The World Bank Report No: ISR7771 Implementation Status & Results Barbados Barbados Second HIV/AIDS Project (P106623) Public Disclosure Copy Operation Name: Barbados Second HIV/AIDS Project (P106623) Project Stage: Implementation Seq.No: 8 Status: ARCHIVED Archive Date: 09-Nov-2012 Country: Barbados Approval FY: 2009 Product Line: IBRD/IDA Region: LATIN AMERICA AND CARIBBEAN Lending Instrument: Specific Investment Loan Implementing Agency(ies): National Commission on HIV/AIDS Key Dates Board Approval Date 07-Aug-2008 Original Closing Date 30-Nov-2013 Planned Mid Term Review Date 05-Dec-2011 Last Archived ISR Date 22-Mar-2012 Effectiveness Date 06-Jan-2009 Revised Closing Date 30-Nov-2013 Actual Mid Term Review Date 05-Dec-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) The project would support the implementation of the 2008-2013 Barbados National HIV/AIDS Strategic Plan, specifically to increase: - Adoption of safe behaviors, in particular amongst key populations at higher risk. - Access to prevention, treatment and social care, in particular for key populations at higher risk. - Capacity of organizational and institutional structures that govern the NAP. - Use of quality data for problem identification, strategy definition and measuring results. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component 1: Prevention and Care 31.50 Component 2: Institutional Strengthening 3.50 Overall Ratings Public Disclosure Copy Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating Implementation Status Overview Barbados is making progress in combating HIV/AIDS. Barbados has eliminated mother to child HIV transmission (MTCT) since 2007 and 100% of identified HIV positive pregnant women received a complete course of antiretroviral therapy (ART) to reduce MTCT in 2012. The rate of AIDS related mortality has dramatically decreased, related to the greater availability of ART. Observed and modeled epidemic trends indicate that the rate of incident HIV infection in Barbados is static or declining. The available data indicate that Barbados Page 1 of 5 The World Bank Report No: ISR7771 is on track to achieve MDG 6 (halt or reverse HIV/AIDS) by 2015. The country has expanded access to HIV testing services for most at risk populations (MARPs). Coverage of those eligible for ART services under national guidelines has been above 80% since 2010 and well exceeds the project target of 60%. The Grant Scheme to support civil society organizations (CSOs) was launched in September 2011. To date, a total of 22 proposals have been submitted, of which 11 were approved. Public Disclosure Copy Locations No Location data has been entered Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percentage of female sex workers reporting the Percentage Value 80.00 0.00 85.00 use of a condom with their most recent client Date 31-Dec-2006 20-Jul-2012 31-Dec-2012 Comments Baseline reported for 2006 No data on this indicator at this mission. The BSS survey for female sex workers (FSW) will be conducted in 2013. Percentage of men reporting the use of a Percentage Value 64.00 0.00 70.00 condom the last time they had sex with a male Date 31-Dec-2007 30-Jun-2012 31-Dec-2011 partner Comments Baseline reported for 2007. No data available for this indicator yet. The BSS survey is currently in the field collecting data for MSM and the data are expected to be available at beginning of 2013. Percentage of young men and women aged Percentage Value 21.00 50.00 65.00 15-24 years reporting the use of a condom the Date 31-Dec-2006 31-Dec-2009 31-Dec-2013 last time they had sex with non marital non Comments Baseline reported for Data from 2009 KAPB study cohabitating sexual partner. Public Disclosure Copy 2005-2006 Percentage of young women and men aged Percentage Value 94.30 96.70 90.00 15-24 indicating sexual relations as a way of Date 31-Dec-2006 31-Jan-2012 31-Dec-2013 transmitting HIV Comments Baseline reported for Data from 2011 KAPB study Target is to maintain at least a 2005-2006 rate of 90%. Page 2 of 5 The World Bank Report No: ISR7771 Percentage of identified HIV positive pregnant Percentage Value 96.00 100.00 95.00 women who gave birth in the last 12 months Date 31-Dec-2008 30-Jun-2012 31-Dec-2013 receiving a complete course of ARV to reduce Comments Baseline reported for year- Data for 2012 shows 100% Target is to maintain a MTCT Public Disclosure Copy end 2008. (7/7) and data for 2011 is PMTCT rate above 95% over 95.5% (21/22). the 2008-2013 period. Percentage of people living with HIV on first Percentage Value 60.00 61.80 70.00 line antiretroviral regimen achieving virologic Date 31-Dec-2008 30-Jun-2012 31-Dec-2011 success within the first 6 months of treatment. Comments Baseline reported for year- Total: 61.8% for 2011 Target is to maintain a end 2008. End-project target has not virologic success above 70%. achieved yet. Limited progress may be linked to: (i) data entry problems (i.e. existing viral load data not being entered), and (ii) some patients not having viral load taken at start of treatment. Percent of most at-risk populations (female sex Percentage Value 0.00 0.00 70.00 workers and men who have sex with men) Date 31-Dec-2011 31-Dec-2012 reached with HIV prevention services. Comments No baselines The MSM and FSW BSS The target for FSW is 70% surveys will provide data for and the target for MSM is this indicator. The BSS 75%. survey started in 2012 for MEM and the BSS survey for FSW will be conducted in 2013. Amount of funds spent by CSOs under results- Amount(USD) Value 0.00 27944.75 150000.00 based agreements. Date 31-Dec-2008 30-Mar-2012 31-Dec-2013 Comments US$12,440.07 is planned for 2012/13 Evidence-based Strategic Plan 2014-2018. Text Value Strategic PLan 2008-2013 In progress. 2014-2018 Plan developed by MOH is preparing a strategy June 2013 Public Disclosure Copy plan for the health sector response and it would be a part of the overall Strategy Plan. Date 31-Dec-2008 31-Jul-2012 30-Jun-2013 Comments The NHAC is coordinating the process. Intermediate Results Indicators Page 3 of 5 The World Bank Report No: ISR7771 Indicator Name Core Unit of Measure Baseline Current End Target Amount spent on HIV/AIDS in the past 12 Amount(USD) Value 6900000.00 7458720.00 6650000.00 months Date 31-Dec-2007 31-Mar-2012 31-Dec-2011 Public Disclosure Copy Comments US$6.9 million baseline US$7.5 million reported for Target is to be met every year reported for 2006-2007. 2011-2012 of 70% of Eligible Program Expenditures (EPEs) which is at least US$6.65 million. Data on Financial Performance (as of 13-Oct-2011) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P106623 IBRD-75850 Effective 07-Aug-2008 25-Sep-2008 06-Jan-2009 30-Nov-2013 30-Nov-2013 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P106623 IBRD-75850 Effective USD 35.00 35.00 0.00 11.10 23.90 32.00 Disbursement Graph Public Disclosure Copy Key Decisions Regarding Implementation The Barbados’ National AIDS Program continues to face challenges and the Government and Bank teams are working together to address them. Page 4 of 5 The World Bank Report No: ISR7771 Restructuring History Level two Approved on 29-Jul-2011 Public Disclosure Copy Related Projects There are no related projects. Public Disclosure Copy Page 5 of 5