UNDP Proposal To MoFA HIV SRHR Programme Southern Africa UPDATED Final

Linking Policy and Programming: Strengthening Legal and Policy
Environments for reducing HIV Risk and Improving Sexual and Reproductive
Health (SRH) for Young Key Populations in Southern Africa
Organisation United Nations Development Programme
Contact Person Tilly Sellers, HIV, Health and Development Team Leader,
UNDP Africa Regional Centre.
Email: tilly.sellers@undp.org
Mobile: +251 929907053
Consortium Members African Men for Sexual Health and Rights (AMSHeR)
Health Economics and HV/AIDS Research Division
(HEARD) of the University of KwaZulu-Natal.
Project Location SADC Region - Angola, Madagascar, Mozambique, Zambia,

Zimbabwe
Duration of Project 2016-2020
Development Objective To improve sexual and reproductive health outcomes for

young key populations in SADC countries
To strengthen HIV/SRH related rights of young key

Programme Objective
populations in law, policy and strategy in 5 SADC Countries
– Angola, Madagascar, Mozambique, Zambia, Zimbabwe
HIV/SRHR Proposal from UNDP Consortium to the Netherlands Ministry of Foreign Affairs, July 2016 1
Contents
List of Acronyms ................................................................................................................................ 4
1. Rationale for the Project: Problem Analysis and Definition ....................................................... 6
1.1 Sexual and Reproductive Health (SRH) for Young Key Populations in Southern Africa ........ 6
1.2 Political Environments for Young Key Populations and SRHR in Southern Africa ................ 7
1.3 HIV/SRH-Related Human Rights of Young Key Populations in Southern Africa ................... 9
1.4 Capacity of Key Actors in Southern Africa in HIV/SRHR for Young Key Populations ....... 13
1.5 Linking HIV/SRH Policy to Service Provision in Southern Africa ........................................ 14
1.6 Strengthening Data and Understanding of the Process of Law/Policy Reform ...................... 14
2. Proposal Development .............................................................................................................. 15
2.1 Country Selection.................................................................................................................... 15
2.2 Involvement of Key Stakeholders in Proposal Development ................................................. 21
2.3 What the Proposal Builds on ................................................................................................... 22
2.4 How the Project works with other Initiatives ......................................................................... 24
3. Project Implementation ............................................................................................................. 32
3.1 Project Objectives and Expected Results ................................................................................ 33
3.2 Theory of Change.................................................................................................................... 36
3.3 Project Interventions ............................................................................................................... 36
4. Project Monitoring and Review ................................................................................................ 42
4.1 Baseline Study and Midterm Review of the Project ............................................................... 42
4.2 Monitoring of Activities and Interventions ............................................................................. 43
4.3 Results Framework ................................................................................................................. 44
4.4 Project Activities and Deliverables ......................................................................................... 48
5. Management Arrangements and Accountability ....................................................................... 49
5.1 Management structure ............................................................................................................. 49
5.2 The Project Team .................................................................................................................... 50
5.3 Financial and Administrative Management ............................................................................ 51
5.4 Fund Transfer to UNDP Country Offices ............................................................................... 52
5.5 Fund Transfers to NGO Partners ............................................................................................ 52
5.6 Anti-fraud and anti-corruption policy ..................................................................................... 54
5.7 Quality assurance .................................................................................................................... 55
5.8 Project Cooperation Agreement .............................................................................................. 55
5.9 Management Structure ............................................................................................................ 56
6. Project Inputs ............................................................................................................................ 56
7. Financial Resources Required ................................................................................................... 57
8. Project Timeframe .................................................................................................................... 58
9. Project Risk Analysis and Mitigation Strategies ....................................................................... 60
10. Project Reporting .................................................................................................................. 64
11. References ............................................................................................................................. 64
List of Acronyms
ACHPR The African Commission for Human and People’s Rights
AIDS Acquired immune-deficiency syndrome
AMSHeR African Men’s Sexual Health & Rights
ARASA AIDS and Rights Alliance for Southern Africa
ASWA African Sex Workers’ Association
AU African Union
AUC African Union Commission
CAL Coalition of African Lesbians
CEDAW Convention on the Elimination of All Forms of Discrimination Against Women
CSO(s) Civil society organisation(s)
CSE Comprehensive Sexuality Education
GAFTM Global Fund for AIDS, Tuberculosis and Malaria
GHHR Program on Global Health and Human Rights
HEARD Health Economics and HV/AIDS Research Division of the University of KwaZulu-Natal
HHD HIV, Health and Development team in UNDP
HIV Human immunodeficiency virus
IATI International AID Transparency Initiative
ICCPR International Covenant on Civil and Political Rights
ICESCR International Covenant on Economic, Social and Cultural Rights
INERELA+ The International Network of Religious Leaders Living with, or Personally affected, by
HIV.
ILA Interactive Learning and Action
KELIN Kenya Legal and Ethical Issues Network on HIV and AIDS
LEA Legal environment assessment(s)
LGBTI Lesbian, gay, bi-sexual, transgender and intersex
MDR-TB Multi-drug resistant tuberculosis
MoFA Ministry of Foreign Affairs
MSM Men who have sex with men
MTE Mid-term evaluation
ND National dialogue
NSP(s) National Strategic Plan(s)
PrEP Pre-exposure prophylaxis
PLHIV People/person living with HIV
PWID Person who injects drugs
REC Regional economic community
SADC Southern African Development Community
SALC Southern African Litigation Centre
SAT Southern Africa Trust
SDG Sustainable Development Goal
SGBV Sexual and Gender Based Violence
SOP Standard Operating Procedure
SRHR Sexual and Reproductive Health and Rights
SW Sex worker(s)
TB Tuberculosis
TG Transgender
UNDP United Nations Development Programme
USC University of Southern California
XDR-TB Extensively Drug Resistant Tuberculosis
1. Rationale for the Project: Problem Analysis and Definition
Key populations as defined in this proposal (sex-workers, men who have sex with men, people who
inject drugs, people in prison, lesbians, gay-identified men, bisexual, transgender and intersex people)
are extremely diverse groups. What makes them ‘key’ populations is that they have in common much
higher rates of HIV and STIs than other groups and they face frequent human rights violations,
systematic disenfranchisement, violence, social and economic marginalization and/or criminalization.
These groups are also ‘key’ to the response to HIV and to improving sexual and reproductive health
(SRH) outcomes in that their engagement in advocacy for strengthened service provision and for policy
and law review is critical.
Young people, who are also members of key populations, are a neglected subset of this group. Young
key populations face additional legal, policy barriers to access to HIV and SRH services, just because
they are adolescents or young adults. It is also still rare to see their specific needs, rights and SRH issues
included in national strategies or even in civil society advocacy efforts.
1.1 Sexual and Reproductive Health (SRH) for Young Key Populations in Southern Africa
Young people aged 10–24 years constitute one-quarter of the world’s population 1 and in 15 countries
in Sub-Saharan Africa, 50% are under 18 years (UNFPA 2014). Young people are among those most
affected by the global epidemic of HIV. In 2013, an estimated 4.96 million people aged 10–24 years
were living with HIV, with young people aged 15–24 years accounting for an estimated 35% of all new
infections worldwide. 2 Young women are disproportionately affected by HIV. According to UNAIDS
estimates, in sub-Saharan Africa the number of new HIV infections among young women in the age
group 15-24 is approximately 300,000 compared to approximately 160,000 among young men in the
same age group. 3 Sexual and gender based violence, the high rate of teenage pregnancy, child marriage,
poverty and gender inequalities are some of the reasons that young women and girls in particular are at
high risk of poor health outcomes, including HIV. 4
Although it has only 6.2% of the world’s population, Eastern and Southern Africa is home to half of
the world’s people living with HIV. The region continues to be the hardest-hit by the epidemic, with
46% of the world’s new HIV infections and 42% of global AIDS-related deaths in 2015. Nearly 50%
of new HIV infections in the region in 2015 were in eight countries: Ethiopia, Kenya, Malawi,
Mozambique, Uganda, United Republic of Tanzania, Zambia and Zimbabwe (UNAIDS, 2016).
In recent years, the region has seen a reduction in new infections and more people are now able to access
treatment. These benefits are not, however, being realised for key populations. According to the
UNAIDS Global AIDS Update (2016), in sub-Saharan Africa, key populations accounted for more than
20% of new infections in 2015. Stigma, discrimination, criminalisation of same-sex relationships, drug
use and sex work, punitive laws, restrictive policies and national strategies that do not recognise their
needs in terms of service provision, compounded by high levels of sexual and gender based violence,
police harassment and other human rights violations all contribute to continued high levels of HIV
infection amongst key populations in the region.5
High rates of infection amongst key populations in Southern Africa is well documented. Statistics from
the proposed project countries show for example, that: HIV prevalence among MSM in Zambia is 17.5
compared to 12.4 %, among the adult population; 6 in Angola HIV prevalence among female sex
workers is estimated to be 7.2% against 2.4% among the general population; HIV prevalence among
female sex workers in Mozambique is 27.5% compared to 10% among the general population, while
prevalence among sex workers in Zimbabwe is 50% compared to the 14% national average. In
Madagascar, HIV prevalence among people who use drugs and MSM stands at 7.2% and 14.1%
compared to the national average of 0.4%. 7 In Zambia, HIV prevalence among people in prison is
estimated at 27.4% 8 compared to 12.4% for the general population. Transgender people are largely
invisible in research in Southern Africa but the few epidemiological studies that have been conducted
in the region have shown disproportionately high HIV prevalence ranging from 6% to 68%.9 It is also
worth noting that issues facing intersex people are not well understood or acknowledged in Southern
Africa.
Although there is less data specific to young key populations, there is evidence that they are equally, if
not more at risk of poor SRH outcomes in Southern Africa. For example, a study in the Republic of the
Congo found that HIV prevalence among MSM aged 15–19 years in 2012 was 4.5% compared to 1%
among the general population. In Zimbabwe, prevalence of herpes simplex virus 2 was found to be
around 50% among young females under 20 years selling sex, rising to 80% by the time they reached
25 years. Another study in Madagascar showed that young people aged 16–19 years who sell sex were
at higher risk of chlamydial and gonococcal infection than those aged 20 or older. 10
1.2 Political Environments for Young Key Populations and SRHR in Southern Africa
The 2030 Agenda for Sustainable Development, adopted by all African Member States, aims to leave
no-one behind and the engagement of young people is critical to achieving the Sustainable Development
Goals (SDGs). SDG 5 specifically recognises the importance of addressing impacts of gender-based
discrimination and inequalities on HIV risk and on the SRH of young women and includes indicators
on whether or not legal frameworks are in place to promote, enforce and monitor equality and non -
discrimination on the basis of sex; and on the number of countries with laws and regulations that
guarantee women aged 15-49 access to sexual and reproductive health care, information and education.
Governments have a legal obligation to respect, protect and fulfil the rights of young people to life,
health and development, and indeed, societies share an ethical duty to ensure this for all young people.
This includes taking steps to lower their risk of acquiring HIV, while developing and strengthening
protective systems to reduce their vulnerability. However, in many countries in Southern Africa,
education and health systems ignore or reject young key populations and fail to provide the information
and services, including treatment, they need to keep safe. There is also a significant lack of information
and education about sexuality and gender identity that young people in Southern Africa need to make
informed choices.
The political and socio cultural context in Southern Africa remains restrictive for young key
populations, with the exception of some regional initiatives. For example, the African Commission on
Human and Peoples Rights (ACHPR) has taken a number of positive actions, including developing
special mechanisms and passing resolutions to protect the rights of key populations including LGBTI
and people in prison. In addition, the SADC Parliamentary Forum has developed a Model Law on HIV
and in June 2016, adopted a Model Law on Eradicating Child Marriage. 11
Regional and international treaties guarantee a number of rights relevant to the sexual and reproductive
health of adolescents, including those who identify as members of key populations. These include the
right to health, the right to non-discrimination, the best interests of the child, the right to privacy, the
right to be heard, the right to free expression and freedom of thought, right to life, protection from child
abuse and torture, protection from harmful social and cultural practices, acknowledgement of the
evolving capacity of the child, and the right to the survival and development of the child. These rights
are guaranteed under the Convention on the Rights of the Child, the International Covenant on Civil
and Political Rights, the International Covenant on Economic Social and Cultural Rights, the
Convention on the Elimination of All Forms of Discrimination Against Women, the African Charter on
the Rights and Welfare of the Child, and the African Charter on Human and Peoples Rights.
In June 2011, with the UN Political Declaration on HIV/AIDS,12 Member States committed to
reviewing laws and practices that block effective HIV responses. They also committed to ensuring that
national AIDS strategies and plans protect and promote the human rights of all people, in line with
existing human rights commitments.13 The African Union (AU) Roadmap on Shared Responsibility and
Global Solidarity for AIDS, TB and Malaria in Africa launched in 2012, echoes this commitment and
has identified the need for investment in programmes to overcome social and legal barriers to uptake of
HIV-related health services. Regular annual reviews of progress of the Roadmap in this area have
furthermore noted the need to continue to strengthen rights protection for key populations.
The Global Commission on HIV and the Law’s (GCHL) report titled Risks, Rights and Health which
was launched during July 2012 14 includes a number of recommendations relevant for young key
populations, including the need to: prohibit discrimination against children affected by HIV; enact and
enforce the right of every child to comprehensive sexual health education; ensure young people have
safe access to health and HIV services; and reform laws to ensure that the age of consent for autonomous
access to HIV and SRH services is equal to or lower than age of consent for sex. Recommendations are
also made for specific key populations and include the need to: repeal laws criminalising consensual
sex between same-sex adults; remove legal, regulatory and administrative barriers to (key population)
organisations, including for them to register; ensure identity documents recognise affirmed gender;
prohibit discrimination on the basis of gender identity and sexual orientation; stop police harassment
and mandatory HIV testing; enforce laws against child sexual abuse as opposed to consensual adult sex
work; repeal punitive conditions e.g. the ban on needle and syringe exchange programs; and promote
effective measures to prevent violence against key populations.
In addition, the GCHL report has recommendations related to trafficking, including ensuring that the
enforcement of anti-human-trafficking laws is carefully targeted to punish those who use force,
dishonesty, or coercion to procure people into commercial sex, or who abuse migrant sex workers
through debt bondage, violence, or by deprivation of liberty. Anti-human-trafficking laws must be used
to prohibit sexual exploitation, and they must not be used against adults involved in consensual sex
work. Of particular interest in relation to young key populations, the GCHL report recommends that
countries enforce laws against all forms of child sexual abuse and sexual exploitation, clearly
differentiating such crimes from consensual adult sex work. Further, it encourages countries to shut
down all compulsory detention or “rehabilitation” centres for people involved in sex work or for
children who have been sexually exploited. It recommends instead, that sex workers are provided with
evidence-based, voluntary, community empowerment services and that sexually exploited children are
provided with protection in safe and empowering family settings, selected based on the best interests of
the child.
Significantly, the need to protect the rights of people in prison, women, people living with HIV and
LGBT individuals has also been explicitly recognised by The African Commission on Human and
People’s Rights (ACHPR). For instance, the ‘African Women’s Protocol’ specifically recognises the
sexual and reproductive health rights of women in the context of HIV. In 2013, The ACHPR’s
Committee on the Protection of the Rights of People Living with HIV and those at Risk, Vulnerable to
and Affected by HIV (‘the people living with HIV Committee’) urged for the adoption of legal
frameworks to protect the rights of people living with HIV and other vulnerable persons and to enhance
access to HIV treatment, care and support. Additionally, in 2013, the Resolution on Involuntary
Sterilisation and the Protection of Human Rights in Access to HIV Services was adopted by the
Commission at its 54th Ordinary Session,15 and a resolution (“Resolution 275”) on Protection Against
Violence and other Human Rights Violations Against Persons on the Basis of their Real or Imputed
Sexual Orientation was adopted in 2014 during the 55th Ordinary Session of the Commission.16 The
Special Rapporteur on Prisons, Conditions of Detention and Policing in Africa has also reported on HIV
in its country reports on human rights protection for people in prison in various countries.
1.3 HIV/SRH-Related Human Rights of Young Key Populations in Southern Africa

Despite the guarantees and commitments at global and continental levels, significant gaps remain in
national and regional legal environments. There is also a lack of national alignment with these
international and regional commitments. This is echoed in regional and national policy and strategic
frameworks with the result that young people in Southern Africa face significant barriers to accessing
HIV and SRH services. Young key populations face many hurdles in existing law and policy: punitive,
discriminatory, conflicting and age restrictive laws and policy in relation to age of consent to sex,
marriage, access to HIV testing, contraceptives, abortion and SRH services; overly broad laws and
policies to protect against sexual exploitation; mandatory parental consent notification requirements;
and restrictive policies relating to access to SRH services and commodities in schools and prisons and
to Pre-Exposure Prophylaxis (PrEP).
Many countries in Southern Africa do not provide for the age at which adolescents can independently
consent to specific SRH services, such as HIV testing, contraception, and abortion, if lawful. For
instance, Zambia does not, under law, provide for the age at which adolescents can independently
consent to obtaining contraception and this lack of specific provisions in the law has resulted in part in
the low rates of contraceptive use by adolescents in Zambia. 17 In addition, conflicting laws regarding
the age of consent to sex (including differing ages of consent to heterosexual versus homosexual sex,
where same-sex sexual relationships are lawful), marriage and access to sexual and reproductive health
and rights (SRHR) create uncertainty amongst service providers, creating further barriers to access to
services for young people.
The failure to provide for a specific age of consent violates international and regional law, particularly
the right to health, among others. Countries have also failed to adequately address child marriage within
national frameworks despite significant evidence linking child marriage with negative health impacts
on adolescents. 18 For instance, Angola legally prohibits the marriage of anyone under 18. However,
under the law it permits the marriage of girls aged 15 and over and boys aged 16 and over with parental
consent or if in the best interest of the child. 19 Such legal exceptions increase the likelihood of higher
rates of child marriage and can violate rights under international and regional law. The rights potentially
violated include the right to non-discrimination and the protection against harmful social and cultural
practices and child abuse.
Even where there are adequate legal protections, young people are not aware of the legal protections
and appropriate officials fail to implement and enforce the legal protections. For instance, Swaziland
legally provides for abortions in cases of rape under its Constitution. However, access to abortion
services in cases of rape is difficult as most rape victims are not aware that abortion is legal in cases of
rape and there are other barriers, not least the various evidentiary requirements to prove rape in the first
place. In part due to this, unsafe abortion is common, accounting for 50% of all obstetric complications
and 37% of health facility based maternal deaths. 20 Depending on the context, the failure to provide
access to legalized abortion services can violate the right to non-discrimination and the right to health.
In terms of gender and young key populations and the law, Southern African laws that promote and
protect gender equality are either lacking or not adequately enforced. Equality/anti-discrimination laws
that prioritize gender equality are often lacking as are employment laws protecting gender equality in
the workplace and personal laws (e.g. marriage laws, personal status laws) that provide women and men
with equal rights. Laws that specifically recognize the vulnerability of young women and girls to HIV
and provide for equal access to health care without discrimination for women are also not
comprehensive.
Young people in general bear the burden of confusing legal and policy environments in relation to HIV
and SRH. Young people who are also members of key populations face these legal and policy barriers
and more besides. A summary of issues for each specific key population is detailed below:
Sex Workers: Sex work, or aspects of sex work such as public soliciting, living on the earnings
of sex workers, brothel keeping, procurement etc., is criminalised in 35 AU Member States.21
Enforcement efforts, punitive sanctions, and the threat of violence can deter young sex workers
from accessing HIV prevention services, constrain their ability to negotiate condom use, and
prevent the roll-out and rigorous assessment of HIV interventions.22 In Kenya, the
implementation of vague loitering laws, that are open to interpretation by law enforcement, has
presented barriers to the scale-up of targeted services for sex workers.23 Human rights violations
against sex workers, including violations of the right to health, freedom from arbitrary detention
and from torture and other cruel, inhuman and degrading treatment, have been documented in
Kenya.24 Sex workers interviewed in Malawi, Botswana, Namibia and South Africa reported
fear of and routine police abuse including sexual violence and beatings.25 Police extort money
and confiscate condoms in a context of police raids where sex workers are unlawfully arrested
and detained. Often condom possession is used by police as a pretext for detaining sex workers
without cause and holding them in custody without filing any formal charges or obtaining a
warrant for arrest. In several countries, including Kenya, Namibia and South Africa, sex
workers report that police and prosecutors cite condom possession as “evidence” of a person’s
engagement in sex work, to justify an arrest (make a probable cause determination) and/or as a
basis for a conviction on prostitution related charges.26
Young sex workers are extremely vulnerable to risks of unwanted pregnancies, 27 HIV and other
STIs, due to their relative inexperience, youth and lack of assertiveness with clients. However,
in only very few countries, has there been nationwide scale-up of HIV programmes specifically
for sex workers and very few attempts to work with young sex workers. Most programmes
across Southern Africa have limited scale, scope and coverage. Violence, stigma and
discrimination and criminalising laws and by-laws (particularly targeting sex work/sex
workers) are all major contributing factors. There is also strong evidence that the
criminalisation of sex work increases vulnerability to HIV and other sexually transmitted
infections.28 Studies suggest that decriminalisation of adult sex work generally would have the
greatest effect on the course of HIV epidemics across all settings, averting 33–46% of HIV
infections in the next decade globally.29
Women who have sex with women: While very little HIV transmission results from sex
between women, structural factors, including sexual violence, make lesbians and other women
who have sex with women more at risk of acquiring HIV than would otherwise be thought.
Violence against lesbian women has been well-documented in South Africa, where lesbian
women are specifically victims of what has been termed as ““corrective rape””.30 A review
done by Action Aid in 2009 on “corrective rape” in South Africa noted that such violence
increased the women’s risk to HIV and sexually transmitted infections.31 An AMSHeR and
CAL report on violence against persons based on real or perceived sexual orientation and
gender identity similarly found that sexual assault led to, amongst other things, unintended
pregnancies and HIV transmission.32 Stigma, discrimination and lack of knowledge regarding
lesbians and other women who have sex with women is also thought to make such women less
able to access appropriate HIV treatment and care services if they are infected.33
Gay men and other men who have sex with men: Some men who have sex with men in
Africa identify as gay or bisexual men, others do not. Over 30 Member States of the African
Union (AU) criminalise same-sex relationships in some way. Some countries allow for life
imprisonment and even the death penalty for those convicted.34 These legal frameworks expose
these populations to targeted harassment, violence and marginalization from health care and
other service providers.35 In some countries, laws also ban organizations that represent or
support lesbian, gay, bisexual or transgender individuals and discourage service providers from
reaching these communities.36 Some outreach organizations and health service providers have
stopped or reduced the scope of their activities because of fear of harassment and prosecution.37
There has, however been some progress. In 2015, Mozambique became the latest African
country to decriminalize consensual relations between persons of the same sex by removing
colonial era provisions on "vices against nature" as part of a wider reform of the Penal Code.
Transgender People: There is a significant lack of visibility and recognition of the rights of
transgender people in Southern Africa. Laws rarely recognize the right of a transgender person
to have their self-identified gender in personal documentation and records. Countries that do
not allow legal gender recognition or have highly restrictive laws or regulations for changing
name and sex violate fundamental human rights obligations.38 This lack of recognition impacts
on access to employment, health care and participation in society, which can increase
vulnerability to HIV 39 - as documented, among others, in studies from Kenya and South
Africa.40 These laws have also been used to limit the right to association, although this right
was recently guaranteed through a court ruling in Kenya allowing the registration of a
transgender rights organisation.41 Economic marginalization, social isolation, unmet health
needs and low HIV-related knowledge further increase vulnerability. Many transgender people
experience difficulty accessing health care; those who were able to access health care reported
abuse from health care providers.42 Very few health care workers ranging from HIV counsellors
to nurses and physicians have received any training on addressing the specific health needs of
transgender people. Consequently, consistent access to competent clinical prevention,
treatment, or care services is rare for people belonging to this group.43 It is understood that each
level of marginalisation drives HIV risk for transgender people and is often supported by
existing national legal frameworks which contradict international human rights frameworks.
Intersex People: Intersex people in Africa can be vulnerable to violations of their human
rights, making them more vulnerable to HIV. Intersex children are subjected to surgical and
hormonal procedures, without their consent and without any medical need, with the sole
purpose of ‘normalizing’ the external appearance of their genitalia. These are irreversible
medical practices and often result in genital insensitivity, sterilization, physical and mental
trauma. Intersex persons also face stigma and discrimination at different levels, including in
accessing proper health care, education, sanitation, and sports. Further, most countries in Africa
do not have legal provisions permitting individuals to change their gender marker on critical
identification, such as school and birth certificates, resulting in intersex persons having
difficulty in obtaining employment and housing. Finally, there is limited research and
understanding of the particular vulnerabilities to HIV intersex persons face resulting in little
targeted programming for intersex persons in the HIV response.
People who inject drugs: Few countries in Southern Africa are providing services to people
who use drugs, and where services do exist, access remains inconsistent due to criminalization
and marginalization of this community. Discrimination within the health care sector and fear
of being reported to the police and other authorities by health workers hinders access to medical
and drug treatment. Criminal laws, disproportionate penalties, and punitive law enforcement
practices exacerbate stigma and result in human rights abuses, including police mistreatment,
arbitrary detention, and denial of essential medicines and health services. Legal prohibitions on
the provision of sterile needles and opioid substitution therapy directly impede HIV prevention
efforts. Testimonies confirm that police raids and arrests of centres and outreach workers
impede service delivery and keep people who use drugs away from services, resulting in an
increase of risky behaviour.44 A study among people who use drugs in Kenya found that nearly
one third had been arrested by the police or had their injecting equipment confiscated in the
previous six months.45 In the Seychelles, 8% of people who inject drugs reported being refused
a service in the past 12 months because of their injecting drug use and just over 50% had been
arrested in the past 12 months.46 The National Drugs Enforcement Agency in the Seychelles is
also reported to throw away needles and syringes when effecting arrests, leading to sharing of
needles amongst people who inject drugs and exacerbating the risk of HIV exposure.47
Respondents to the Mauritius People Living with HIV Stigma Index study, 60% of whom
identified themselves as people who inject drugs and 40% of whom reported to be ex-detainees,
consistently identified a pattern of stigma and discrimination in health care settings, including
denial of access to sexual and reproductive health and rights. Over one quarter of respondents
reported avoiding going to hospital when needing care.48 Young women who use drugs are
often especially disadvantaged when harm reduction services, if they exist, do not pay attention
to SRH needs beyond HIV.
People in prison: The HIV burden among people in prison in some settings may be up to 50
times higher than in the general population. 49 Prisons are often overcrowded due in part to
inappropriate, ineffective and excessive criminal laws. People who are already more likely to
be exposed to HIV, including people who use drugs, sex workers, and gay men and other men
who have sex with men, are overrepresented in prisons. Overcrowding and lack of hygienic
sanitation increases vulnerability to infections such as HIV, tuberculosis and hepatitis. People
in prison are also at risk of violence and disruption in HIV prevention and treatment services,
including access to harm reduction measures. Young people in prison can also be exposed to
sexual abuse. 50 Despite international standards that require the provision of health services in
prisons, 51 ill-equipped prisons, overcrowding and the denial of treatment in these settings is
contributing to the TB epidemic and emergence of MDR and XDR-TB in Southern Africa.52
The frequent use of pre-trial detention and lack of affordable bail contribute to overcrowding
and its negative effect on prison health.53 Additionally, criminal laws prohibiting same-sex
sexual activity, and correctional laws prohibiting sex in prisons, are often raised as a barrier to
providing condoms in prisons. Many countries do not allow for distribution of condoms in
prisons, since sexual activity is forbidden, but there is evidence that condoms can be provided
in a wide range of prison settings—including in countries where same-sex activity is
criminalized such as Lesotho — and that people in prison use condoms to prevent HIV infection
during sexual activity when condoms are accessible in prisons.
There are, therefore, substantive gaps in legal and policy frameworks in Southern Africa and a
significant lack of alignment in many cases with regional and international treaties and commitments.
In order to improve HIV/SRH outcomes, there is an urgent need to strengthen and monitor HIV/SRH
legal, policy and strategy environments for young key populations.
1.4 Capacity of Key Actors in Southern Africa in HIV/SRHR for Young Key Populations
Key actors in strengthening legal, policy and strategy environments and access to justice for young key
populations include parliamentarians, the judiciary, health and other policy makers, lawyers and law
enforcement officials, National Human Rights Institutions, members of key populations and human
rights CSOs. Most of these key actors are largely unaware of the needs and rights of young key
populations. 54 There is confusion about age of consent issues and the status of civil versus customary
law and there is a lack of data and knowledge on legal and policy barriers to services.
Law and policy reform and enactment in most African countries is done by all three branches of
government: the executive, the legislature (parliament) and the judiciary. It is critical to engage with all
three branches of the government in order to create enabling environments that promote access to SRHR
for young key populations. Parliament is generally tasked with enacting laws and managing and
engaging in any process of reforming laws. Parliamentarians often lack understanding of how
discriminatory and punitive laws create barriers to access to SRHR for young key populations. The
executive, which includes a number of relevant ministries, such as the Ministry of Health, has a number
of relevant roles, including initiating legislation and policies, leading policy reform and inputting on
any legal reforms. The executive also creates guidelines, plans and protocols for the implementation of
services. It is important that the executive understand the needs and rights of young key populations so
that they can advance appropriate laws, policies and plans and implement programmes that include and
prioritise the rights of young key populations. The judiciary, often overlooked, also plays a significant
role in law and policy reform. Unlike Parliament and the executive, the judiciary generally can only
engage in law and policy reform when approached by individuals either challenging a particular law or
policy or requesting the court to order the Parliament or executive to enact particular laws or policies.
Once approached, the judiciary can issue orders resulting in the change in laws and policies. All of this
plays an important role in creating a protective environment for young key populations in the context
of HIV. Work with the Africa Judges Forum has shown gaps in understanding of the judiciary regarding
key population issues. Sensitising members of the judiciary to the ways in which discriminatory,
punitive and conflicting laws, policies and practices impact on access to SRHR of young key
populations will encourage progressive jurisprudence that protects and promotes their health rights.
Finally, it is also critical to find a way to work with those who implement and enforce these laws,
policies and plans on the ground in order to promote access to SRHR for young key populations. Health
care providers and law enforcement officials find it hard to make sense of conflicting laws and policies
regarding age of consent to sex, medical treatment, HIV testing and access to contraception. There is
also resistance to challenging stigmatising attitudes towards young people’s sexuality and to
recognising the impact of violence and harassment of key populations on their health and wellbeing.
This is compounded by the fact that health service and law enforcement policies and strategies relevant
to young key populations are not conducive to service access. In addition, training curricula for service
providers and law enforcement officers need updating to include attention to the needs and rights of
young key populations.
In order to ensure that rights of young key populations are respected in law, policy and strategy, there
is an urgent need, therefore, for capacity strengthening, including legal literacy of key stakeholders such
as police, members of parliament, policy makers/the executive, the judiciary, health care workers, and
members of key populations.
1.5 Linking HIV/SRH Policy to Service Provision in Southern Africa

Experience from other regions shows that if young people are involved in policy-and decision-making,
their needs are more likely to be met. However, young key populations are rarely, if ever, involved in
policy development or consulted during law reform and there are no real-time mechanisms that link
experiences of service provision with policy. As a result, governments do not have access to appropriate
information which would enable them to adequately fund research, prevention, treatment and care for
In addition, as noted above, HIV and SRH service-providers are often poorly equipped to serve young
key populations, while the staff of programmes for young people may lack the sensitivity, skills and
knowledge to work specifically with members of key populations. 55 One fundamental barrier to
ensuring that young key populations are involved in decision-making and programme planning
processes is the lack of a reference group that is representative of broad key population constituencies
and which is legitimate in the perception of both the key population communities and government.
Young key populations need support to organise credible representation which can advocate for
strengthened legal and policy frameworks and for better service delivery. At the same time, the capacity
of key population organisations to meaningfully engage in policy development, advocate for improved
service delivery and to work with broader networks of human rights and HIV service organisations
needs to be strengthened. A key population- led advocacy forum needs to be formally established at
national level to act as an advisory and monitoring group on the inclusion of the needs of young key
populations in law reform, policy, strategy and national proposal development. This advocacy forum,
once recognised by government, can input into national HIV strategic plans, Global Fund and PEPFAR
programming, into national youth development policies, and other policies – including and importantly
relating to HIV/SRH rights and service delivery. Indicators on the service delivery needs of young key
populations need to be developed and nationally recognised and the WHO requirements for
comprehensive programming for key populations need to be put in place and implementation
systematically monitored. 56
Opening up and safeguarding this type of space for civil society advocacy is critical to ensure
government accountability on delivering HIV and SRH services and ensuring rights for young key
populations. In addition, having a representative reference group can serve to strengthen existing
coalitions, reaching out to less like-minded partners and linking regional and national discussions to
local realities. There is, therefore, an urgent need to pilot and scale-up ways in which civil society can
use community inputs to influence policy development and strengthen service provision.
1.6 Strengthening Data and Understanding of the Process of Law/Policy Reform

At the time of writing, while project countries all have indicators in their National Strategic Plans
(NSPs) for young people and for key populations (separately), there are as yet no national indicators
that track progress in addressing the rights and needs of young key populations. In order to make in-
country strategies and programs more responsive to the specific rights and needs of young key
populations, appropriate indicators need to be developed and inserted into NSPs. However, as
mentioned before, there is a paucity of data on these groups. This not only pertains to data on disease
prevalence and incidence but also to insights on the barriers to access to HIV/SRHR services as
perceived by different key populations, as well as by policy makers and service providers. Data is also
needed on the special needs of the different young key populations and the implementation gaps at
country level in responding to these needs. This knowledge will serve as an important input for the
development of appropriate indicators for country plans and to inform policy reforms.
In addition there is little data on law and policy reforms which are known to be complex and lengthy
processes. Several models exist in the literature, describing the process of policy reform. A commonly
used model is the ‘Phase model’. According to this model, policy decision-making occurs in phases
(policy formulation, adoption and implementation), and is led by a single actor; often the government
of a country. More recent insights are that the policy process is not only shaped by the decisions of
individual actors but by the interactions between the decisions taken by several actors.57 A greater
insight into law and policy reform processes that leads to a reduction or removal of barriers to service
access for young key populations will be valuable for inspiring and driving further change in SADC
and the continent at large.
There is a near universal acceptance that an imperfect knowledge base should not constrain
comprehensive attempts to change policy – particularly for vulnerable communities. WHO expresses
the position thus: “We must learn by doing…. We do not have pre-set solutions to the problems that
will arise. For this reason, mechanisms for ongoing evaluation and analysis of programme performance
and a focused agenda for operations research (OR) are crucial.” There is, therefore, a need not only to
strengthen data for national policy, planning and indicator development, but to conduct operational
research on barriers to SRHR for young key populations, service needs and gaps and cross-country
comparative analysis of change processes.
2. Proposal Development
Using the problem definition set out in the above analysis, a short concept note was developed which
was used as the basis for this proposal. During the development of the proposal, the consortium took
into account considerations regarding country selection, how to involve key stakeholders in proposal
development, what lessons have already been learned that the proposal can build on and what synergies
can be exploited with other initiatives in order to maximize the impact of the project. These are outlined
in the sections below.
2.1 Country Selection

There are 15 countries in SADC. In order to develop a project that focuses on a smaller number of
countries but which can impact on a larger number, countries were selected on the following criteria:
a) High HIV prevalence amongst key populations

b) High levels of stigma, discrimination and violence against key populations
c) National law/policy for young key populations restrict access to HIV/SRH services
d) High levels of gender-based violence, child marriage, teenage pregnancy and HIV infections
amongst young women58 59 60 61
e) No Legal Environment Assessment (LEA) for HIV/SRH completed
f) Different political and penal systems that remain as legacies from the British, French and
Portuguese colonial powers – to inform the cross-country analysis and potential for broader
application of the project interventions
g) Consortium has offices and partners to facilitate implementation
h) Possibility of cross-border interventions
i) All 3 SADC languages covered (to ensure wide dissemination of materials)
j) Results can leverage funding (notably GFATM)
Using this criteria, Angola, Mozambique, Zambia and Zimbabwe were selected as project countries.
Madagascar was added because the National HIV response focuses on key populations, because
injecting drug use has been documented in the country and because there has been relatively little recent
support provided to Madagascar due to political upheaval. The sections below gives a brief background
for each country, showing the current status relating to HIV and sexual and reproductive health and
rights for young key populations as far as is known, and specific areas that could potentially be
strengthened by the project.
Angola is a Southern African country with a population of 24.3 million.62 It is a SADC Member
State and the adult HIV prevalence in Angola is estimated at 2.3%. 63 HIV prevalence among
female sex workers is estimated at 7.16%. 64 HIV prevalence among young women aged 15-24
years of age at 1.1%,65 which is almost double the prevalence among young men of the same
age group (0.6%).66 According to the SADC Gender Barometer (2014), HIV prevalence among
MSM in Angola is 8%.67
Angola has an HIV-specific law on HIV and AIDS dating back to 2004 which contains both
protective provisions for people living with HIV, as well as punitive provisions that place
obligations upon people with HIV, such as women with HIV, to disclose their status. The HIV
law also makes the intentional as well as the negligent transmission of HIV a crime punishable
under the Penal Code. It makes no mention of the rights of key populations. Reported stigma
and discrimination faced by people living with HIV is very high; the INCAPSIDA 2010
reported 51% of people living with HIV complained of stigma and discrimination.68
There is a high level of stigma and sexual and gender-based violence with Angola’s 2014 report
to UNAIDS indicating that 23% of women reported having experienced physical or sexual
violence.69 The law on domestic violence does not specifically criminalise marital rape. A
review of age of marriage laws in SADC region in 2015 showed that Angola legally prohibits
the marriage of anyone under 18 without the consent of the parties to the marriage. However,
under the law it permits the marriage of girls aged 15 and over and boys aged 16 and over with
parental consent or if in the best interest of the child.70 Concern has been expressed over the
large number of girls married before 17 years, especially those married to partners who are 10
or more years older. 71
The National Strategic Plan (NSP) for Angola has indicators that focus on HIV prevalence,
knowledge about HIV as well as sexual behaviour among young people (women and men). The
NSP has indicators that measure/focus on condom-protected sex, the reach of HIV prevention
services among MSM, HIV testing among MSM/key populations and proportions of key
populations and LGBT living with HIV.
However, legal barriers to access to services exist for key populations. Although the provision
is vague and not often enforced, the Penal Code criminalises adult consensual same sex
relationships and has highly punitive laws for people who inject drugs.72 Angola’s prisons are
significantly overcrowded and it has one of the highest rates of pre-trial detainees.73 Further,
there is a lack of clarity in the law as to the age of consent to HIV testing and access to
contraceptives, among other sexual and reproductive health services.
Examples of key areas to strengthen: Build capacity to review the HIV law to remove
punitive provisions and promote effective enforcement of protective laws to strengthen the
rights of women and girls and key populations; strengthen laws and their implementation and
enforcement to address the high level of sexual and gender based violence; review the Penal
Code which criminalises same sex relationships; strengthen NSP indicators to include issues
affecting young key populations; address the law regarding the minimum age of consent to
marriage; review laws related to age of consent to sexual and reproductive health services;
review laws and policies related to people in prison; strengthen policy relating to service
provision for young key populations.
Republic of Madagascar, an island nation in the Indian Ocean, and a member of SADC, with a
population of around 22 million.74 In 2009, the country experienced a violent political crisis,
following the overthrow of the former President by the then Mayor of Antananarivo, backed by
some elements in the army. This unconstitutional change of power resulted in the country’s
suspension from all international fora. The country was readmitted to the African Union in 2014
following successful elections held in 2013.
HIV prevalence in Madagascar was estimated at 0.4% in 2013.75 The epidemic is concentrated
among populations at high risk of infection (key populations). 2012 national data says that HIV
prevalence among female sex workers is 1.3%, among MSM 14.9%, and 7.1% among people
who use drugs. Additionally it is noted that a high proportion of MSM (79%) sell sex.76
Madagascar’s response to the HIV epidemic has been characterised by strong political
commitment and the National AIDS Council is chaired by the president of the country.
Same-sex sexual activity among persons at least 21 years of age is legal in Madagascar. The
Penal code carries provisions of prison (2 to 5 years) and fines in case of acts that are “indecent
or against nature with an individual of the same sex under the age of 21”. However, a US State
Department Report (2011) found that “sexual orientation and gender identity were not widely
discussed in the country, with public attitudes ranging from tacit acceptance to violent rejection,
particularly of transgender sex workers”. The report also found that, “LGBT sex workers were
frequently targets of aggression, including verbal abuse, stone throwing, and even murder,” and
commented that general attitudes were homophobic.77
The Penal Code protects women from domestic violence; however it is narrowly defined as
physical abuse and marital rape is not explicitly criminalized. The HIV law, although generally
protective, contains punitive provisions criminalizing both intentional and negligent HIV
transmission. Access to justice is weak and people are generally reported to have limited
awareness of their rights in the context of HIV and AIDS. Law No 97-039 of 11/04/1997 deals
with drug control and criminalises the provision of any equipment that may facilitate the use of
drugs.78 This provision creates a barrier to the provision of harm reduction services (such as
needle-exchange programmes) for people who use drugs. 79
The HIV response in Madagascar focuses primarily on young people and key population
groups: MSM, sex workers and people who use drugs. The NSP reflects this with indicators
focusing on measuring HIV testing and trends among young people, key populations and also
has measures to understand prevention and treatment coverage for sex workers, MSM and
people who use drugs.
The legal age of marriage in Madagascar is 18. The Family Law of Madagascar raised the
minimum age for marriage from 14 years for girls and 17 for boys, to 18 years for all children.
However, the President of the Court may authorize a marriage upon the request of the child’s
parents or guardian and the consent of the child.80 In practice child marriage continues at
alarming rates. The UNFPA CPD (2014) for Madagascar states that 48% of girls are married
before adulthood; with more than 40% of girls become mothers before they are 18 years (early
sexual debut). In addition there is lack of sexuality education and weak access to services. 81
The age of consent to sexual activity is provided at 14 years of age. However, the law is unclear
as to the age of majority and thus, the age of consent to HIV testing and contraceptives, among
other sexual and reproductive health services is unclear in the law. As of 2011, the World Bank
found that contraceptive use among women is under 40%.82
Madagascar’s people in prison are severely overcrowded. According to UNODC as of 2007,

the prisons in Madagascar is between 120-170 percent above planned levels.83 Further, the
percentage of pre-trial detainees is one of highest in Africa.
Examples of key areas to strengthen: Build capacity to review the HIV law to remove
punitive provisions criminalising HIV transmission, strengthen laws and policies protecting
against child marriage and promoting sexuality education, and on age of consent to sexual and
reproductive health services, including contraceptives; review laws, policies and practices
related to people in prison; prevent and address human rights violations against young key
populations; develop mechanisms for access to justice for young key populations; strengthen
policy relating to service provision for young key populations; review NSP indicators to better
address the needs of young key populations.
Mozambique is a member of SADC, and has an estimated population of 24.7 million (2014
estimate). With an adult HIV prevalence 10.6%, Mozambique ranks as the country with the 8th
highest prevalence of HIV.84 HIV prevalence among young women aged 15-24 is three-fold
higher (11.1%) than among their male counterparts (3.7%). Prevalence studies among female
sex workers in 3 main cities in Mozambique in 2011 showed that the estimated HIV prevalence
was 31.2%, 23.6%, and 17.8% among FSWs in Maputo, Beira and Nampula, respectively. A
similar HIV prevalence study among MSM showed the estimated prevalence to be 8.2%, 9.1%,
and 3.7% among MSM in Maputo, Beira and Nampula/Nacala, respectively.85
A 2012 Stigma Index Survey completed by the national network of people living with HIV,
RENSIDA, showed that HIV-related stigma and discrimination remains a concern and impedes
the national response to HIV in Mozambique, resulting in barriers to access to HIV-related
health care services.8687 Women report discrimination on the basis of their HIV status, including
being evicted from their homes and abandoned by their husbands when their HIV status
becomes known. 88
As mentioned above, in 2015, Mozambique became the latest African country to decriminalize
consensual relations between persons of the same sex by removing colonial era provisions on
"vices against nature" as part of a wider reform of the Penal Code. Despite this, sexual
minorities have reported various forms of discrimination89 and have been denied the right to
form support organisations with legal status, despite constitutional protection of the right of
association. Sexual minorities report being denied public health services when they disclose
their sexual orientation or practices or being discouraged from using the services and disclosing
their health needs due to the attitudes and practices of health care providers (e.g. during HIV
testing and counselling sessions).90 However, Mozambique has labour laws prohibiting
discrimination on the basis of sexual orientation. This is important to note because in Botswana,
during the LEGABIBO case, the fact that there was a similar labour law whilst at the same time
Penal Code provisions on same-sex sexual acts, led to the Court of Appeal concluding that
homosexuality is not a crime and that LGBT persons have the same rights as anyone else.
From 2013-2015, Mozambique reviewed its two HIV-related laws, the Law 02/2005 focusing
on HIV in the workplace, and the Law 12/2009 against stigma and discrimination of people
living with HIV and AIDS, with the aim to consolidate the provisions, provide protection for
vulnerable and key populations and remove provisions criminalising HIV transmission.
Mozambique is amongst the 10 countries top in the world with the highest rates of child
marriage, with over 50% of children married before they are 18 years of age,91 despite the fact
that the Mozambique Family Law Act (2004) prohibits marriage for children under 18 years of
age. Further, Mozambique sets the age of consent to sexual activity at 18 and the age of consent
to HIV testing at 16. However, the age of consent for contraceptives and for accessing other
sexual and reproductive health services is unclear in the law.92
Mozambique has the highest percentage of pre-trial detainees with almost 75% of its prison
population being pre-trial detainees as of 2007.93 Further, the prisons continue to be severely
overcrowded.94
Examples of key areas to strengthen: Build capacity to review law and policy
implementation on child marriage; review laws, policies and practices related to people in
prison; address age of consent to sexual and reproductive health services; strengthen access to
justice for young women and young key populations; adjust relevant policy based on recent
review of Penal Code; strengthen policy relating to service provision for young key
populations; review NSP indicators to address the needs of young key populations.
Zambia, a SADC Member State has a population of 16.2 million (2015 estimate),95 and the adult
HIV prevalence in 2013-14 was 13.3%, of which prevalence among women (15.1%) was higher
than in men (11.3%).96 Drivers of HIV transmission, which equally lead to sexually transmitted
infections and unintended pregnancies, include high levels of transactional sex, multiple sexual
partners and gender-based violence (17% among women and girls aged 15-49 years). In
addition, some 45% of girls aged 25-49 years were married by age 18 and 65% by age 20.97
The legal age of marriage is 21. However, children 16 and older can marry with parental
consent.
There is no anti-discrimination law relating to HIV and AIDS. Women with HIV report high
levels of stigma and discrimination within their families and communities including being
forced from their family homes.98 They also report discriminatory treatment within the health
care sector, including reports of coerced terminations of pregnancy and coerced sterilisations.99
The Gender Based Violence Act´s definition of sexual abuse, read with the Penal Code, may
criminalise a wide range of acts, even those with limited risk of HIV transmission that may
expose a person to HIV exposure in the event of non-disclosure of HIV status.100 The Zambian
Penal Code (Sec. 155, 156 & 158) criminalises same sex relationships. Additionally, the issue
of key populations and LGBTI people and their access to HIV and SRH services are deeply
contested in the country. The Zambia NAC included LGBT and key population representatives
in reviewing the NSP in 2013 with the result that key populations were formally included in
the response for the first time. In addition, the representatives from the key population group
also supported the Zambia NAC in developing their Global Fund Proposal.101
The Narcotic and Psychotropic Substances Act lists methadone, buprenorphine and naloxone
as controlled substances thereby preventing people who inject drugs from accessing opioid
substitution therapy, which is a critical component of the comprehensive package for
preventing HIV among people who inject drugs. The Act further limits any harm reduction
interventions for people who inject drugs and refers to harm reduction as “aiding and abetting”.
The HIV response focuses on the general population primarily in response to the nature of the
Zambian epidemic. Indicators focus on HIV prevalence among young men and women, testing
and treatment and on sexual debut for young people. In the NSP the ‘key populations’ are
defined as people living with HIV, women and children, adolescents (10-14), young people
(15-24), people with disabilities, people in prison, sex workers and their clients, migrant and
mobile populations.
Zambia does not, under law, provide for the age at which adolescents can independently consent
to obtaining contraception and this lack of specific provisions in the law has resulted in part in
the low rates of contraceptive use by adolescents in Zambia.102
The poor state of Zambia’s prison has been well-documented. Prisons are significantly
overcrowded. The Zambia Human Rights Commission found in 2013 that all prisons were at
overcapacity. Most notably, the capacity of the Mongu Central is 180 but as of 2013 it housed
a population of 570.103 Further, Zambia has refused to provide condoms to people in prison,
increasing people in prison’ vulnerability to HIV.104 Section 19 of the Prisons Act105 classifies
committing sodomy as a major prison offence106 and prevents the distribution of condoms in
prisons.
Examples of key areas to strengthen: Build capacity to strengthen anti-discrimination

protection for populations in the context of HIV and AIDS; review law and policy and its
implementation on child marriage, criminalisation of HIV non-disclosure and on
criminalisation of same sex relations; strengthen access to justice for young women and key
populations; review law and policy relating to service provision and consent for young key
populations; review NSP indicators to include young key populations; and review laws, policies
and practices related to people in prison, including practice of not providing condoms.
Zimbabwe, a SADC Member State, with a population of 13 million (Census 2012),107 has an
adult prevalence rate of 15%. The country has an estimated 1.2 million people living with HIV,
the third-largest HIV burden in Southern Africa. HIV prevalence among women aged 15-24
years is 1.5 times higher than their male counterparts.108 Fear of stigma and discrimination
remains a barrier to seeking services by males, in particular key populations and young
people.109
The adolescent fertility rate is estimated at 120 births per 1,000 women aged 15-19 years.
Around 20% of women aged 20-24 years have had at least one live birth before the age of 18.
Barriers to reduce teenage pregnancy are sociocultural norms; high school drop-outs; limited
access to contraception; household poverty; lack of comprehensive sexuality education, both in
schools and communities; and low coverage of youth-friendly services at public health
facilities. Thirty percent of women aged 15-49 years have experienced physical violence since
age 15 and 18% of women have experienced it within the past 12 months. The 2012 census
indicated that 31% of girls and boys were coerced into marriage. This is due to social norms
denying conjugal rights; manhood and bride price; household poverty; religious practices;
infidelity and polygamy; and harmful traditional practices such as forced virginity testing. 110
Despite the gains in legal equality, women continue to experience high levels of inequality in
society, particularly in rural areas. Inequality is pervasive in customary laws and practices and
women are treated as minors with limited rights to own and inherit property. Women do not
have equitable access to property and inheritance or adequate access to sexual and reproductive
health services.111
Sodomy and ‘deliberate transmission of HIV’ is criminalised in Zimbabwe ‘Criminal Act of

2005’. Section 79 of the Criminal Law (Codification and Reform Act) contains an exceptionally
broad criminalisation provision, making it potentially applicable to a wide range of acts.
Activists have also recorded instances of violence against LGBT persons by law and order
forces (GALZ, 2014) in the country.
In the 2011-2015 National Programme, ‘key populations’ were defined as female sex workers
and MSM. The NSP also measures proportion of key populations who have been reached with
HIV services.112
The age of consent to heterosexual sexual activity and HIV testing is set at 16. Adolescents
below the age of 16 years cannot give consent to HIV testing; they require the consent of a
parent or legal guardian for an HIV test. The age of consent for accessing contraceptives and
other sexual and reproductive health services is unclear. This limits access to HIV prevention
services, such as testing and condoms, for young people and delays treatment for children
without parents or guardians. As of 2011, the contraceptive prevalence rate in Zimbabwe was
only 65%.113
The Committee on the Rights of the Child has raised concerns at the fact that children in
Zimbabwe are subjected to criminal liability at 7 years of age and the lack of a clear legal
prohibition of life imprisonment without the possibility of release and the indeterminate
sentencing of young people. Recently, the Zimbabwe Prisons and Correctional Services has
indicated it will consider distributing condoms in prison, a positive step towards decreasing
people in prison’ vulnerability to HIV.114
There are reports that in Zimbabwe the police still arrest sex workers for loitering for the
purpose of prostitution although the offence no longer exists – clearly pointing to the need to
strengthen capacity of law enforcement officials.
Examples of key areas to strengthen: Build capacity to address the high level of sexual and
gender based violence and gender inequality; review criminal laws which criminalises same
sex relationships and transmission of HIV; review laws, policies and practices related to sex
workers and people in prison; address laws relating to the age of consent to sexual and
reproductive health services; strengthen NSP indicators to include issues affecting young key
populations; strengthen policy relating to service provision and consent for young key
populations.
2.2 Involvement of Key Stakeholders in Proposal Development

Apart from the Consortium members, the following key population groups were consulted in the design
of the original concept and reviewed the proposal: GALZ, Zimbabwe; IRIS, Angola; LAMBDA,
Mozambique; Trans Bantu Zambia and FIMIZORE Madagascar.
Their inputs helped to define the involvement of civil society and key population organisations in the
project, to firm up the design of community-led interventions (see below, interventions 6 and 7) and to
identify potential partners and allies at country level. They also suggested that the budget include time
for a project officer 100% time per country and demonstrable and progressively increasing voices and
participation of young key populations within the governance structure of their own organisations as an
outcome of the project for civil society. In addition, they suggested a platform for sharing learning and
experiences on the project among the participating countries – meetings of representatives of the
advocacy working groups from each country. Their suggestions have been included in the proposal and
budget.
GALZ Zimbabwe - is a voluntary membership organisation established in 1990 to serve the needs of
the LGBTI community in Zimbabwe, including the provision of quality health and HIV-related
services. It provides non-discriminatory services to lesbian women, gay men, bisexual, transgender and
intersex (LGBTI) persons, strengthens their capacity to claim their rights at the same time educating
the public on LGBTI rights and interests.
IRIS Angola – is an emerging group of MSM and LGBTI persons in Angola working with a Youth
Center to provide HIV/STIs screening and treatment services. AMSHeR has been providing technical
support to IRIS and other Angolan partners to ensure appropriate key population engagement in
GFATM processes.
Lambda Mozambique - was founded in 2006 to promote the civic, human and legal rights of LGBT
people through public awareness and education, advocacy and social dialogue. LAMBDA implements
programmes aimed at advocacy for law and policy change, at addressing HIV vulnerabilities and
improving sexual health. Lambda also documents rights violations against LGBT persons, and carries
out activities to increase public awareness of LGBT health and rights priorities.
Trans Bantu Zambia - supports the primarily young trans and intersex community through peer support
groups, counselling and emergency shelter. It aims to build a strong trans and intersex movement
through training and capacity strengthening and advocates for policies and institutional practices that
respect the human rights of trans and intersex people.
FIMIZORE- is a human rights organisation created in Madagascar in 2005 and includes 18

associations. FIMIZORE covers all of Madagascar and includes under its umbrella groups of sex
workers, MSM and people who use drugs.
The proposal was also sent for review to key regional civil society organisations including KELIN,
Southern Africa Litigation Centre, AIDS Rights Alliance Southern Africa, African Sex Workers
Alliance, Enda Santé and the Uganda Harm Reduction Network. And to the UNAIDS Secretariat and
relevant co-sponsors - UNESCO, UNFPA and UNODC. Comments received included suggestions for
strengthening components relating to sex workers, people in prison and people who use drugs. There
were also suggestions that the proposal include some background on issues of trafficking as it affects
young key populations and emphasise components that promote access to justice.
2.3 What the Proposal Builds on

The proposal builds on and incorporates lessons learned from existing work carried out by consortium
members and others. In particular it draws on the Strategy Note 2016-2020 of UNDP’s HIV, Health
and Development Group. 115 Some specific examples of work that this proposal builds on are detailed
below:
 UNDP implements the Urban Health and Justice Initiative with HEARD, UNAIDS Secretariat,
UN Habitat and other organizations to support fourteen major African cities to design and
implement effective strategies for equitable access of key populations to HIV prevention, treatment
and care. In addition to helping municipalities develop their strategies and plans, an innovative
scorecard for municipalities to self-assess on key criteria has also been developed by UNDP.
 UNDP facilitates the Africa key population Experts Group, a dynamic group of 45 key populations
from 16 countries who have developed and disseminated a Model Regional Strategy on HIV for
key populations. Since its development in 2014, the Model Strategy has been put to use in
development and review of national policies and strategies, as input to GFATM processes and to
advocate for equitable HIV/SRH service provision for key populations in 10 African countries. The
SADC Secretariat used the framework as a resource in the review of the SADC HIV/AIDS strategy
and development of its new strategy 2016-2020.
 UNDP leads the Africa Follow Up to the Global Commission on HIV and the Law. With support
from the Governments of Sweden and Norad (2013-18) and a Regional GFATM grant (2016-18)
UNDP works to strengthen law/policy/strategy for HIV/SRHR in 20 African countries. At regional
level UNDP supports implementation of the AU Roadmap for AIDS, TB and Malaria; helps Partner
States align national laws with the new EAC HIV Law; assists SADC develop an HIV Strategy for
key populations; and SADC Parliamentary Forum to develop a model bill on Eradicating Child
Marriage (which was adopted by the Parliamentary Forum on 3rd June 2016).116 At national level
UNDP supports countries to undertake political scans, conduct legal environment assessments
(LEAs), develop National Action Plans and introduce policy/law reform. UNDP strengthens
capacity of key stakeholders to ensure access to justice and redress for HIV/SRH rights violations
for women and girls, young people and key populations, including in relation to efforts to prevent
and address SGBV. An independent mid-term review of this work was carried out in 2014 by the
University of Southern California and is publicly available. 117Tools, law related databases and
guidance developed by the project are also available. 118
 In 2012 AMSHeR began a joint project with AIDS Accountability International (AAI) to improve
the policy and health environment for the delivery of HIV services to MSM. MSM Health
Scorecards were launched for Kenya, Cote D’Ivoire and Nigeria and included 16 country level
indicators grouped around three thematic areas: holding governments accountable for providing
services; holding civil society accountable for advocacy and monitoring of services; and, holding
funding partners accountable for providing needed resources. In all countries there were major gaps
in addressing SRHR for MSM. AMSHeR has been asked to develop Scorecards for five other
countries in 2016.
 In 2013, AMSHeR partnered with (UNDP), the Southern African AIDS Trust (SAT), and the
USAID funded Health Policy Project (HPP) to implement a regional project named Utetezi in seven
African countries (Ghana, Malawi, Tanzania, Zambia, Togo, Cameroon and Mozambique) to
advocate for increased access to healthcare and HIV related services for MSM. Project objectives
were to: (1) Increase and strengthen capacity for MSM and LGBTI focused advocacy for policy
change at national, subnational and regional levels; (2) Develop and sustain relationships among
government, healthcare providers, and civil society organisations to work together to improve
access to HIV-related services through policy development and eventual implementation, as well
as other policy-related activities; (3) Strengthen the capacity of MSM/LGBT organisations to devise
and implement results-oriented advocacy initiatives for policy change. Utetezi project activities
included national dialogues and workshops which produced operational plans for policy change to
be implemented by these multi-stakeholder working groups. In addition to MSM and LGBTI
groups, these national processes systematically included government bodies such as the National
Aids Councils, Ministries of Health and Ministries of Justice, representatives of National Human
Rights Institutions, Networks of PLHIV and other civil society organisations. Based on this, an
Advocacy Guide for Policy Change around MSM Health was developed for multi-stakeholder
engagement with key populations to improve service delivery in countries. 119 The multi-
stakeholder working groups have been maintained beyond the project duration as important
mechanisms to respond to HIV/SRH human rights violations.
 HEARD staff members serve on regional and international committees that develop standards
linking reproductive health and HIV and AIDS care. Predicated on their work, in 2014, HEARD
provided strategic support to the regional Sida team on current thinking on issues of child and
adolescent health and sexual and reproductive health and rights. These insightful dialogues
contributed to the new Sida regional strategy on SRHR.
 In 2015, HEARD together with Education Development Centre (EDC), Society for Family Health
(SFH) and Mott MacDonald initiated a 5 year programme of work to support the South African
government to implement high quality, evidence-informed sexuality and HIV prevention
education programmes.
 Further, in partnership with the AIDS Foundation of Southern Africa (AFSA) and Tshwaranang
Legal Advocacy Centre, South Africa, HEARD undertook research on understanding barriers to
the collection and use of medico-legal evidence in sexual violence prosecution in South Africa.
 Between 2013 and 2014, HEARD was awarded a SADC grant and 3IE grant on SRHR, mobile
populations and health systems. In separate projects, HEARD is undertaking work in Kenya,
Mozambique, South Africa and Zimbabwe with Dutch funded partner North Star Alliance (NSA)
on methods to close the gap between HIV testing and linkage to treatment and care in at risk
populations (truck drivers, sex workers). Here HEARD is exploring the feasibility of HIV self-
testing and SMS health messages to support HIV prevention. Partners on this work include
Columbia University (USA), Edwardo Molane University (Mozambique) and FACT, Zimbabwe.
 HEARD was also commissioned by IOM to undertake a study on health vulnerabilities of mobile
and migrant populations (seafarers, sex workers and truck drivers) near sea ports as socio-
geographical ‘spaces of vulnerability’ for HIV risk. This work, completed in 2014, pointed to key
social and structural factors that drove high levels of HIV and STI infection amongst mobile and
migrant populations
2.4 How the Project works with other similar UNDP managed Projects
There are three complementary projects managed by UNDP as part of the follow up to the
recommendations of the Global Commission on HIV and the Law:
Project Goal Countries Duration, Budget Sub-

Recipients and
partners
Removing Legal To strengthen the legal and Botswana, Cote 2016-2018

Barriers to Access policy environment to D’Ivoire, Kenya,
Africa Regional reduce the impact of HIV Malawi, Nigeria, $10.5 Million
Global Fund Grant and TB on key populations Senegal, Seychelles,
Sub-Recipients:
in Africa (men who have Tanzania, Uganda,
ARASA, Enda Sante,
sex with men, Zambia
SALC, KELIN
male/female/transgender
sex workers, transgender
people, people who use
drugs, prisoners and
people with HIV)
Strengthening Regional Strengthen national and Burkina Faso, 2016-2018
and National regional legal Cameroon, Chad, DRC,
Legislative environments relating to Gabon, Ghana, Lesotho, $4.2 million
Environments in Sub- HIV/SRHR for LGBT Namibia, Sierra Leone,
No Sub-Recipients
Saharan Africa people and women and Swaziland
girls
Governments of
Sweden and Norway
Sexual Orientation and Reducing Inequalities and Senegal, Tanzania, 2016-2017

Gender Identity and Exclusion, and Combating Zambia
Rights - Africa Homophobia and $800,000
Transphobia Experienced
USAID Implemented in
by Lesbian, Gay, Bisexual
collaboration with
and Transgender (LGBT)
OHCHR
People.
The following staff are employed on the three existing UNDP projects. A completely new team will be
recruited for this Netherlands Government funded project (see Section 5.2 Project Team). Project
managers from these projects have the same supervisor (HHD Team Leader Africa) and meet at least
weekly to maximise the learning from the projects and to avoid duplication.
Global Fund Project
Staff position Percent covered by

GFATM
Global Fund RLB Project Manager (Africa) (P4) (D. Patel) 100%
M&E Specialist (Africa) P3 (D. Owolabi) 100%
HHD Focal persons in 7 countries (Botswana, Cote d’Ivoire, Kenya, 10% Each
Malawi, Senegal, Seychelles and Zambia)
Finance Officer (Africa) NOC (W. Assefa) 100%
Programme Associate (Africa) GS7 (S. Tsegaye) 100%
Finance Associate (Africa) GS6 (O. Dilba) 100%
Sida Project
Staff position Percent covered by Sida
Senior Policy Advisor Human Rights (Africa) (P5) (A. Saha) 100%
Policy Advisor Key Populations (Africa) (P4) (M. Getahun) 30%
Programme Associate (Africa) (G6) (T. Girma) 100%
USAID Project
Staff position Percent covered by USAID
Policy Advisor Key Populations (Africa) (P4) (M. Getahun) 70%
HIV and Gender Advisor (South Africa) (NOC) (N. Mwaka) 30%
Each project has its own activities and budgets and UNDP ensures that there is no duplication in any of
the budgets. This is illustrated in the table below, which shows the outputs per country per project (now
including the proposed project to be funded by the Netherlands Government) and per year.
Country Outputs Project 2017 2018 2019 2020
Angola Political Scan, LEA, National Strengthening Legal and

Action Planning, National Policy Environments for
Mechanisms for community reducing HIV Risk and
inputs into policy established. Improving SRH for Young
Capacity strengthening for key Key Populations in
stakeholders from government Southern Africa.
and CSOs in rights and needs Netherlands Government
of YKPs
Botswana Political Scan, LEA, National Removing Legal Barriers
Action Planning, National to Access Africa Regional
Advocacy Campaign, Strategic Global Fund Grant
Litigation. Capacity
strengthening on rights of KPs
for Law enforcement, Lawyers,
NHRIs, Parliamentarians
Burkina Faso Support offered and provided Strengthening Regional
on request for activities that: 1) and National Legislative
Identify gaps in adherence to Environments for
international and regional HIV/SRHR to Support the
human rights standards related Enjoyment of Human
to HIV and SRHR; 2) Establish Rights of LGBT People
accountability for following up and Women and Girls in
a nationally agreed prioritised Sub-Saharan Africa
plan of action to strengthen SIDA
legal environments for HIV
and SRHR; 3) Strengthen
capacity of key stakeholders to
apply human rights principles
in HIV/SRHR-related work.
Cameroon Support offered and provided Strengthening Regional
Chad Support offered and provided Strengthening Regional
Cote D'Ivoire Political Scan, LEA, National Removing Legal Barriers

Advocacy Campaign. Global Fund Grant
Capacity strengthening on
rights of KPs for Law
enforcement, Lawyers, NHRIs,
Parliamentarians
DRC Support offered and provided Strengthening Regional
Gabon Support offered and provided Strengthening Regional
Ghana Support offered and provided Strengthening Regional
Kenya Political Scan, LEA, National Removing Legal Barriers
Advocacy Campaign. Capacity Global Fund Grant
Lesotho Support offered and provided Strengthening Regional
Madagascar Political Scan, LEA, National Strengthening Legal and
of YKPs
Malawi Political Scan, LEA, National Removing Legal Barriers
Advocacy Campaign, Strategic Global Fund Grant
Litigation. Capacity
Mozambique Political Scan, LEA, National Strengthening Legal and

of YKPs
Namibia Support offered and provided Strengthening Regional
Nigeria Political Scan, LEA, National Removing Legal Barriers

Parliamentarians
Senegal Political Scan, LEA, National Removing Legal Barriers

Parliamentarians
Senegal National Assessment and Sexual Orientation and
Round Table on SOGI and Gender Identity and Rights
Rights. Trainings for CSO on - Africa
working with media in hostile USAID
environments, Regional
meeting on SOGI and Rights
Seychelles Political Scan, LEA, National Removing Legal Barriers
Advocacy Campaign. Capacity Global Fund Grant
Sierra Leone Support offered and provided Strengthening Regional
Swaziland Support offered and provided Strengthening Regional

Tanzania Capacity strengthening on Removing Legal Barriers
rights of KPs for Law to Access Africa Regional
enforcement, Lawyers, NHRIs, Global Fund Grant
Parliamentarians
Tanzania National Assessment and Sexual Orientation and
Rights. Training for CSO on - Africa
Uganda Capacity strengthening on Removing Legal Barriers
rights of KPs for Law to Access Africa Regional
enforcement, Lawyers, NHRIs, Global Fund Grant
Parliamentarians
Zambia Strategic Litigation. Capacity Removing Legal Barriers
strengthening on rights of KPs to Access Africa Regional
for Law enforcement, Lawyers, Global Fund Grant
Zambia National Assessment and Sexual Orientation and
Rights. Training for CSOs on - Africa
Zambia Political Scan, LEA, National Strengthening Legal and
of YKPs
Zimbabwe Political Scan, LEA, National Strengthening Legal and
of YKPs
The projects’ research and knowledge product components and work with AUC/RECs where it exists
are also different but complementary. Like the outputs, these are designed so that each project gains
from the other.
2.5 How the Project works with other external Initiatives

Through its established mechanisms, the consortium will ensure strong, synergistic links with other,
key projects in Southern Africa, notably; 1) the Southern Africa key population-REACH project; 2) the
UNFPA HIV/SRH integration project; 3) UNODC’s work on people who inject drugs and prisons; and
4) the UNESCO work on comprehensive sexuality education in and out of schools.
Cooperation with the UN agencies will be achieved through the joint UN teams on AIDS at regional
and national level. These are a well-established coordination mechanisms for the twelve UNAIDS
cosponsor agencies and the UNAIDS Secretariat.
1) The Southern Africa key population-REACH project which is funded by GFATM and led by HIVOS
was developed in close complementarity with the UNDP-led projects. It overlaps with the new project
in two countries, Zambia and Zimbabwe. The HIVOS project works with key populations to strengthen
regional networks, improve knowledge management and reduce stigma and discrimination. As part of
the agreement with GFATM, HIVOS and UNDP meet at least formally, at least once a year, to share
work plans but in practice there is close and regular contact between the UNDP and the HIVOS Project
Managers. This enables the projects to share information and knowledge products, facilitate the
cooperation with civil society and enhance support to and engagement with government. AMSHER is
a sub recipient of the Southern Africa key population REACH project and as such will help bridge the
two projects at country and community level. The SADC Secretariat is a member of the Steering
Committees for the HIVOS led key population REACH project and the UNDP led project on removing
legal barriers. It will, therefore, facilitate alignment of the various regional level activities in the two
GF supported projects as well as the new UNDP Netherlands Ministry of Foreign Affairs project.
2) The UNFPA-led project on Linking Sexual and Reproductive Health and Rights and HIV has been
implemented in seven Southern African countries including Zambia and Zimbabwe since 2011. 120 The
aim of the project is to demonstrate the benefits of integrating HIV and SRH services for particular
populations. The UNFPA project has implemented different strategies such as enhancing collaboration
between government and civil society, aligning the different national strategies on SRH and HIV, and
developing integration models based on the specific contexts in each country. Based on the lessons from
the UNFPA led intervention, this project will work with the regional UNFPA team for East and
Southern Africa and the UNFPA offices in Zambia and Zimbabwe to assess the specific issues and
challenges of providing integrated services for young key populations in and out of schools and support
countries to develop and implement appropriate strategies.
3) The UNODC project on prison health is being implemented with support from the Netherlands
government and other donors. 121 The UNODC project has undertaken epidemiological analysis of HIV
in prisons, conducted assessments of the legal system on prisoner’s access to health services and taken
inventory of the health system and services in prisons in eleven SADC countries. This project will build
on the work of UNODC in the five project countries particularly focusing on the legal assessments by
(a) analysing to what extent issues of young key populations are addressed in the assessments
undertaken by UNODC and fill any gaps identified, (b) use these assessments to inform the broader
legal environment analyses to be undertaken, and (c) include the recommendations from the assessment
into the national action plan that will be developed following the completion of the LEAs. The project
will also support SADC to integrate issues of young key populations in prison in the relevant regional
strategies and guidelines.
4) This project will be linked to the comprehensive sexuality education (CSE) work implemented by
UNESCO in twenty Eastern and Southern African countries including the five countries covered by this
project. 122 Main areas of linkage between the UNESCO’s CSE work and this project include addressing
stigma, discrimination and violence on young key populations such as homophobic and transphobic
bullying; reaching young people who use drugs with information and services; and ensuring young key
populations friendly access to good quality, comprehensive, life skills-based HIV and sexuality
education (CSE) and youth-friendly sexual and reproductive health services in school settings. To
achieve this, the project will work with the regional UNESCO team for Southern Africa as well as the
UNESCO offices in the five countries to integrate issues of young key populations in national health,
HIV and education strategies, programme implementation guidelines and monitoring and evaluation
systems.
3. Project Implementation
This project will focus on young SW of all genders, young MSM, young LGBTI, young people who
inject drugs and young people in prison.
The project takes its definition of young key populations from the WHO Technical Briefs which were
developed in collaboration with UNDP, UNFPA and UNODC amongst others. 123 This includes people
10–24, including children 10–17 who are sexually exploited and young adults 18–24 who are SW or
adults who have consensual sex with same sex partners. Not all project components will be implemented
with/for children aged 10-17.
The project will focus on strengthening legal/policy environments for young key populations 10–24
years. Only young key population adults aged 18-24, however, will participate in capacity
strengthening, policy/advocacy and research components of the project.
Although the project interventions and available funding will focus on those aged 10-24, the project
will obviously work with members of key populations of any age as opportunities and needs arise. In
particular, the project will ensure that work with young key populations will be entrenched in the
broader work with key population networks at national and regional level in order to strengthen
collaboration and advocacy. It is clear that the project will not start from zero in any of the project
countries, so activities will be designed to work with established key population groups to elevate youth
voices within their groups and to use results from the project to inform their interventions and advocacy
efforts. Key population members who are older than 24 years will therefore be included in project
activities to ensure that there is mutual support and consistency of messaging.
The project will work at SADC regional level and in 5 countries: Angola, Madagascar, Mozambique,
Zambia, and Zimbabwe. Community-based partners, including sex worker and people who inject
drugs-led partners, will be selected at the beginning of the project.
3.1 Project Objectives and Expected Results

The long term Development Objective of the project is to improve SRH outcomes for young key
populations in SADC Countries
The medium term Programme Objective is to strengthen HIV/SRH related rights of young key
populations in law, policy and strategy in 5 SADC Countries (Angola, Madagascar, Mozambique,
Zambia and Zimbabwe.
Specific Objectives:
1. Strengthening the capacity of national governments to put in place HIV/SRH-related legal, policy
and strategy environments that respect the rights of young key populations
2. Strengthening the capacity of regional and national civil society organisations including
community-based groups to claim rights and advocate for strengthened national HIV/SRH-related
legal, policy and strategy environments and improved HIV/SRH service provision for young key
populations
3. Strengthening the capacity and leadership of SADC to facilitate Member States to put in place legal,
policy and strategy environments that respect the rights of young key populations and promote
regional learning
4. Strengthening the understanding of appropriate indicators and monitoring and evaluation processes
that help promote accountability for implementation of human rights enabling activities that arise
from law, policy and strategy assessments, advocacy and research activities
Expected Results envisaged to achieve the specific objectives over the project timeframe are:
Outcome Result 1: Law, policy and strategy which impacts positively on the HIV/SRH and rights of
young key populations is reviewed, reformed, implemented and enforced as appropriate
Outcome Result 2: Capacity strengthening for key stakeholders on needs and rights of young key
populations institutionalised in national plans or curricula
Output Result 1: Gaps in adherence to international and regional human rights standards related to
HIV/SRH for young key populations successfully identified.
Output Result 2: Accountability mechanisms established for following up a nationally agreed
prioritised plan of action to strengthen legal, policy and strategy environments for HIV/SRH for young
key populations
Output Result 3: Capacity to apply human rights principles in HIV/SRH-related work strengthened
through collective capacity strengthening initiatives for key stakeholders (police, policy makers,
judiciary, parliamentarians, National Human Rights Institutions, key population groups, other CSOs
etc.)
Output Result 4: Strengthened mechanisms for community inputs into policy development to
strengthen HIV/SRH service provision for young key populations
Output Result 5: Strengthened understanding of the HIV/SRH service barriers and of the rights of
young key populations in SADC as reflected in regional frameworks
Output Result 6: Strengthened understanding and application of human rights and HIV/SRH related
indicators and milestones for young key populations in national and regional frameworks
The project will contribute to Sustainable Development Goals (SDGs): good health and well-being
(SDG 3), and as mentioned above to gender equality (SDG 5), reduced inequalities (SDG 10), justice
and strong institutions (SDG 16).
The project will also contribute to the African Union Agenda 2063 goals: Support young people
through investment in their health; Eliminate barriers to access to quality health services for women
and girls.
The project will contribute to many of the result areas in the new UNAIDS Strategy 2016-2021,
including: Tailored HIV combination prevention services are accessible to key populations, including
sex workers, men who have sex with men, people who inject drugs, transgender people and prisoners,
as well as migrants; Punitive laws, policies, practices, stigma and discrimination that block effective
responses to HIV are removed.
There are also potential synergies with the recently announced Key Population Investment Fund. In
June, 2016, PEPFAR announced a new $100 million Investment Fund to expand access to proven HIV
prevention and treatment services for key populations. The new fund will support innovative, key
population-led approaches to help ensure no one is left behind in the HIV/AIDS response. 124
Project components are shown in the diagram below:
Diagram of project components
Problem Gaps Interventions Output Results Outcome Results Goal
Constraining 1. National Legal

political and Environment
Increased vulnerability of Young key populations to HIV and SRH related problems
Assessments (LEA) and

legal
National Action Plans
environments completed 1. 1. Gaps in adherence
to international and 1.Law, policy and
for HIV/SRHR
Improved HIV/SRHR of Young key populations

2. National Political Scan regional human rights strategy which
related human
carried out and Law, standards related to impacts
rights of Young
Policy and Strategy HIV and SRHR for positively on
key
reviewed as per young key the HIV/SRH
populations populations
recommendations of LEA and rights of
and as prioritised in successfully identified
young key
National Action Plans
2. Accountability populations is
3. Capacity strengthening established for a reviewed,
Limited for key stakeholders in nationally agreed reformed,
HIV/SRH-related needs action plan to implemented
capacity of key
strengthen legal,
actors in and rights of young key and enforced
policy and strategy
HIV/SRHR for populations
environments for HIV
Young key 4. Relevant tools and
and SRHR for young 2.Capacity
populations key populations strengthening
guidance on the
HIV/SRH-related needs for key
3. Capacity of key
and rights of each young stakeholders to apply stakeholders on
key populations human rights needs and
developed principles in rights of young
HIV/SRHR related key populations
5. Assist SADC to work strengthened
strengthen regional institutionalised
Limited data frameworks to ensure 4. Mechanisms for in national
and evidence they address community inputs plans
on HIV/SRHR into (HIV/SRH) policy
6. Capacity strengthening development for
for Young key activities for Young key young key
populations populations in HIV/SRH populations
rights and access to strengthened
justice
5. Strengthened
7. National Mechanisms understanding of the
for community inputs HIV/SRH service
into policy and service barriers and of the
provision established rights of young key
populations in SADC
8. Baseline study and
mid-term review 6. Strengthened
understanding and
9. Operational research application of human
on barriers to SRHR for rights and HIV/SRH
young key populations, related indicators and
milestones for young
service needs and gap
key populations
10. Cross-country
comparative analysis of
change processes
3.2 Theory of Change
The project will be based on the following theory of change:
Effective and sustainable responses for HIV/SRH require a reduction of the stigma and
discrimination associated with HIV/SRH and most affected populations, a legal environment that is
gender-sensitive and that enables access to and use of key prevention, treatment services and
commodities and the political will to protect and include marginalized (young) key populations in
policy and governance.
3.3 Project Interventions

Specific interventions will be employed as part of this project:
1. Conducting National Legal Environment Assessments (LEA) and developing National Action
Plans
2. Developing National Political Scans and supporting the implementation of Law, Policy and
Strategy review/reform as per recommendations of LEA and as prioritised in National Action
Plans
3. Implementing capacity strengthening activities for parliamentarians, national human rights
institutions, policy makers, law enforcement and the judiciary in HIV/SRH-related needs and
rights of each young key population
4. Developing relevant tools and guidance on the HIV/SRH-related needs and rights of each
young key population
5. Assisting SADC to strengthen regional frameworks to ensure they address HIV/SRH
needs/rights of young key populations
6. Implementing capacity strengthening activities for young SW, young LGBTI, young people in
prison, young people who use drugs in HIV/SRH rights and on access to justice
7. Establishing a mechanism for community inputs into policy development and implementation
related to HIV/SRH service provision for young key populations
8. Conducting and reporting on a baseline study and mid-term review
9. Conducting and reporting on operational research on barriers to SRHR for young key
populations, service needs and gaps
10. Conducting and documenting cross-country comparative analysis of change processes
Young key populations will be capacitated to be an integral part of each intervention as experts,
researchers and facilitators. All interventions are synergistically linked. Regional activities will
enable better scale-up across SADC countries and facilitate policy harmonisation for cross-border
collaboration. Consortium members and key stakeholders from each project will be invited to a Project
Start-up Meeting at the beginning of the project at which Standard Operating Procedures (SOPs) for
each intervention will be agreed. At this meeting, the theory of change will also be discussed and
operationalised. These SOPs already exist for some interventions underway in other countries, such as
the Legal Environment Assessment. SOPs will ensure that interventions are implemented in a consistent
manner in each country and enable better comparison for evaluation purposes. Where consultants or
researchers are employed by the project, care will be taken to recruit those with appropriate skill sets
who also have good experience working with key populations or who come from the key populations
themselves. All project staff will undergo orientation and training in the HIV/SRH rights and issues of
Specific interventions are detailed below under each output, with an explanation for why they have been
chosen and how sustainable the impacts of each intervention are likely to be:
1. National Legal Environment Assessment and National Action Plan Completed
Under this intervention, the project will work with governments and CSOs to implement or update legal
environment assessments in project countries to identify gaps in alignment with regional and
international instruments relating to the rights of children, young people and key populations. Once
gaps have been identified and the assessment nationally validated, the project will facilitate the
development of a government-owned national plan to make necessary reform – which includes an
accountability mechanism (who is responsible for what) which can be followed up by the project and
used for advocacy by CSOs (see intervention 6). LEAs have now been carried out in 10 countries in
Africa and have proved extremely useful as a baseline for initiating human rights-based law and policy-
reform to strengthen HIV/SRH programming in each country. LEA findings have provided the
evidence base for development of National Strategic Plans, evidence to inform relevant policy review,
for developing Global Fund and other proposals and have acted as a basis for prioritizing policy reform,
for advocacy and capacity strengthening. Lessons learned show that in order for the assessment to be
credible, it is extremely important that the assessment is led by government and that there is high level
ownership of the process and outcomes and good understanding of accountability, otherwise there will
be no concrete follow up. Although part of the process, it is important to note that making sure the LEA
is government-led, is regarded as an intervention in its own right. It is equally important that key
population groups and civil society generally, have capacity and are sufficiently resourced to be
involved in collecting, assessing information and prioritizing action. Minimising any risk to key
populations whilst maximizing their participation is a very important part of the LEA. 125 LEAs are
sustainable tools, the findings from which can be used in many ways over a period of time. Should an
LEA need to be updated, capacity will have been built at national and regional level for this to happen
even beyond the timeframe of the project. The process of introducing the LEA concept to government
in Angola is already underway and Zambia have included conducting an LEA in their national Global
Fund project work plan126, however this will be a new intervention for Madagascar, Mozambique, and
Zimbabwe.
2. National Political Scan carried out and Law, Policy and Strategy reviewed as per
recommendations of LEA and as prioritised in National Action Plan
Under this intervention, the project will provide technical and policy support to countries to undertake
necessary law, policy and strategy reform as per the recommendations of the LEA and as prioritised in
the National Action Plan (intervention1). These are long-term processes and opportunities to influence
reform can be easily missed. Based on recommendations from the mid-term evaluation conducted for
the first Sida supported UNDP project on strengthening legal environments, a political scan will be
conducted for each country to outline the dates for policy/strategy review and opportunities for
promoting law reform. It will include a summary of key processes, how to engage with these processes
and will outline which stakeholders are involved. This will be used by the project and also by CSOs
(see interventions 6 and 7) to make the most of opportunities for relevant strategy, policy and law
reform. Given that young key populations often migrate to large cities, the project will also include an
emphasis on strengthening municipal-level strategies and services for key populations. Law, policy and
strategy review are sustainable interventions, laying the foundation for further advocacy and setting
positive precedents which can be used by Civil Society.
3. Capacity strengthening activities carried out for parliamentarians, national human rights
institutions, policy makers, law enforcement and the judiciary in HIV/SRH-related needs
and rights of each young key population
This intervention will include human rights training, capacity strengthening, outreach and consultations
with parliamentarians, national human rights institutions, National AIDS Council officials, health and
other policy makers, senior law enforcement and health officials and the judiciary. It will also be
important to build relationships and create incentives to encourage law firms in the private sector to
provide pro bono services to key populations.
This intervention links directly with interventions 1 and 2 above in as much as capacity strengthening
will focus on providing information and skills to follow up the recommendations of the LEA as
prioritised in the National Action Plans. Learning from previous projects, much of this capacity
strengthening will happen at regional level in order to take people out of their own national context,
enable them to speak freely, to learn from different country experiences and to plan actions that cross
borders (Angola shares a border with Zambia; Zambia, Mozambique and Zimbabwe share borders).
Attention will be paid to follow up to capacity strengthening activities. A pre and post-training
assessment of participants’ knowledge and attitudes will be carried out and participants will be linked
with the Young Key Population Advocacy Working Groups (intervention 6) for active follow up and
for monitoring of accountability at country level. Each participant will be given technical support to
disseminate information acquired during capacity strengthening at country level and to put into practice
what they have learned. The project will endeavour to maintain a consistent multisectoral group for
training from each country throughout the project period to develop in-depth knowledge and engender
lasting attitude change in a select group of key stakeholders. Tools and guidance will be developed
(intervention 4) to strengthen knowledge management and dissemination amongst and from these key
stakeholders.
Learning from the UNDP-facilitated Africa Judges Forum on HIV (which has met annually since 2013),
emphasising what each group is accountable/responsible for will be key to all these activities and there
will be a monitored system of follow up to provide technical support and ensure impact. Capacity
strengthening on its own is not particularly sustainable as an intervention since people change jobs and
new governments are elected. For this reason, it will be important for the project to work with
government to institutionalize capacity strengthening on the rights and needs of young key populations
within national curricula (such as national training for judges and police).
Whilst it will be beyond the scope of this project to train individual police and health workers, the
project will ensure that health service and law enforcement policy and strategy relevant to young key
populations is conducive to service access. In addition, the project will work with government and
relevant training institutions in each country to ensure that curricula are updated to include attention to
the needs and rights of young key populations.
4. Relevant tools and guidance on the HIV/SRH-related needs and rights of each young key
populations developed
Under this intervention the project will design and implement a communications strategy to share results
and lessons learned regularly. Relevant tools for knowledge management will also be produced. Tools
and guidance will focus on updating existing guidance to include HIV/SRH rights for young key
populations. New tools to be developed under this project will include: how to develop indicators to
track progress in responding to young key populations rights and SRH needs; establishing mechanisms
for community inputs into policy development to strengthen service provision; comprehensive review
and guidance on key legal principles for adolescents; and guidance on issues of age of consent for sex,
marriage, medical treatment, access to contraception, HIV testing, harm reduction, drug treatment etc.
This intervention links with all other interventions in the project, but in particular with the baseline
study and operational research components of the project. Tools and research briefs will be translated
into all SADC languages and will be disseminated very widely throughout SADC and across the
continent, using synergies with other projects.
5. Assist SADC to strengthen regional frameworks to ensure they address HIV/SRH
needs/rights of young key populations
Under this intervention, the project will assist SADC to strengthen regional frameworks to ensure they
address HIV/SRH needs/rights of young key populations. UNDP has already facilitated the Africa Key
Population Experts Group to work with SADC and EAC to develop Regional Frameworks for Key
Populations and HIV. This work will be extended to ensure the needs of young key populations are
explicit in these frameworks. The project will also act as a resource for regional framework endorsement
by Member States and support CSOs to monitor regional frameworks and advocate accountability from
national governments. Regional frameworks will be used in strengthening legal, policy and strategy
environments and the capacity of key stakeholders. Given that the process of developing or reviewing
regional frameworks is lengthy and in SADC requires consensus, these regional frameworks will be
invaluable for long-term advocacy for UN and CSO partners.
6. Capacity strengthening activities for young SW, young LGBTI, young people in prison,
young people who use drugs in HIV/SRH rights and access to justice
In each country the project will mobilise groups from each of the key populations and bring them
together in an informal ‘cross key population’ group of around 30 people for the purposes of the project
and to work together beyond the project. This ‘cross key population’ concept has functioned extremely
well at regional level, with the Africa Key Population Experts Group coming together to develop model
frameworks for use by the RECs. These national Key Population Experts groups that will be formed
by the project in each country will serve as a broad reference and advocacy group for issues that all key
populations have in common – stigma reduction, human rights violations and violence reduction, and
improved access to services and to justice. A meeting will be held at the beginning of the project in
every country for this group to be oriented to the project and for them to agree on and prioritise country-
specific issues that the project should follow up.
From the National Key Population Experts group, a representative sub-group will be formed, the Young
Key Population Advocacy Working Group. This will be a small group, led and owned by the young
key populations who will then invite participation from other key stakeholders from government, the
UN and from other CSOs as relevant for each country. For example, an official from Law Enforcement,
someone who is part of the process of developing health service policy, someone from the judiciary etc.
might be invited. The total group will number between 10 and 15 members at most. This Young Key
Populations Advocacy Working Group will then develop a national work plan that will align with the
objectives of the project. In each country, a CSO/key population Coordinator/secretariat will be
recruited to help this Advocacy Working Group manage their work plan and achieve its aims. This
Coordinator will receive support from AMSHeR HQ and from the UNDP Project Focal Point in each
country.
Key to this intervention is that Advocacy Working Group members will be nominated by their peers
after a process of multistakeholder engagement where challenges and advocacy interventions are jointly
identified and developed. This model also fosters ownership and accountability between the Advocacy
Working Group and the broader CSOs/stakeholder base. The Young Key Populations Advocacy
Working groups will have as a broad aim to promote legal and policy frameworks that are conducive
to young key populations access to essential HIV and SRHR services. They will use the Political Scans
(intervention 2) to look for advocacy opportunities and for entry points to engage with law, policy and
strategy review (intervention 2). They will be part of the accountability mechanism set up in the
National Action Plan (intervention 1) to follow up recommendations from the Legal Environment
Assessment (intervention 1).
The project will provide capacity strengthening opportunities and small grants to these groups and to
the broader National Key Population Experts group to strengthen their knowledge of SRHR; to develop
mechanisms to improve access to justice (through lawyers, complaints procedures, the judiciary etc.)
and to address and prevent human rights violations; for advocacy at the regional, national and municipal
level; and for young key population engagement in policy processes. This intervention has the potential
to mobilise a new generation of leaders within the diverse key population communities at country level
who can bring new energy and ideas around the use of technology for changing attitudes.
7. National mechanisms for community inputs into policy development and implementation
related to HIV/SRH service provision for young key populations established
Putting in place legal environment that respects the rights of young key populations can be a long term
goal whereas influencing policy, strategy and service provision is more immediate and can be viewed
as a milestone towards law reform. A variety of policies at various levels can impact on the ability of
young key populations to access HIV/SRHR and other services and while addressing the broader legal
environment should be the ultimate goal, the project will also focus on community input to policy
development to provide more immediate impacts on access to services for young key populations.
Under this intervention, the project will build on AMSHeR’s work with Utetezi and establish a robust
mechanism to ensure community inputs into policy development to strengthen service provision. The
Advocacy Working Groups will act as ‘reference groups’ on effective programming. Their inputs will
provide real time information about key population experiences of HIV/SRH service provision, about
human rights violations and experiences of access to justice that will inform all project interventions.
Scorecards, already developed by AMSHeR, will be updated and used for each young key population
to assess service provision against WHO and other global guidelines. These scorecards assess how
governments are providing services; how civil society is advocating for and monitoring services and
how funding partners are providing needed resources. The scorecard also looks at the level of
investment in community-led programmes and form a comprehensive tool for monitoring
accountability. Because AMSHeR is using this scorecard in other project countries, it will also form a
uniform basis of comparison on improvements across countries. It is anticipated that the Scorecard will
become a credible reference document on the state of implementation of services for young key
populations, functioning in a similar manner to the shadow reports.
8. Baseline study and mid-term review

The project will conduct a baseline study in which the necessary data on the different young key
populations (notably young SW of all genders, young MSM, young LGBTI, young people who inject
drugs and young people in prison) will be collected and the appropriate outcome indicators for the
project and interim milestones to track longer term progress in law/policy reform will be determined.
As this project covers five different countries as well as a diversity of key population groups, we
anticipate substantial differences between the available data per country as well as substantial gaps
within these data. Hence, we expect there is need for a robust baseline study at the start of the project.
The baseline study will be supplemented by a mid-term review to assess to what extent outcome
objectives are achieved with findings feeding into the independent end-line evaluation which will be
organised by Netherlands Ministry of Foreign Affairs. It will also determine attributable contributions
of specific project components, including a cost-effectiveness analysis.
From a theoretical point of view, it is best to view the effectiveness of a programme as the result of the
interaction of three different dimensions. The first one is the effectiveness of the intervention in
achieving a specific outcome (such as law or policy review/reform). The second one is the technical
efficiency of the intervention, i.e. the extent to which interventions are implemented at minimum cost.
And the third one, which can be called the targeting efficiency, reflects the extent to which target groups
are reached by the selected interventions.
This framework highlights the interaction among the coverage of the intervention, its effectiveness, unit
cost, and the baseline of the group being targeted. It is proposed to apply this methodology as an
organizing principle for the project. The analysis will assess how the project interventions are likely to
contribute to intended changes within target countries. The focus of the analysis will be on the priority
groups given their importance to the project. The data for the analysis will come from various sources,
including the baseline studies.
The baseline and mid-term evaluation will be designed to complement other ongoing evaluations of
projects that aim to remove legal and policy barriers to access, such as those being undertaken by Global
Fund and UNDP.
9. Operational research on barriers to SRHR for young key populations, service needs and
gaps
Operational Research will focus on investigating the barriers to SRHR for young key populations, on
service needs and gaps. Interventions to strengthen capacity of key stakeholders and to develop
accountability mechanisms will also be systematically monitored and run parallel to operational
research activities. As such, the output of this component will directly feed into and inform project
interventions 1-7. The research agenda will be developed in close consultation with the key stakeholders
in each country and engage young key populations in all stages of the research. The different studies
will be designed in such a way that they contain built-in feedback loops; informing and strengthening
policy reform processes and scale-up of age and gender appropriate services for young key populations.
Research findings will be shared through the project’s communication strategy with a wider audience.
The project will undertake research using a range of methods drawn from the social sciences. Policy
analysis will be used to provide a global, regional and country level perspective. Secondary data analysis
of available cohort and population sample data will be used to identify vulnerable population sub-groups
and assess trends over time. Appropriate tools here will be the construction of multivariate and
multilevel models. Health economic methods will be used to assess cost and benefit of interventions,
with a special emphasis on applying methods developed in well-established interventions. Formative
field work will be used as a tool for contextualising larger scale survey findings and to monitor the
progress of interventions at the community level. Methods will include in depth interviews, focus
groups discussions and stakeholder interviews for example with government and NGO service
providers. Use of these data will be conditional on appropriate ethical review, maximising the
anonymisation of information and informed consent.
10. Cross-country comparative analysis of change processes
A cross-country comparative analysis of change processes will be undertaken in the final years of the
project to understand how the project has contributed towards meaningful change for young key
populations. It will generate generalisable learnings about how political, legal and programmatic
components have interacted in support of change as well as to draw lessons on how policy and
programmes can constructively be linked in Southern Africa and beyond. Project experiences and
records will serve as a basis for the comparison, which will be complemented by interviews and focus
group discussions with key stakeholders in the project. The project will use a research design that
incorporates the Interactive Learning and Action approach (or ILA approach), in which representatives
from all the different stakeholder groups are actively engaged in the research process; starting from
jointly thinking through how to best study the change brought about by the project, reflect on interim
research outcomes, suggest how processes could possibly be modified to stay on track and to interpret
final research outcomes, and lessons learned. The ILA is a cyclical process in which stakeholders use
joint reflection as a means to generate new insights and knowledge. It is a very suitable approach to
study policy reform, which are complex and, often non-linear, processes. The cross-country exchange
is intended to further enrich the individual country processes and contribute to the end-line evaluation
of the project.
The diversity of project countries is anticipated to be logistically challenging in terms of research

outputs and the above interventions (8-10) will be carefully planned. This diversity is also a strength
of the project, in that it will enable implementation across complex situations where research is limited.
The project will benefit from and work with existing research partners in Universities (Catholic
University of Angola; University of Antananarivo, Madagascar; Universidade Eduardo Mondlane,
Mozambique; University of Zambia; Africa University, Mutare Zimbabwe) in each project country,
building on existing relationships. HEARD will provide a strong monitoring, supervision and training
component, using a core team to strengthen country capacity and ensure standardisation of methods
across countries for each research intervention described above. Country level research teams will
undergo orientation and training so that they are aware of basic instruments and have knowledge of the
HIV/SRH rights and issues of young key populations. Quality control will also be a key component
of research (and other) interventions, with HEARD staff spending time working with research teams in
each country on a regular basis.
4. Project Monitoring and Review

Monitoring of this programme is a complex piece of work requiring assessment at multiple levels—
project, region, national —and across diverse political, epidemiological and cultural settings.
4.1 Baseline Study and Midterm Review of the Project

In order to assess effectiveness and show progress in the legal and policy environment, a baseline study,
midterm and end line evaluations are required employing a purposeful mix of quantitative, qualitative
and policy measures, as explained under project intervention 8. The project will conduct a baseline
study and midterm review whilst the Netherlands Ministry of Foreign Affairs will organise an end-line
evaluation of all partners in the regional SRHR and HIV/AIDS program in Southern Africa.
As a cornerstone of this M&E, a human rights-based approach will be employed to bring into focus not
only the relevance, effectiveness and sustainability of activities carried out but also the processes of
project implementation. Particular attention will be given to the principles of inclusion, participation,
equality and non-discrimination, and accountability as addressed in project activities.
4.2 Monitoring of Activities and Interventions
Systematic monitoring of the programme will be an integral component. Monitoring will focus on
systematic collection of data from implementation of the various programme activities and from sources
listed in the Results Framework (see table below for details). Informed by the baseline study, additional
information will be included in the monitoring process to capture interim milestones that signify that
progress towards longer term goals is being made.
Outcomes of each activity will be comprehensively summarized to provide input to the monitoring
process. The procedures for progress monitoring and results evaluation will vary by activity but will be
coordinated at the regional level by UNDP. The UNDP Country Office staff who have responsibility
for coordinating the programme at country level will also monitor outputs and outcomes. These
Country Office staff will have a dual reporting line – to the UNDP Country Director so that results are
reported as part of the overall contribution UNDP makes to government priorities in a country and also
to the Regional Centre where results will be collated and reported to Netherlands Ministry of Foreign
Affairs. Each UNDP Country Office also has a dedicated senior level professional M&E staff member.
These M&E experts are responsible for verification of results against indicators on all country level
projects and activities. They are also responsible for capacity development on M&E within the UNDP
Country Office. Depending on the specific activities being implemented as part of this programme in
each country, approximately five percent of their time will be dedicated to providing M&E support to
this programme. This staff time has not been explicitly included in the programme budget but forms
part of UNDPs contribution – like any time dedicated by the Resident Representative, the UNDP
Country Director and other Country Office staff.
Regular activity monitoring reports will feed into results-based communication materials that will be
shared with stakeholders, external partners and Netherlands Ministry of Foreign Affairs. For internal
purposes, the programme will be monitored in accordance with the programming policies and
procedures outlined in the UNDP User Guide, including through Atlas tracking systems and the
Enhanced Results Based Management system (EBRM). In addition, monitoring and reporting will link
with the UNAIDS UBRAF Monitoring and Evaluation Framework and its related indicators. The
UBRAF monitoring framework also involves its own mid-term review, peer reviews across UNAIDS
Cosponsoring agencies, and annual reporting to the UNAIDS Programme Coordinating Board.
Within the UNDP annual cycle:
 On a quarterly basis, a quality assessment shall record progress towards the completion of key
results, based on quality criteria and methods captured in a Quality Management table.
 An Issues Log shall be activated in Atlas and updated by the Project Manager to facilitate
tracking and resolution of potential problems or requests for change.
 Based on the initial risk analysis submitted, a risk log shall be activated in Atlas and regularly
updated by reviewing the external environment that may affect the project implementation.
 Based on the above information recorded in Atlas, Project Progress Reports shall be submitted
by the Project Manager to the Programme Management Committee, using the standard report
format available in the executive Snapshot.
 A project Lesson-learned log shall be activated and regularly updated to ensure on-going
learning and adaptation within the organisation, and to facilitate the preparation of a Lessons-
learned report at the end of the project’
 A Monitoring Schedule Plan shall be activated in Atlas and updated to track key management
actions/events.
 An Annual Review Report shall be prepared by the Project Manager and shared with the
Programme Management Committee.
 Based on the above report, an annual project review will be conducted soon after during the
fourth quarter of the year to assess the performance of the project and appraise the Annual Work
Plan for the following year.
4.3 Results Framework

Programme Description Objectively Verifiable Sources and means Assumptions
Indicators (OVIs) of Verification
Development Objective: To Young key populations can UNAIDS Annual

improve SRH outcomes for access good quality HIV/SRH Report for Sub-
young key populations in services. 127 Saharan Africa
SADC Countries GARPR128 Reports
Overall Programme Objective: Reported reduction in legal and UN Joint Teams on Addressing harmful
To strengthen HIV/SRH related policy barriers to access to HIV AIDS Surveys impact of punitive and
rights of young key populations and SRHR services for young discriminatory laws,
in law, policy and strategy in 5 key populations UNDP Country regulations and practices
SADC Countries Office Annual increases access to HIV
Reports prevention and treatment
and other SRHR services
National
for young key populations
Commitments and
Policies Instrument
Reports (NCPI)129
Specific Objective 1: Number of countries improving UN Joint Teams on Strong legal and policy
legal, policy and strategy AIDS Surveys frameworks on key issues
Strengthening the capacity of environments: either weakening affecting young key
national governments to put in /repealing punitive laws policies UNDP Country populations are an
place legal, policy and strategy or practices relating to age of Office Annual essential component of
environments that respect the consent, sexual and gender- Reports effective HIV/SRHR
rights of young key based violence etc., which response strategies
populations. National
violate the rights of young key
Commitments and
populations; or enacting and
Policies Instrument
strengthening protective, non-
Reports (NCPI)
discrimination laws, policies, or
practices; and amending Media reports
national response strategies
accordingly - with support from National law, policy
the project130 and strategy
documents
Specific Objective 2: Number of countries putting in UN Joint Teams on The participation and
place measures to increase AIDS Surveys engagement of civil
Strengthening the capacity of HIV/SRHR-related access to society in advocating for
regional and national civil justice programming for young UNDP Country evidence and rights based
society organisations including key populations (through legal Office Annual laws in support of
community-based groups to services, legal literacy, Reports effective HIV/SRHR
claim rights and advocate for responses is essential to
strengthened national legal, addressing informal /customary National promoting action to
policy and strategy law, judicial sensitization) Commitments and strengthen legal, policy
environments and improved Policies Instrument and strategy environments
HIV/SRH service provision for Reports (NCPI) for young key populations
young key populations
Media reports
Specific Objective 3: Frameworks in place to support SADC Annual Support from the RECs is
Member States to strengthen reports necessary to help countries
Strengthening the capacity and legal, policy and strategy align with and develop
leadership of SADC to facilitate environments for e.g. prevention sub-regional laws and
Member States to put in place of child marriage, sexual and model bills on HIV/SRHR
legal, policy and strategy gender-based violence, to for young key populations
environments that respect the strengthen age of consent issues
rights of young key populations and prevent human rights
and promote regional learning violations against young key
populations
Specific Objective 4: Number of countries National Plans and Developing and

incorporating indicators and Global Fund standardising indicators
Strengthened understanding of milestones developed by the proposals for human rights work will
appropriate indicators and project into their existing M&E enable better tracking of
monitoring and evaluation systems progress and potentially
processes that help promote encourage countries to
accountability for operationalise human
implementation of human rights rights commitments in the
enabling activities that arise context of HIV and SRHR
from legal assessments, for young key populations
advocacy and research activities
Expected Results Indicators Sources of Baseline Targets by year Necessary

Information conditions
Outcome Result Number of Draft laws As 2018: 2 countries Environment
1: Law, policy and countries determined by engaged in created in which
strategy which engaged in LEA Policy and LEA which is activities to civil society and
impacts positively follow-up for strategy reviews the baseline strengthen the legal community based
on the HIV/SRH relevant law, for each and policy organisations and
and rights of policy and Operational country environment for individuals can
young key strategy review Plans young key safely and fully
populations is and reform to populations; 2019: participate in
reviewed, improve Meeting and 2 additional; 2020: debate on human
reformed, HIV/SRH rights training reports 1 additional rights and law and
implemented and and access to capacity
enforced as services for Participant lists strengthening on
appropriate young key human rights and
populations law
Outcome Result Number of National As 2017: Capacity National
2: Capacity Countries Development, determined by strengthening for environment
strengthening for including Youth, HIV, LEA which is key stakeholders created in which
key stakeholders capacity SRH Plans and the baseline included in human rights of
on needs and rights strengthening of Strategies for each national plan or young key
of young key key stakeholders country curricula in populations is
populations on young key 1country. 2018: 1 considered a
institutionalised in populations and priority to address
national plans or human rights in Reviews of additional; 2019: 2
curricula national plans or national plans additional
curricula e.g. in and strategies 2020: 1 additional
law enforcement
training or National
training for the Curricula e.g.
judiciary for judiciary,
law
enforcement
Output Result 1: Number of Meeting and LEA started 2017: 1 country Governments in
Gaps in adherence Countries which training reports in Angola in completed LEA; project countries
to international have completed 2016 2018: 2 additional; willing to conduct
and regional LEAs Participant lists 2019: 2 additional review and reform
human rights of legal
standards related Percentage of LEA Reports. Of stakeholder environment
to HIV and SRHR CSOs organisations
for young key representing consulted during
populations 1)SRHR, gender LEA, at least 50%
successfully and human rights should represent
identified issues and 2) Key SRHR, gender and
Populations human rights issues
involved in LEA and 20% should
processes represent Key
Populations
Output Result 2: Number of Meeting and No country 2018: 1country Selected
Accountability countries with training reports has action completed action governments
established for validated action plan with plan and willing to be
following up a plans and Participant lists mechanism accountability accountable for
nationally agreed mechanism for for mechanism in reform of legal
prioritised plan of accountability for LEA Reports accountability place; 2019: 2 environment
action to LEA follow up and Action for LEA additional; 2020: 2
strengthen legal, Plans follow up additional
policy and strategy
environments for
HIV and SRHR for
young key
populations
Output Result 3: Number of Reports from As 2017: 1 regional Environment
Capacity to apply capacity capacity determined by and 5 country created in which
human rights strengthening strengthening LEA which is level; 2018: 1 civil society and
principles in HIV- activities for key events the baseline regional and 5 community based
related work stakeholders131 Participants for each country level organisations,
strengthened lists country 2019: 1 regional individuals can
through collective and 5 country level safely and fully
capacity 2020: 1 regional participate in
strengthening and 5 country level debate on human
initiatives for key rights and law and
stakeholders capacity
(police, policy strengthening on
makers, judiciary, human rights and
parliamentarians, law
National Human
Rights Institutions,
key population
groups, other
CSOs etc.)
Output Result 4: Number of National policy, No countries 2018: 1country has Key national
Strengthened countries with strategy reviews functioning stakeholders
mechanisms for Advocacy mechanism; 2019: understand the
community inputs Working Groups National 2 additional; 2020: importance of
into (HIV/SRH) of young key Scorecards 2 additional community inputs
policy populations into policy
development for established and Advocacy development and
strengthened engaging with Working Group have capacity to
service provision national reports use these inputs to
for young key institutions and review policy and
populations policy processes Key population strategy on service
on rights and organisations provision for key
HIR/SRH service governance populations
access reports
2018: 2
Key population organisations
organisations include young key
including young populations in
key population governance
issues and voices structures; 2019: 2
in the governance additional; 2020: 2
of their additional
organisations
Output Result 5: Number of SADC Annual No countries 2018: 3 countries SADC can work
Strengthened Member States in reports have aligned in process of with member states
understanding of the process of as yet with aligning national to agree
the HIV/SRH aligning their National law, key law/policy or frameworks and the
service barriers national laws, policy, strategy population strategy with need to align with
and of the rights of policies and reviews framework or regional model laws
young key strategies as per with SADC frameworks
populations in regional PF Model law 2020: 2 additional
SADC as reflected frameworks on child countries
in regional and/or model marriage
frameworks laws; Number of
countries
incorporating
research findings
into review
processes
Output Result 6: Number of Indicators for None 2018: 1 country That human rights
Strengthened national and HIV/SRH for using appropriate components for
understanding and regional young key indicators young key
application of frameworks using populations in 2019: 2 additional populations are
human rights and appropriate national and countries using explicit and
HIV/SRH related indicators or regional appropriate budgeted in
indicators and milestones to frameworks, indicators national plans
milestones for track plans and 2020: 2 additional
young key progress/change proposals countries using
populations in in legal, policy appropriate
national and and strategy indicators
regional environments
frameworks
4.4 Project Activities and Deliverables
Interventions Countries Deliverables Budget
Regional USD $
1. National Legal Environment Angola  5 National Steering Committees 1,040,860
Assessments and National Action Madagascar Established
Plans completed Mozambique  5 Legal & Policy Environment
Zambia Assessments carried out,
Zimbabwe reported and disseminated
 Country supervision visits
carried out
 5 National Validation meetings
held and reported
 5 National Action Planning
meetings held and reported
2. Law, Policy and Strategy review as Angola  5 Political Scans carried out, 845,719
per recommendations of LEA and as Madagascar reported and disseminated
prioritised in National Action Plan Mozambique  National law, policy, strategy
(including National Political Scan) Zambia reviews carried out in 5
Zimbabwe countries
3. Capacity strengthening activities for Regional  4 Regional capacity 546,588

parliamentarians, policy makers, law strengthening meetings held,
enforcement and the judiciary in reported and followed up
HIV/SRH-related needs and rights of
each young key population carried out
4. Relevant tools and guidance on the  4 Tools developed and 218,644

HIV/SRH-related needs and rights of disseminated
each young key population developed
5. Assist SADC to strengthen regional  5x6 young key populations 373,722

frameworks to ensure they address travel to regional framework
HIV/SRH needs/rights of young key meetings every year
populations  SADC supported to include
young key populations in
regional frameworks
6. Capacity strengthening activities for Angola  5x4 National meetings 1,384,151
young SW, young LGBTI, young Madagascar conducted for young key
people in prison, young people who Mozambique populations
use drugs in HIV/SRH rights and Zambia  Small grants for young key
access to justice Zimbabwe population advocacy made in
each country
 Annual regional meetings for
YKPs
7. Mechanism for community inputs into Angola  2 Regional consultations for 1,833,177
policy and service provision Madagascar Young Key Populations held
established Mozambique  Advocacy Working Group
Zambia Meetings for Young Key
Zimbabwe Populations in each country
 Scorecards updated and
disseminated
8. Baseline study and mid-term review Regional  5 baseline studies implemented, 660,004
reported and disseminated
 Development of appropriate
indicators and project milestones
 Project mid-term review carried
out, reported and disseminated
9. Operational research on barriers to Regional  Five country research agendas 671,970
SRHR for young key populations, formulated and research
service needs and gaps proposals for country studies
developed
 Ethical approvals from
appropriate institutions obtained
for country studies
 Research reports and briefs
produced
 Peer-reviewed articles written
10. Cross-country comparative analysis of Regional  Regular reflection meetings with 588,983
change processes country research groups
 Research proposal for
comparative analysis developed
 Ethical approvals from
appropriate institutions, if
necessary, obtained
 Research reports and briefs
developed
 Peer-reviewed articles written
5. Management Arrangements and Accountability

5.1 Management structure
Programmatically this project will be linked to UNDP’s global programme of follow-up to the Global
Commission on HIV and the Law (GCHL). However, the project will be managed as a stand-alone
project in line with UNDP’s Programme and Operations Policies and Procedures (POPP) which requires
all project oversight to be provided by a Project Management Committee (PMC).
UNDP established a PMC to manage the different projects it is implementing under the Africa follow
up to the GCHL. Oversight of this project will, therefore, be done by this already existing PMC which
comprises of the Africa HIV, Health and Development Team Leader, the Director of the UNDP HIV,
Health and Development Group, the Deputy Director of the Africa Regional Bureau, two UNDP
Resident Representatives, Regional Directors of UNAIDS, UNFPA and UN Women, two
representatives from civil society and the Head of Division HIV/AIDS from the Department of Social
Affairs at the AUC. The Project Management Committee meets once a year to approve annual work
plans, review progress in the implementation of the project, and provide guidance for the specifications
of the outputs and programme activities. In addition to the annual meeting, the Project Management
Committee may agree to meet at other times via tele-conferencing/video-conferencing if required.
Implementation of the project will be managed and coordinated directly by the HIV, Health and
Development team of the UNDP Regional Centre. A senior Policy Advisor will be recruited as a Project
Manager to lead the day to day activities of the project. The Project Manager is accountable for
adherence to UNDP policies and procedures and will, among other things, be responsible for:
 Managing the overall conduct of the project;
 Implementing activities by mobilizing goods and services;
 Checking on progress and watching for plan deviations;
 Ensuring that changes are controlled and problems addressed;
 Monitoring progress and risks;
 Reporting on progress including measures to address challenges and opportunities.
Activities will be implemented in close collaboration across regional, country and global levels within
UNDP. AMSHeR and HEARD will implement their activities in line with the cooperation agreement
with UNDP which is attached to this proposal.
5.2 The Project Team

The Consortium members will allocate staff members time for the project as follows:
For UNDP, Implementation of this project will be led by the Africa Region HIV, Health & Development
(HHD) team. The regional HHD team will be responsible for overall management of the project
including all programmatic and financial communication with the consortium members. The regional
team will also be responsible for implementation of regional level activities and partnership with
regional level partners.
The UNDP Country Offices will manage agreed in-country activities with technical support from the
Regional Team. To make the most efficient use of resources, much of the work will be carried out by
email and meetings held on Skype. Where absolutely necessary and where there is a clear role for a
regional team member, visits will be made to countries. The HHD Focal points in UNDP Country
Offices generally meet every other year and are actively encouraged to regularly share their learnings
and challenges with one another by email and through the UNDP online platform and through the
dedicated website for the GCHL follow up located at the www.hivlawcommission.org/africa.
UNDP will allocate the following staff members time exclusively to the project:
 Director HIV, Health & Development Group (Global) (P6) 5% time (UNDP Contribution)
 Regional HHD Team Leader (Africa) (P6) 10 % time (UNDP Contribution)
 Senior Policy Advisor (Project Manager) (P5) – 100% (Project budget)
 Programme Specialist (P2) – 100% time (Project budget)
 Five UNDP country office focal points (NOC) – (20 % each) (Project budget)
 Programme Associate (G7) – 100% time (Project budget)
In addition UNDP will make use of a pool of consultants with extensive experience on HIV and the
law, human rights and strategic litigation, programming for key populations and LGBT issues. These
English and French speaking consultants have been supporting the different GCHL follow up projects
on a regular basis. Additional Portuguese speaking consultants with similar experience will be identified
and included in the pool to support the activities of this project in Angola and Mozambique.
AMSHeR will allocate the following staff members time exclusively to the project:
 Research and Knowledge Management Manager – 25%
 Member Capacity Strengthening Manager – 25%
 Law and Human Rights specialist – 25 %
 Finance and Compliance officer – 30%
 Programmes Coordinator – 25%
 Project Coordinator [country-based in a young key populations or key populations organisation
x 5] – 100%
 Advocacy Officer/director of programmes or equivalent [country-based in a young key
populations or key populations organisation x 5] – 30%
HEARD will allocate the following staff members time exclusively to the project:
 executive Director and Researcher Professor 10%

 Senior Researcher and Research Coordinator - 50%
 Junior Health Economist – 100 %
 Finance Administrator – 5%
 Junior Data Entry Researcher 100 %
 10 x Country Researchers (2 per country for data collection, analysis and translation) – 50 %
5.3 Financial and Administrative Management

Internal Control Framework
The project will be implemented in line with the internal control framework prescribed in the POPP.
This framework defines the roles, segregation of duties, authorities, responsibilities and accountabilities
of the UNDP staff members involved in the project implementation.
UNDP’s Financial Regulations and Rules (FRR), clearly indicate that all personnel of UNDP are
responsible to the Administrator for the regularity of actions taken by them in the course of their official
duties. Any personnel who take any action contrary to these Financial Rules or the instructions which
may be issued in connection therewith may be held personally responsible and financially liable for the
consequence of such action”.
The accountabilities of individual staff members are described precisely with reference to their “role”
in the office. The internal control mechanism is structured around these roles.
However, three of the roles – Project Manager, Approving Manager, and Disbursing Officer – exercise
authority for UNDP procurement, expenditure and disbursement transactions. These three roles are
especially important from an internal control perspective. An overview of the three authorities is as
follows:
 The First Authority has the primary responsibility for managing the resources being spent.
This person is referred to as the “Project Manager”, and approves eProcurement requisitions
(for PO transactions) and requests for non PO payments (for non-PO transactions). This
authority equates to the “committing officer” in UNDP Financial Regulation.
 The Second Authority, referred to in this document as the “Approving Manager”, approves
POs and non-PO payment vouchers (for non-PO transactions). This authority equates to the
“verifying officer” in UNDP Financial Regulation.
 The Third Authority, referred to as the “Disbursing Officer”, approves disbursements. This
authority equates to the “disbursement officer” in UNDP Financial Regulation. The
‘disbursing officer’ role holds third authority in the requisition to payment process, exercised
by (a) authorizing pending disbursements, and (b) exercising the role of Bank signatory as it
relates to the method of payment. This role, which will also be documented in the SLA, will
be primarily assigned to the Deputy Country Director-Operations (DCD/O) and in his/her
absence to the Country Director.
5.4 Fund Transfer to UNDP Country Offices

Funds for country-level activities to be implemented by UNDP will be provided to UNDP Country
Offices using one of three modalities: 1) A chart of accounts is provided to Country Offices within the
project and under the Regional Office department; 2) Funds are decentralized to Country Office
departments within the project; 3) Funds are transferred to a Country Office project.
This project will primarily use the first modality in order to enable the Regional Team to have the
greatest degree of direct oversight over country-level expenditures. This modality enables Country
Offices to spend directly against the project but requires the Regional Team to manage and oversee all
financial transactions. A chart of accounts is provided to Country Offices detailing the financial
information that can be used for initiating a specific activity and sets a ceiling amount for how much
the Office can spend, in line with the project document and approved work-plan. The chart of accounts
also provides a framework for budgeting, recording and reporting on financial transactions at country
level. All transactions are reviewed and approved by the Regional Team on the basis of UNDP’s Internal
Control Framework, which segregates duties of individuals to minimize conflict of interest or
inappropriate use of funds.
The other modalities may be used occasionally if there is specific justification. For example, option
three may be considered in cases where a country office already has a project that is implementing
linked activities. UNDP Internal Controls Policy is available on the UNDP website.
5.5 Fund Transfers to NGO Partners

Risk assessment
UNDP rules require that there be a detailed mapping and analysis of a Partner organization’s
responsibilities and the corresponding capacities to manage the associated accountabilities and risks
effectively. Risk assessment and risk management are also formal management requirements under the
UNDP’s Enterprise Risk Management (ERM) policy. In addition, UNDP is included under the UN
policy for the Harmonized Approach to Cash Transfers (2005) which requires, inter alia, that UN
agencies adopt a risk management approach and select specific procedures for transferring cash on the
basis of the joint assessment of the financial management capacity of Implementing Partners.
The UNDP risk management policies and procedures establish a five-step process as follows:
1 The identification and classification of risks;

2 The measurement and evaluation of risks;
3 The prioritization and ranking of risks in relation to each other;
4 The development of a Risk Management Action Plan (RMAP) applicable to each programme
5 The development of a programme of monitoring and follow-up.
Based on the risk analysis UNDP and the Partner will develop a Risk Management Action Plan (RMAP)
to address the identified risk for the project, prior to signing a grant agreement or during contract
execution. The RMAP covers several aspects including procurement, financial management, HR
management, and monitoring and evaluation.
Capacity assessment
In addition to the risk assessment, UNDP will also conduct an independent capacity assessment of the
Partner organization prior to signing a grant agreement and transferring any funds. This is to determine
that Partners meet the minimum institutional and technical capacity requirements which include:
1. Financial management systems that:
a) correctly record all transactions and balances

b) disburse funds to suppliers in a timely, transparent and accountable manner
c) support the preparation of regular, reliable financial statements
d) safeguards property; and
e) are subject to acceptable auditing arrangements
2. Institutional and programmatic:
a) legal status to enter into a grant agreement with UNDP;

b) effective organizational leadership, management, transparent decision-making and
accountability systems;
c) adequate infrastructure, transportation and technical information systems to support
proposal implementation, including the monitoring of performance of outsourced entities
in a timely and accountable manner; and
d) adequate expertise (relating to HIV, SRH, young people, key populations) and cross-
functional expertise (finance, procurement, legal, M&E).
3. Monitoring and evaluation systems that:
a) collect and record programmatic data with appropriate quality control measures;
b) support the preparation of regular reliable programmatic reports; and
c) make data available for the purpose of evaluation and other studies.
Depending on the outcome of the capacity assessment UNDP will take different measures. If UNDP
determines that the Partner represents significant risk or does not possess all the required capacity to
carry out the activities envisioned under the programme, these factors need to be formally addressed
for example, through Precedent/Special Condition to the grant agreement or a capacity development
plan, as part of the agreement, or through specific disbursement modalities (no advance or direct
payment), as risk mitigation measures.
Based on the results of the capacity assessment UNDP and the Partner could also develop a Capacity
Development Plan (CDP), to be annexed to the grant agreement, addressing in detail how capacity will
be developed in the identified areas of weakness, and how organizational capacities will be maintained
and strengthened in other areas. As the Partner implements the activities in the grant agreement, and as
the CDP is being carried out, UNDP can reassess the capacity of the Partner, from time to time, to
address the assessment findings.
Fund request and transfer
Partners request funds at the same time that they submit their progress reports to UNDP, except for the
first funding request which is provided to the Partner as an advance so that implementation of activities
can be initiated, on the basis of the grant agreement, through an agreement on advances. The first
instalment would cover the initial start-up cost and the cost of bridging the reporting period for the first
quarter. The second and subsequent disbursements will be advanced on a quarterly basis. Total
disbursement for the fiscal year should not exceed the approved annual work plan and budget. UNDP
can authorize advances for up to four months of programme expenditures without a bank guarantee if
it is not possible to obtain one. Any advances outside this time-frame must be cleared by UNDP
Comptroller’s Division.
After the first funding request, subsequent requests are made in tandem with Partner progress reports.
The funding request must be signed by the person or persons authorized by the Partner to do so and, in
form and substance, be agreed by UNDP.
Funding is provided on the basis of performance, which includes project management and financial
performance as well as external factors that may have had an impact on performance. Partner progress
reports, containing both financial and programmatic data, and other agreed documentation, must show
satisfactory management and use of the resources before UNDP can provide the funds requested. The
amount of funding that UNDP approves will depend on the information provided in the progress report.
UNDP can also provide funds to Partners over shorter or longer time-frames than requested, depending
on an assessment of programme needs and the nature of activities.
The grant agreement is a performance-based funding mechanism; hence the agreed budget is a
maximum figure that could be reduced if performance is not adequate. The grant agreement will list
measurable deliverables and link them to the corresponding costs.
UNDP will request Partners to provide clarification and supporting documents with respect to funding
requests. Prior to fulfilling a funding request, UNDP would verify that at least 80 percent of the funds
provided to the Partner in the previous disbursement have been utilized and that 100 percent of all
disbursements before the previous disbursement have been spent in accordance with a grant agreement.
In the framework of a grant agreement, UNDP can make payments directly to suppliers. However, such
payments must be requested by the Partner accompanied by accurate and complete financial and
programmatic documents. In addition, Partners may request that UNDP make direct payments to other
institutions undertaking programme activities as specified in their work plan and budget. Any direct
payment requests will be formally authorized by UNDP against the Partners’ work plan, budget and
performance framework.
5.6 Anti-fraud and anti-corruption policy

The UNDP policy on fraud and other corrupt practices (the UNDP Anti-fraud Policy) is an important
part of UNDP’s corporate governance, establishing the framework for preventing, identifying, reporting
and effectively dealing with fraud and other forms of corruption. It is in line with the UNDP
Accountability System, adopted by the executive Board to support ethical values and standards, increase
transparency and proper stewardship of resources, as well as to clarify and align all relevant activities.
An important part of this System is the Institutional Oversight Arrangement which is the general process
of monitoring, evaluating, reporting, auditing, and investigating alleged fraud. These activities aim to
ensure organizational, financial, and operational accountability, effectiveness of internal controls,
prevention, detection and investigation of fraud and malpractice, and the promotion of organizational
integrity.
The UNDP risk management policies and procedures establish a five-step process as follows:
1. The identification and classification of risks;

2. The measurement and evaluation of these risks;
3. The prioritization and ranking of risks in relation to each other;
4. The development of a risk management plan applicable to each programme;
5. The development of a programme of monitoring and follow-up.
Fraud and corruption both involve the taking or conversion of money, property, or valuable items by an
individual who is not entitled to them. They involve an act or omission that intentionally misleads, or
attempts to mislead, a party to obtain benefit. In the case of corruption the item of value is taken by
someone to whom it was entrusted, while fraud consists of the use of false or misleading information
to induce the owner of the property to relinquish it voluntarily. The complete UNDP Policy on Fraud
and other Corrupt Practices is available at:
http://www.undp.org/content/dam/undp/documents/about/transparencydocs/UNDP_Anti-
fraud_Policy_English_FINAL.pdf
5.7 Quality assurance

All UNDP programmes and projects are required to adhere to the quality standards set by the
organization. The UNDP program manager for this project will therefore be responsible for assuring
that the design and implementation of projects meets these quality standards in terms of the relevance,
efficiency, effectiveness, sustainability, as well as meeting social and environmental standards. This
will be done through the quality assurance assessments which are required for all UNDP programmes
and projects, regardless of their budget, size, location, duration, characteristics, context, or
circumstances. The UNDP project manager will prepare the quality assessment (QA) that will be
submitted to the Quality Assessment Approver who reviews the credibility of the QA. The QA
Approver must function at a higher level of accountability than the QA Assessor and for this project
will be the HHD Team Leader. UNDP, POPP - Quality Standards for Programming are available at:
https://info.undp.org/global/popp/ppm/Pages/Quality-Standards-for-Programming.aspx#Description
5.8 Project Cooperation Agreement

Implementation of the project activities by the three consortium partners will be based on and be guided
by a Project Cooperation Agreement (Memorandum of Understanding) signed by all Consortium
partners – UNDP, AMSHeR and HEARD and attached with this proposal as Annex 1. The MoU
describes governance and collaboration structures and the tasks and responsibilities of the lead partner
(the embassy’s contract partner) and other consortium partners. This Project Cooperation Agreement is
distinct from the legally binding financial contractual arrangement, the grant agreement referred to in
section 5.4 above which will be signed between UNDP and each of the Consortium partners after the
capacity assessment.
5.9 Management Structure
UNDP Project Management Committee
Project Assurance Project Management

 UNDP Director HIV,
Health and Development  UNDP Regional HHD Team Leader
 UNDP Project Manager  UNDP Project Manager
 UNDP Programme Associate
Project Implementation
 UNDP Country Offices Implementation Support
 UNDP Regional Centre  UNDP Operations team in Country
 AMSHeR and Affiliate Offices and Regional Centre
organizations  AMSHeR Operations team
 HEARD  HEARD Operations team
6. Project Inputs
Annex 2 provides details on the total resources needed to implement the project, including human and
financial resources.
With regard to GMS, the direct programme management cost included in the budget refers to costs such
as human resources recruited directly for the project, audit costs and office costs directly related with
the project implementation. This is in line with article 5 of the first amendment made in 2008 which
replaced paragraphs 6.2 and 6.3 of the 2005 Framework Agreement. The amendment indicates that in
addition to the 7% (this has been raised to 8% percent by the UNDP Executive Board decision 2013/9)
GMS which covers the list of activities outlined in annex 4 of the Framework Agreement, all direct
costs of implementation including the costs of the implementing entity or implementing partner will be
identified in the project budget against a relevant budget line and borne by the project as long as they
are unequivocally linked the project.
Apart from the above, all other activities listed in annex 4 of the Framework Agreement including
identification, formulation and appraisal of the project, preparation of project documents, mobilization
of staff in the start-up phase, etc. are covered from UNDP resources. Similarly, monitoring of the project
implementation including visits to project countries, conducting meetings with project staff and
consortium members and organizing progress review meetings, keeping financial records, reporting, IT
and knowledge transfer will be covered from the GMS. None of these meetings are included in the
project budget.
Financial Resources Required
Annex 2 also provides a detailed budget by intervention and by country. Below is a summary by
intervention of the financial resources required from the Netherlands Ministry of Foreign Affairs, in
$USD as per agreement and totaling $8,049,895. The UN EUR to USD exchange rate of 1.11 for July
2016 was used for this budget.
Total direct programme costs by Year 1 Year 2 Year 3 Year 4 Total

intervention in USD $
Total intervention (1) 248,655 236,207 112,427 112,427 709,716
Total intervention (6) 281,572 347,312 331,572 281,572 1,242,028
Total intervention (7) 500,201 531,139 500,201 512,251 2,043,793
Total by intervention 1,999,707 1,951,812 1,827,319 1,674,769 7,453,606
Total direct programme costs by Year 1 Year 2 Year 3 Year 4 Total

country in USD $
Country (Angola) 231,311 206,314 210,132 179,132 826,889
Country (Mozambique) 230,981 243,254 198,859 167,859 840,953
Country (Zambia) 204,797 189,187 192,199 161,199 747,382
Country (Zimbabwe) 204,487 188,879 192,379 161,379 747,124
Country (Madagascar) 219,679 232,062 191,719 160,719 804,179
Country (Regional) 908,451 892,117 842,031 844,481 3,487,079
Total direct programme costs by 1,999,707 1,951,812 1,827,319 1,674,769 7,453,606
country
Total direct programme costs by Cost Year 1 Year 2 Year 3 Year 4 Total
Type in US$
Regular UNDP Staff Costs 512,440 512,441 512,441 512,441 2,049,762
Contractual Service Indivisual 474,597 474,597 474,597 474,597 1,898,388
(Partners costs)
Consultants 271,350 93,100 151,850 61,600 577,900

Travel and meeting costs 643,787 666,846 585,899 535,899 2,432,433
Printing and publication 26,900 49,200 31,900 19,600 127,600
Professional Services(Audit fees) 17000 102000 17000 17000 153,000
Office Costs 53632 53628 53632 53632 214,524
Total direct programme costs by Cost 1,999,707 1,951,812 1,827,319 1,674,769 7,453,606
type
Total Programme Costs in USD $ Year 1 Year 2 Year 3 Year 4 Total
Total direct programme costs 1,999,707 1,951,812 1,827,319 1,674,769 7,453,606

GMS @ 8% 159,977 156,145 146,186 133,982 596,288
Grand total programme costs 2,159,683 2,107,957 1,973,504 1,808,750 8,049,895
UNDP will contribute an additional estimated $1 million to the project over the 4 years. This will cover:
Project Quality Assurance and Supervision costs such as time from the Director HIV, Health &
Development Group (Global), from the Regional HHD Team Leader (Africa) and for Project
Management Committee meetings and from the Senior Management in UNDP Country Offices in the
5 project countries; Advocacy for Young Key Population Issues such as inclusion of young key
population members in the Africa Key Population Experts Group which meets at least annually, costs
of young key population participation in regional and global meetings and conferences and costs of
relevant government participation in regional and global meetings; Capacity Building of CSO
Partners in areas such as financial management, human resources, monitoring and evaluation.
HEARD will contribute an additional estimated $52,000 to the project over the 4 years. This will cover
the costs of time from the Research Director and from the Operations Director.
AMSHeR will contribute an additional estimated $30,000 to the project over the 4 years. This will
cover the costs of time from the executive Director and the Deputy Director.
7. Project Timeframe
The table below shows interventions and associated activities/milestones per quarter, by numbered
intervention. Please refer to Annex 2 for the corresponding detailed budget per year. The project is
currently budgeted and planned for16 quarters. Please note that this timeframe may be adjusted and
refined during the first work-planning meeting of partners when synergies between different activities
become more apparent.
Activity Year 1 Year 2 Year 3 Year 4

Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 National Legal Environment Assessments and National Action Plans conducted in 5 countries
Five national steering X
committees established
Five national X X
consultants recruited
1 Regional consultant
recruited
Legal & Policy X X X X X
Environment
Assessment carried out
and disseminated
National Validation and X X
Action Planning
meetings held and
LEAs launched
2 Law, Policy and Strategy review as per recommendations of LEA undertaken in 5 countries
Five national X
consultants recruited
2 Regional consultants
recruited
Political scans carried X X X
out and reports
produced
3 Capacity strengthening activities for parliamentarians, policy makers, law enforcement and the
judiciary undertaken in five countries
1 Regional consultant X X X X
recruited and training
tools developed/adapted
Regional trainings X X X X
conducted
4 Relevant tools and guidance on the HIV/SRH-related needs and rights of each young key
population developed
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 regional consultant X X X X
recruited
Tools for different X X X X
thematic areas
developed and
disseminated
5 Assist SADC to strengthen regional frameworks to ensure they address HIV/SRH needs/rights of
Young KPs from X X X X
project countries
participate in regional
SADC events and
meetings
6 Capacity strengthening activities for young SW, young LGBTI, young people in prison, young
people who use drugs in HIV/SRH rights and access to justice in 5 countries
National training for X X X X
Small grants for young X X X X
KP organizations
7 Mechanism for community monitoring to feed into policy and service provision established
Regional consultation X X X X
for Young Key
Population groups
10 x 4 National X X X X X X X X X X X X X X
dialogues for Young
Key Population groups
8 Baseline study and mid-term review
5 local research teams X
recruited, supervised by
HEARD core research
team
5 baseline study reports X
Development of X X
appropriate indicators
and project milestones
MTR report X X X
9 Operational research on barriers to SRHR for young key populations, service needs and gaps
5 local research teams X
recruited, supervised by
HEARD core research
team
Five country research X X
agendas
Research proposals for X
country studies
Ethical approvals from X X
appropriate institutions
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
obtained for country
studies
10 Cross-country comparative analysis of change processes
Research groups X
established in each
country
Regular reflection X X X X
meetings with country
research groups
Research proposal for X
comparative analysis
Ethical approvals from X X
appropriate institutions,
if necessary, obtained
Research reports and X X
briefs
Exchange meeting and X X
meeting report
Peer-reviewed articles X X
8. Project Risk Analysis and Mitigation Strategies

The table below highlights potential risks related to the particular context in Southern Africa, to the
programme and the interventions and potential risks related to the implementing organisations. Each
risk is analysed in terms of potential impact and likelihood of occurrence and measures that the project
will take to mitigate each risk are outlined.
Potential Contextual Potential Impact Mitigation Measures

Risks and Likelihood
HIV/SRH-related law Project is delayed This consortium has proven experience in mitigating this type of
reform processes, can or derailed risk. Risk mitigation strategies have been built into the project,
become politicised. including the inclusive and participatory nature of the overall
There are many Medium risk implementation strategy, its focus on broad international,
social and political regional and national human rights commitments, and a concrete
sensitivities around commitment to transparency and strategic partnerships with key
same-sex rights, regional and national institutions. Continued and close
sexual and interaction and engagement with regional and national civil
reproductive health society groups/networks and with regional and national UN
rights more broadly actors will also be vital for mitigating this type of risk. Previous
as well as customary projects have enabled consortium members to gain insights into
and religious laws, mitigating risks when engaging with sensitive social and
practices, values and political issues, and will deploy lessons learned from that
norms. experience.
Project is Project activities UNDP is a trusted government partner and will work with
misunderstood and will be blocked by government to ensure that there is clear agreement on the
misrepresented as government objectives of the project. The consortium will be explicit about
promoting Low risk activities involving children 10-17 years.
homosexuality and
recruitment of
children
National Suspicion and a These risks will be mitigated by the project being, as mentioned
governments level of mistrust above, part of a larger process of general HIV-related legal
potentially feel that in the project environment strengthening. As shown in UNDP’s work on LEA
the project is solely engendered, in Malawi and in DR Congo, key stakeholders, some nervous at
about LGBT resulting in the outset, were very pleased to see that the LEAs showed gaps
significant in legislation, access to justice and implementation of the law
Governments may barriers to across a wide variety of issues – including for children, in the
also feel that UNDP implementation workplace, relating to access to medicines etc. Priority issues for
is pursuing a key populations came up in exactly the same way as these other,
particular agenda and Low risk less sensitive issues, and were neither under- nor overstated in
working outside of its the assessment and the LEA report. Key stakeholders were then
remit as an impartial able to prioritise action in the short/medium and long term
policy advisor to according to the levels of comfort felt. This meant that senior
government. government officials felt that they had some control over the
pace of change, but that LGBT issues were placed firmly on the
agenda.
Change of Project activities The Political Scans that will be carried out in each country will
Government in will be delayed as identify when elections are planned and interventions will be
project countries new champions strategically timed to minimise delay. Project partners also often
are sought and build relationships with opposition party members and thus a
new relationships change in government may not be so disruptive as relationships
built may already exist.
Medium Risk
Potential Risks Potential Impact Mitigation Measures
related to the and Likelihood
programme and the
interventions
Project activities young key All partners have an excellent track record in strategies to protect
expose young key populations and key populations and keep them safe whilst participating in
populations to CSOs unable to project activities. Advice on the design of activities will be taken
violations of human safely and fully from the Africa key population Experts Group. Standard
rights. participate in operating procedures will be developed for each activity.
debate on human
rights and law
Medium risk
Ethical clearance for Research HEARD will carefully design the research to allow time for
research components components are ethical clearance. HEARD works with in-country focal persons
takes a long time or is delayed or not located in NACs or health ministries to ease securing ethical
not forthcoming delivered permission for research.
Medium risk
Governments Project will not be Increasing evidence shows that addressing HIV/SRH related
unwilling to conduct able to deliver on rights is a cost effective strategy. All project countries expressed
review and reform of its targets interest in being part of the project. Project interventions are not
legal environment restricted to issues of key populations, but are broad-based legal
Low risk and policy assessments.
Programme and Investments made Sustainability is one of the critical pillars of the programme and
interventions are not by the project will these and other measures will be built in right from the planning
owned by key not be sustainable stage:
stakeholders at and will not have • The project will undertake country processes and regional
country and regional impact beyond the engagements in a way that is inclusive, participatory and
level project timeframe encourages leadership by representative and multi-sectoral
national structures, so that countries and SADC (i.e.:
Low risk government and civil society) participate fully in efforts to assess
their legal and regulatory frameworks, identify key gaps and
challenges, prioritise recommendations and develop action
plans.
• The project will build on existing work currently being done at
both national and regional levels to strengthen legal and
regulatory frameworks, and ensure that HIV and human rights
programming is mainstreamed into existing plans, such as
national strategic plans on HIV and AIDS, country development
plans and UN Development Assistance Frameworks, as well as
within SADC development plans related to health, HIV/SRH
and the SDGs.
• The Project will Include a focus on strengthening the capacity
of and providing support to duty-bearers at both national level
(e.g. national governments) as well as regional level on issues of
HIV/SRH, human rights and law.
• The project will support the development of national Young
Key Populations Experts to ensure ongoing expertise and
support for HIV/SRH, law and human rights issues in the region.
• The project will promote linking, sharing and learning across
countries and across the region to increase long-term national
and regional knowledge and capacity in HIV/SRH, law and
human rights and efforts to strengthen legal and regulatory
responses.
Countries do not LEA report is Balancing the need for national ownership with strong technical
listen to or take on based on attitudes input is another challenge that is envisaged. However, two
board evidence based rather than on strategies will be deployed which have helped previous projects
technical advice in evidence and address this issue. Firstly, the project initiates a legal assessment
LEA, Action young key or a national dialogue only after national entities have engaged
Planning and populations’ with the issue and agreed to move forward. Secondly, technical
law/policy reform needs and rights support is not only provided regionally, but national experts are
are not respected always involved in the assessment often as consultants. This
in law/policy ‘leading from the back’ has helped not only in national buy-in of
reform – the the project, but has also ensured that national capacity is
project can cause developed by the project
harm.
Medium risk
Domestic resources Longer term To promote financial sustainability, the consortium will seek to
are insufficient to objectives of the use the project to both institutionalize on-going action on human
continue with long project will not be rights and HIV and to leverage additional funds from national
term law and policy realised and the governments and development partners. Experience from other
reform beyond the ground work will projects has shown that while there is a reliance on external
not be utilised funding to get this work off the ground, once countries commit
timeframe of the to policy and law reform, the need for financial support is limited
project Medium risk to requests for specific technical expertise which is much more
sustainable.
There are The project The project does not envisage any environmental risks related to
environmental risks impacts implementation of activities. However, efforts will be made to
related to negatively on the ensure that all activities as much as possible reflect the principles
implementation of environment of environmental protection and sustainable development. For
interventions example, equipment purchased under the framework of the
Low risk project will not violate environmental principles and regulations.
Procurement of air travel will be analysed and carefully planned
in order to reduce carbon emissions.
To make sure that this is the case, a new project-level
environmental and social screening procedure launched by
UNDP in 2012 will be applied to this project.
Potential Risks Potential Impact Mitigation Measures

related to the and Likelihood
implementing
organisations
Project results and Project will not be The consortium will ensure that communication and visibility
products not well visible, lessons are integrated in the programme plan to communicate the
communicated not shared and positive results of programme, focusing on outcomes and the
impact of the impact of results and on lessons learned. All partners will use
project will not be their own communication channels. UNDP will update project
maximised. activities and achievements on the Africa Follow Up site located
within the Global Commission on HIV and the Law website. All
Low risk communications efforts undertaken by the project will enjoy the
support of UNDP’s Communication and Knowledge
Management units at the country and regional levels. AMSHeR
will update project activities and achievements on the AMSHeR
website and all communications efforts will be supported by the
AMSHeR Media and Communication Advocacy manager.
HEARD will dedicate a section of its main website to the project;
project research will be published in peer review journals and
key findings will be developed into policy briefs for key
stakeholders.
Project is Expected results UNDP internal controls are comprehensive. A Management
mismanaged, funds will not be Committee will be established for oversight. UNDP will
misused achieved. undertake capacity assessments of HEARD and AMSHeR
covering financial management 132 and assist HEARD and
Low risk AMSHeR to strengthen capacity as necessary. Disbursements
will be based on performance.
There is a lack of Results cannot be UNDP was previously ranked as the world’s most transparent
transparency in terms validated aid organization in the October 2014 international Aid
of project Transparency Index – which sets a common global benchmark
management Low risk for more timely, accurate and comprehensive aid information.
UNDP has maintained this ranking in the 2016 Index, which
ranks 46 aid organisations in total, including bilateral donors,
UN Agencies, other multilaterals, etc. UNDP was the only
organisation to score above 90% on the 2016 Index.
9. Project Reporting
As the lead partner, UNDP will be responsible for submitting annual reports to Netherlands Ministry of
Foreign Affairs in line with the General Arrangement between the Netherlands Ministry for
Development Cooperation and UNDP. As per this arrangement, within ... months (to be defined in the
contract) of the end of each year, UNDP will submit to the Minister a concise progress report on the
previous year, drawn up in English, which will include the following information both for the reporting
period as well as cumulative information from the start of the project:
 An overview of the progress made in the implementation of activities and the results achieved
and not achieved.
 An overview of personnel – and material resources acquired within the scope of the project.
 The provisional financial data and indicators relevant to monitor the progress.
 Best practices and lessons learned.
 Relevant risks and bottlenecks as well as the measures taken or to be taken.
The final report will cover the last year and a review of the entire implementation from 20-- to 20--(as
defined in the contract). It will therefore include an overview of the results achieved which are then
compared with the objectives formulated at the start of the project and any subsequent approved changes
during the complete period of implementation.
This project will be published in line with International AID Transparency Initiative (IATI) standards
following the publication guidelines of the Netherlands Ministry of Foreign Affairs. Reports will be
published on the basis of the results and resources framework in the project proposal.
UNDP will coordinate the overall reporting on the IATI platform but the consortium partners will be
responsible for publishing the respective activities they implement and are accountable for. In cases
where there are overarching results to which all consortium partners contribute, these results would be
published in the parent activity while at the same time the detailed outputs and outcomes are published
connected to the underlying activities. UNDP and the consortium partners will synchronize their results
and indicators in order to clarify the relationship between the hierarchies of results.
Given the sensitive nature of the project the necessary caution will be taken to ensure safety of
implementing partners, organizations and individuals by anonymising data sources, aggregating data
for different levels of reporting (national and regional), excluding personal information, etc.
UNDP will develop a detailed IATI publication outline and adapt the necessary publishing tool and
templates as per the MoFA guidelines and the IATI standards. This can be adapted for other projects as
appropriate.
10. References
1 Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population
Prospects: The 2012 Revision, http://esa.un.org/unpd/wpp/index.htm.
2 UNAIDS 2012
3 UNAIDS, 2014 Gap Report, page 32.
4 http://www.unaids.org/en/resources/presscentre/featurestories/2015/march/20150312_ESA
5 UNAIDS (2016). Global AIDS Update. Available at http://www.unaids.org/sites/default/files/media_asset/global-AIDS-
update-2016_en.pdf. Accessed on 1 July, 2016.

6 UNAIDS, Synthesis of the latest evidence on the HIV epidemic and programmatic response among people left behind (Sex
Workers, Men having Sex with Men, Transgender populations and People Who Inject Drugs) in the Eastern and Southern
Africa region, Draft Report, 2015
7 Rachel Baggaley et.al Young key populations and HIV: a special emphasis and consideration in the new WHO
Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations, JIAS, 2015 18 (Suppl 1),
p 86.
8 The Gap Report, UNAIDS, 2014
9 WHO (2011). Guidelines: prevention and treatment of HIV and other sexually transmitted infections among men who have
sex with men and transgender people: recommendations for a public health approach. Geneva: World Health Organisation.
10 HIV and Young People who Sell Sex, Technical Brief, Geneva, WHO 2015.
11 http://www.southernafricalitigationcentre.org/2016/06/09/news-release-sadc-parliamentarians-adopt-model-law-on-
eradicating-child-marriage-and-protecting-children-already-in-marriage/
12 UNGASS, 2011. Political Declaration on HIV/AIDS
13 Ibid.
14 Global Commission on HIV and the Law, 2012. Risks, Rights & Health. Available at www.hivlawcommission.org
[Accessed 9 July 2012]. See www.hivlawcommission.org for further information on the Global Commission on HIV and the
Law, submissions on HIV and the law made at 7 Regional Dialogues and in particular, the Africa Regional Dialogue on HIV
and the Law, 4 August 2011.
15
ACHPR 54th Ordinary Session (2013). Resolution 260: Resolution on Involuntary Sterilisation and the Protection of
Human Rights in Access to HIV Services. Available at http://www.achpr.org/sessions/54th/resolutions/260/ (Accessed 15
May 2015).
16 ACHPR 55th Ordinary Session (2014). Resolution 275: Resolution on Protection against Violence and other Human
Rights Violations against Persons on the basis of their real or imputed Sexual Orientation or Gender Identity. Available at:
http://www.achpr.org/sessions/55th/resolutions/275/ (Accessed 15 May 2015).
17 UNICEF, A Report Card of Adolescents in Zambia available at
http://www.unicef.org/zambia/A_Report_Card_Of_Adolescents_In_Zambia.pdf (accessed 26 Feb 2015).

18 A Childhood Lost: A Report on Child Marriage in the UK and the Developing World from the UK All-Party
Parliamentary Group on Population, Development and Reproductive Health (November 2012) 8.

19 African Child Policy Forum, Minimum Age of Marriage (Sept 2013).
20 Mills S, Lyimo O, Mabuza PSP, Ankrah V, Dlamini D, Thwala-Tembe M, Nhlabatsi B, Bango M. November 2010.
Improving the Quality of Maternal and Neonatal Health Services in Swaziland: A Situational Analysis. Swaziland Ministry
of Health, World Bank, UNICEF, WHO and UNFPA.
21 UNDP Regional Support Centre for Africa (2014). A report on progress towards achieving law and human rights goals
within the UNDP Regional Centre for Africa (2014) A report on progress toward rights goals within the African Union
Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa (2012-2015).
22 Shannon K and Montaner J (2012). The politics and policies of HIV prevention in sex work. The Lancet Infectious
Diseases, 12(7): 500-502. And ARASA Botswana report

23 KELIN (2014). Punitive laws and practices affecting HIV responses in Kenya.
24 FIDA (2008). Documenting Human Rights Violations of sex workers in Kenya.
25 SALC (2013). No justice for the poor: A Preliminary Study of the Law and Practice Relating to Arrests for Nuisance-
Related Offences in Blantyre, Malawi. SALC and CHREAA

26 Open Society Foundations (2012). Criminalising Condoms. How Policing Practices Put Sex Workers and HIV Services at
Risk in Kenya, Namibia, Russia, South Africa, the United States, and Zimbabwe. Accessed at:
http://www.opensocietyfoundations.org/reports/criminalizing-condoms
27 UNFPA. (2013) Motherhood in Childhood: Facing the challenge of adolescent pregnancy. New York
28 Ibid.
29 Shannon, Kate et al.Global epidemiology of HIV among female sex workers: influence of structural determinants. The
Lancet , Volume 385 , Issue 9962 , 55 - 71

30 AMSHeR and CAL (2013). Violence Based on Perceived or Real Sexual Orientation and Gender Identity in Africa.
31 ActionAid (2009). “Hate Crimes: The Rise of “corrective rape” in South Africa”. Available
https://www.actionaid.org.uk/sites/default/files/doc_lib/correctiveraperep_final.pdf. (Accessed 22 May, 2015).

32 AMSHeR and CAL (2013). Violence Based on Perceived or Real Sexual Orientation and Gender Identity in Africa.
33 UNAIDS 2009. “UNAIDS Action Framework: Universal Access for Men who have Sex with Men and Transgender
People”. Available: http://data.unaids.org/pub/report/2009/jc1720_action_framework_msm_en.pdf (Accessed 22 May,

2015).
34 UNDP Regional Support Centre for Africa (2014). A report on progress towards achieving law and human rights goals
within the African Union Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in
Africa (2012-2015).
35 International Lesbian, Gay, Bisexual, Trans and Intersex Association (2013) Africa from a Lesbian and Gay Human
Rights Perspective
36 Bandawe C and Mambulasa M (2012). CEDEP needs assessment for effective implementation of human rights, HIV and
other health related interventions among MSM and WSW in Malawi.

37 UNAIDS (2014). The Gap Report. Accessed at:
http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/unaidspublication/2014/UNAIDS_Gap_r
eport_en.pdf
38 Including the right to recognition before the law, the right to non-discrimination and equality, the right to privacy, the right
to health, and the right to freedom from torture and cruel, inhuman or degrading treatment or punishment. See Open Society
Foundations (2014). License to be yourself. Laws and Advocacy for Legal Gender Recognition of Trans People. Accessed
at: http://www.opensocietyfoundations.org/reports/license-be-yourself
39 Open Society Foundations (2013). The Global Commission on HIV and the Law: Transgender People. A Brief for Civil
Society. Accessed at: http://www.opensocietyfoundations.org/sites/default/files/HIV-and-the-Law-Transgender-People-
20130930_0.pdf
40 Stevens M (2012). Transgender access to sexual health services in South Africa: findings from a key informant survey.
amfAR and Gender Dynamix and Kenya Human Rights Commission (2011). The Outlawed Amongst Us. A Study of the
LGBTI Community’s Search for Equality and Non-Discrimination in Kenya. Nairobi: Kenya Human Rights Commission.
41 Human Rights Campaign (2014). Court allows Kenyan Transgender Rights Group to officially register. HRC Blog, 30
July 2014.
42 Stevens M (2012). Transgender access to sexual health services in South Africa: findings from a key informant survey.
AMfAR and Gender Dynamix; Kenya Human Rights Commission (2011). The Outlawed Amongst Us. A Study of the
LGBTI Community’s Search for Equality and Non-Discrimination in Kenya. Nairobi: Kenya Human Rights Commission;
Baral S et al (2011). Human Rights, the Law, and HIV among Transgender People. Working Paper prepared for the Third
Meeting of the Technical Advisory Group of the Global Commission on HIV and the Law, 7-9 July 2011. Accessed at:
http://www.hivlawcommission.org/index.php/working-papers?task=document.viewdoc&id=93
43 Baral SD, Beyrer C, & Poteat T (2011). “Human Rights, the Law, and HIV among Transgender People. Working Paper
prepared for the Third Meeting of the Technical Advisory Group of the Global Commission on HIV and the Law, 7-9 July
2011”. Available: http://www.hivlawcommission.org/index.php/working-papers?task=document.viewdoc&id=93. Accessed
on 22 May, 2015.
44 KELIN (2014). Punitive laws and practices affecting HIV responses in Kenya.
45 IDPC (2013). HIV prevention among people who use drugs in East Africa. Briefing note. International Drug Policy
Consortium.
46 UNDP (2014). Seychelles Legal Environment Assessment of HIV/AIDS. Accessed at:
http://www.hivlawcommission.org/index.php/elibrary?task=document.viewdoc&id=203
47 UNDP (2014). Seychelles Legal Environment Assessment of HIV/AIDS. Accessed at:
48 National AIDS Secretariat, Mauritius (2013). People Living with HIV Stigma Index Report.
49 Todrys K and Amon J (2012). Criminal Justice Reform as HIV and TB Prevention in African Prisons. PLOS Med, 9(5).
50 Gear, S. (2010). Imprisoning men in violence. Masculinity and sexual abuse: a view from South African prisons. South
Africa Crime Quarterly, 33.

51 UNODC Policy Brief: HIV Prevention, Treatment and Care in Prisons and other Closed Settings: A Comprehensive
package of interventions 2013

52 TimesLive (2014). Treat TB Like HIV, say activists. 10 June 2014. Accessed at:
http://www.timeslive.co.za/local/2014/06/10/treat-tb-like-hiv-say-activists
53 ARASA, PRISSCA and Human Rights Watch (2010). Unjust and Unhealthy. HIV, TB and Abuse in Zambian Prisons.
Accessed at: http://www.hrw.org/sites/default/files/reports/zambia0410webwcover.pdf

54 UNAIDS Regional Support Team for ESA: HIV, Human Rights and Social Justice for PLHIV, Key Populations and
Vulnerable Groups in ESA. A Rapid Contextual Analysis of Current Trends and Issues – In Draft, to be published 2016.
55 The GAP Report, UNAIDS, Geneva, 2014.
56 The Implementation Toolkits are available at -
https://www.unfpa.org/sites/default/files/pub-pdf/TRANSIT_report_UNFPA.pdf [TRANSit]
http://apps.who.int/iris/bitstream/10665/90000/1/9789241506182_eng.pdf [SWit]
http://www.unfpa.org/publications/implementing-comprehensive-hiv-and-sti-programmes-men-who-have-sex-men [MSMit]
57 Heisman, T & van Buuren, A. Models for research into decision-making processes: on phases, streams rounds and tracks of
decision making. Handbook of Public Health Policy. Eds. Araral, E., Fritzen, S., Howlett, M., Ramesh, M., & Wu, X. London:
Routledge
58 UNECA Violence Against Women in Africa, A Situational Analysis, 2010
59 UNICEF: Ending Child Marriage - Progress and Prospects, 2013
60 SADC Parliamentary Forum Draft Model Bill on Eradicating Child Marriage 2016
61 UNFPA. (2013) Motherhood in Childhood: Facing the challenge of adolescent pregnancy. New York
62 https://en.wikipedia.org/wiki/Demographics_of_Angola
63 UNAIDS Angola HIV Factsheet (2013): http://www.unaids.org/sites/default/files/epidocuments/AGO.pdf
64 AIDS Information (http://aidsinfo.unaids.org/) for HIV Prevalence among Sex Workers Angola.
65 AIDS Information (http://aidsinfo.unaids.org/) for HIV Prevalence among young women 15-24 years, Angola
66 AIDS Information (http://aidsinfo.unaids.org/) for HIV Prevalence among young men 15-24 years, Angola
67 Morna CL, Dube S, Makamure L & Robinson KV (Eds). SADC Gender Protocol Barometer (2014).
http://www.genderlinks.org.za/article/sadc-gender-protocol-2014-barometer-2014-07-25
68 UNAIDS/INLS (2014). REPÚBLICA DE ANGOLA RELATÓRIO DE PROGRESSO DA DECLARAÇÃO POLÍTICA
SOBRE VIH/SIDA – UNGASS 2012.

http://www.unaids.org/sites/default/files/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_AO_N
arrative_Report[1].pdf
6969 UNAIDS, Country progress report 2014,
http://www.unaids.org/sites/default/files/country/documents/AGO_narrative_report_2014.pdf[accessed on 12 April 2016]

70 African Child Policy Forum, Minimum Age of Marriage (Sept 2013).
71 Committee on the Elimination of All Forms of Discrimination Against Women, Concluding Observations on the sixth
periodic report of Angola, 2013,

http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CEDAW/C/AGO/CO/6&Lang=En
[accessed 8 May 2016]
72 ARASA, HIV and Human Rights in Southern Africa, 2009; UNAIDS, Making the law work for the HIV Response: A
Snapshot of Selected Laws that Support of Block Universal Access to HIV Prevention, Treatment, Care and Support, July
2010,
http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/priorities/20100728_HR_Poster_en.pdf
73 UNODC et al. (2007). HIV and Prisons in sub-Saharan Africa: Opportunities for Action.
https://www.unodc.org/documents/hiv-aids/publications/UNODC_UNAIDS_WB_2007_HIV_and_prisons_in_Africa-
EN.pdf
74 Madagascar. https://en.wikipedia.org/wiki/Madagascar
75 AIDS Information (http://aidsinfo.unaids.org/) for Adult HIV Prevalence, Madagascar
76 Ibid.
77 US Department of State (2011). Country Reports on Human Rights Practices for 2011.
http://www.state.gov/documents/organization/186425.pdf
78 Article 105
79 UNAIDS, Madagascar NCPI Report, 2012. Available at
http://www.unaids.org/en/dataanalysis/knowyourresponse/ncpi/2012countries/Madagascar%20NCPI%202012.pdf
80
http://www.genderindex.org/country/madagascar [Accessed 13 May 2016].
81 UNFPA (2014). Country Programme Document for Madagascar (2015-2019).
http://www.unfpa.org/sites/default/files/portal-document/DP-FPA-CPD-MDG-7%20-%20Madagascar%20CPD%20-
%20FINAL%20-%2025%20Nov14.pdf
82 World Bank (April 2011). Reproductive Health at a Glance: Madagascar.
https://www.unodc.org/documents/hiv-aids/publications/UNODC_UNAIDS_WB_2007_HIV_and_prisons_in_Africa-
EN.pdf
84 UNAIDS (2014). Global AIDS Response Progress Report GARPR.
http://www.unaids.org/sites/default/files/country/documents/MOZ_narrative_report_2014.pdf
85 Ibid.
86 http://www.unaids.org/ctrysa/AFRMOZ_en.pdf; See also GCHL Africa Regional Dialogue, Pretoria, 3-4 August 3:
MONASO: Rede Mocambicana de Organizadoes Contra a SIDA at p.82

87 Information taken from http://www.stigmaindex.org/454/press-releases/in-mozambique-plhiv-are-helping-themselves-
2012.html [accessed on 20 August 2013]

88 http://www.state.gov/j/drl/rls/hrrpt/humanrightsreport/#wrapper (accessed 12 August 2013)
89 http://www.state.gov/j/drl/rls/hrrpt/humanrightsreport/#wrapper (accessed 12 August 2013)
90Submission to Global Commission on HIV and the Law Africa Regional Dialogue, Pretoria, 3 – 4 August 2011: LAMBDA
Mozambique at p.425
91 UNICEF et al. (2015). Child Marriage and Adolescent Pregnancy in Mozambique: Causes and Impact.
http://www.unicef.org.mz/wp-
content/uploads/2015/07/EN_Statistical_Analysis_Child_Marrige_Adolescent_Pregnancy_aw-Low-Res.pdf
92 UNDP (2016). Review of Age of Consent Laws (Draft).
94 Tina Lorizzo (December 2012). Prison Reforms in Mozambique Fail to Touch the Ground: Assessing the Experience of
Pre-Trial Detainees in Maputo. 42 SA Crime Quarterly 29.

95 http://worldpopulationreview.com/countries/zambia-population/
96 Zambia NAC (2015). ZAMBIA COUNTRY REPORT
97 UNFPA Zambia CPD (2016-2020). http://www.unfpa.org/sites/default/files/portal-document/Zambia%20CPD%20-
%20ODS.pdf
98 Submission by Individual, Zambia, Africa Regional Dialogue on HIV and the Law, 4 August 2011
99 See People Living with HIV Stigma Index: Zambia; see also HRI, 2009 cited in GCHL, Regional Issue Brief: Women, HIV
and the Law, 2011

100 Key Informant Interview, Malala Mwondela, ZARAN, 6 September 2012
101 Zambia NAC (2015). ZAMBIA COUNTRY REPORT
102 UNICEF (undated). A report card of Adolescents in Zambia.
http://www.unicef.org/zambia/A_Report_Card_Of_Adolescents_In_Zambia.pdf
103 Zambia Human Rights Commission. (2013). Preliminary Findings Of The Human Rights Commission During Visits
Undertaken To Prisons And Other Places Of Detention.

104 Oscar Simooya. (29 January 2014). Prison Condom Distribution Debate Rages. Times of Zambia.
105 Cap 97
106 See submission by PRISCCA, Zambia, Africa Regional Dialogue on HIV and the Law¸4 August 2011
107 Zimbabwe National Statistics Agency (2012). Census 2012: National Report.
http://www.zimstat.co.zw/sites/default/files/img/National_Report.pdf
108 AIDS Information (http://aidsinfo.unaids.org/) for HIV Prevalence among young women 15-24 years, Zimbabwe
109 UNAIDS (2014). Zimbabwe HIV Country Factsheet. http://data.unaids.org/publications/fact-sheets01/zimbabwe_en.pdf
110 Zimbabwe National Statistics Agency (2012). Census 2012: National Report.
http://www.zimstat.co.zw/sites/default/files/img/National_Report.pdf
111 Submission by Southern African Litigation Centre, South Africa, Africa Regional Dialogue on HIV and the Law, 4
August 2011. Available at www.hivlawcommission.org

112 Zimbabwe GARPR (2015). Zimbabwe Country Report.
113 World Bank. (May 2011). Reproductive Health at a Glance: Zambia.
114 Zim Correctional Services Want Condoms Distributed in Jails. News24 (9 June 2016).
115 Connecting the Dots: Strategy Note 2016-2020, HIV Health and Development, UNDP June 2016
116 SALC News Release (2016). ‘NEWS RELEASE: SADC PARLIAMENTARIANS ADOPT MODEL LAW ON
ERADICATING CHILD MARRIAGE AND PROTECTING CHILDREN ALREADY IN MARRIAGE’. Available at:
http://www.southernafricalitigationcentre.org/2016/06/09/news-release-sadc-parliamentarians-adopt-model-law-on-
eradicating-child-marriage-and-protecting-children-already-in-marriage/
117 available at http://hivlawcommission.org/index.php/elibrary?task=document.viewdoc&id=222
118 National dialogue guidance link: http://hivlawcommission.org/index.php/elibrary?task=document.viewdoc&id=175
LEA guidance link : http://hivlawcommission.org/index.php/elibrary?task=document.viewdoc&id=176

Compendium of judgements : http://hivlawcommission.org/index.php/elibrary?task=document.viewdoc&id=130
119 The Guide is available at http://www.amsher.org/wp-content/uploads/711_MSMAdvocacyGuideFINALSept.pdf
120 UNFPA (May 2015): Linking Sexual and Reproductive Health and Rights and HIV in Southern Africa
http://esaro.unfpa.org/sites/esaro/files/pub-pdf/Regional%20booklet%20final%20-
%20Linking%20SRHR%20%26%20HIV%20in%20Southern%20Africa.pdf
121 UNODC/UNAIDS (2014) Guidance note: Services for People who inject Drugs.
http://www.unodc.org/documents/hiv-aids/publications/2014_guidance_servicesforpeoplewhoinjectdrugs_en.pdf
122 UNESCO, Comprehensive Sexuality Education, A Global Review, 2015
123 WHO Technical Briefs on HIV and Young People who Sell Sex/MSM/Transgender People/Inject Drugs. 2015
124 http://www.pepfar.gov/press/releases/258269.htm
125 UNDP, Legal Environment Assessment, An operational guide to conducting national legal, regulatory and policy
assessments for HIV. January 2014. Available at

126 Although it is understood that the amount in the budget for the LEA will only cover the assessment itself and not the rest
of the related activities necessary to ensure that the recommendations are followed up.
127 This includes that services are physically and economically accessible (available), scientifically acceptable (i.e. in line with
WHO minimum standards), adaptable to the needs of the beneficiaries (flexible and sensitive to the specificity of the target)
and non-discriminatory.
128 Global AIDS Response Progress Reporting
129 http://www.unaids.org/en/dataanalysis/knowyourresponse/ncpi/2012countries/
130 This will include but not be limited to strengthening national capacity to: review overly broad provisions that criminalise
intentional transmission of HIV; review laws that criminalise abortion or prohibit access to contraception; Enact and enforce
laws to prohibit violence, rape and sexual assault; Prohibit forced abortion, sterilisation and other forms of violence in health
care; Enact and enforce laws to prohibit harmful norms such as early marriage; Enact and enforce right of every child to
comprehensive sexual health education; Enact and enforce laws to ensure young people have safe access to HIV and SRHR
services; Reform laws to ensure age of consent for autonomous access to HIV and SRH services is equal to or lower than age
of consent for sex; Repeal laws prohibiting sex work and use of civil / administrative offences to penalise sex work; Stop
police harassment and mandatory HIV testing; Ensure anti-trafficking laws punish those using force, coercion; and enforce
laws against child sexual abuse as opposed to consensual adult sex work
131 Ibid
132 Capacity Development Toolkit to Strengthen National Entities to Implement National Responses for HIV & AIDS,
Tuberculosis and Malaria.

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Linking Policy and Programming: Strengthening Legal and Policy

Organisation United Nations Development Programme

Project Location SADC Region - Angola, Madagascar, Mozambique, Zambia,

Duration of Project 2016-2020

Development Objective To improve sexual and reproductive health outcomes for

To strengthen HIV/SRH related rights of young key

AIDS Acquired immune-deficiency syndrome

AMSHeR African Men’s Sexual Health & Rights

ARASA AIDS and Rights Alliance for Southern Africa

ASWA African Sex Workers’ Association

AUC African Union Commission

CAL Coalition of African Lesbians

CEDAW Convention on the Elimination of All Forms of Discrimination Against Women

CSO(s) Civil society organisation(s)

CSE Comprehensive Sexuality Education

GAFTM Global Fund for AIDS, Tuberculosis and Malaria

GHHR Program on Global Health and Human Rights

HHD HIV, Health and Development team in UNDP

HIV Human immunodeficiency virus

IATI International AID Transparency Initiative

ICCPR International Covenant on Civil and Political Rights

ICESCR International Covenant on Economic, Social and Cultural Rights

ILA Interactive Learning and Action

LEA Legal environment assessment(s)

LGBTI Lesbian, gay, bi-sexual, transgender and intersex

MDR-TB Multi-drug resistant tuberculosis

MoFA Ministry of Foreign Affairs

MTE Mid-term evaluation

NSP(s) National Strategic Plan(s)

PrEP Pre-exposure prophylaxis

PLHIV People/person living with HIV

PWID Person who injects drugs

REC Regional economic community

SADC Southern African Development Community

SALC Southern African Litigation Centre

SAT Southern Africa Trust

SDG Sustainable Development Goal

SGBV Sexual and Gender Based Violence

SOP Standard Operating Procedure

SRHR Sexual and Reproductive Health and Rights

UNDP United Nations Development Programme

USC University of Southern California

XDR-TB Extensively Drug Resistant Tuberculosis

1.3 HIV/SRH-Related Human Rights of Young Key Populations in Southern Africa

1.5 Linking HIV/SRH Policy to Service Provision in Southern Africa

1.6 Strengthening Data and Understanding of the Process of Law/Policy Reform

2.1 Country Selection

a) High HIV prevalence amongst key populations

Madagascar’s people in prison are severely overcrowded. According to UNODC as of 2007,

Examples of key areas to strengthen: Build capacity to strengthen anti-discrimination

Sodomy and ‘deliberate transmission of HIV’ is criminalised in Zimbabwe ‘Criminal Act of

2.2 Involvement of Key Stakeholders in Proposal Development

FIMIZORE- is a human rights organisation created in Madagascar in 2005 and includes 18

2.3 What the Proposal Builds on

Project Goal Countries Duration, Budget Sub-

Removing Legal To strengthen the legal and Botswana, Cote 2016-2018

Sexual Orientation and Reducing Inequalities and Senegal, Tanzania, 2016-2017

Global Fund Project

Staff position Percent covered by

M&E Specialist (Africa) P3 (D. Owolabi) 100%

Finance Officer (Africa) NOC (W. Assefa) 100%

Programme Associate (Africa) GS7 (S. Tsegaye) 100%

Finance Associate (Africa) GS6 (O. Dilba) 100%