, utilities, Conferences (international inclusive), meetings, lobbying, advocacy work and running a transitory home.
SUB-TOTALS IN UGX.
190
138
138
138
128
128


CORE






780,000,000

PROGRAMMES








Trainings, recognition support and motivational aspects to plan/programme for MARPs
30
20
10
10
10
10
90,000,000
Training 900 CORPS , reward and recognition mechanism
Staff Salaries
300
300
200
300
300
300
1,700,000,000
NSSF, benefits and  deductions
Support supervision and counselling services
5
20
20
20
20
15
100,000,0000
Follow-up, adherence, supporting good practices.
Communication, literature, IEC
50
10
10
10
10
10
100,000,000
Website, Internet, in-house staff development, Printed materials....
SUB-TOTAL UGX.
385
350
240
340
340
335
1,990,000,000














VALUE FOR MONEY CHECKLIST:

  1. Established  a mechanism through which it is possible to address MARPs issues in Uganda
  2. Over 1500 MARPs-related programmes “experts” identified, trained and able to pass on information and skills for demanding HIV Services.
  3. A mechanism through which MARPs channel their issues for next steps (actual redress, referral, experience sharing, documentation, conferences and visibility platforms).
  4. Over 20,000 spaces where MARPs-related issues are discussed every quarter of the year for 6 years in Uganda.
  5. Reports and documentation featuring MARPs-related issues and promising practices.
  6. Testing the international commitments and giving feed-back on their implementation in Uganda.
  7. Literature extolling success stories about MARPs.
  8. Evidence gathering and sharing
  9. Broadened approaches combining rights, HIV, Development applied side by side MARPs issues.
  10. Structures for reporting abuses using other forms of media e.g., play, writing, poetry.
  11. A resource desk review tool developed about who is who when it comes to MARPs issues in Uganda.
  12. Dedicating energy, resources and time to MARPs issues in Uganda.

WE THANK YOU ALL FOR HAVING GIVEN US YOUR TIME