January 2006

HIV/AIDS Prevalence in Mauritania

At the end of 2003, USAID, WHO and the Mauritanian Ministry of Health estimated that the national adult HIV prevalence rate is 0.6% and that 10,000 people are living with HIV/AIDS in a country of 2.8 million. Recent studies indicate a prevalence rate of 0.98% among pregnant women and 0.50% among military recruits. (SENLS annual report 2005)

Mauritania’s socially conservative population is predominately Muslim and open discussion about HIV/AIDS is difficult. And social taboos against sex outside marriage in Mauritania's staunchly Islamic society mean that condoms are handed out furtively by groups of activists, rather than being sold openly in shops and pharmacies. There is also a severe lack of proper treatment and care facilities. In December 2004, Mauritania opened its first HIV/AIDS testing and treatment center in the capitol city of Nouakchott. This center is jointly funded and operated by the Red Cross and The World Bank and is the only place to access HIV treatment in the country. In Nouadhibou, a busy port in the desert north of Mauritania and a crossroads for fishermen, mine workers and clandestine migrants heading towards Europe, efforts to address AIDS are nascent. ( “Fight against AIDS slow to take root in port city of Nouadhibou.” IRIN PlusNews. April 2005.

National Response to HIV/AIDS and the Private Sector

Only a few large companies operate in the country; the majority of the private sector is organized into eight federations. The recent discovery of offshore oil has the potential to create an economic boom in the country in the coming years. However, the changing economic landscape could create social changes that could lead to increased prevalence of HIV/AIDS. Other priority sectors include mining (The World Bank has contributed $18 million towards developing the mining sector in the country), fisheries, agriculture, transport and tourism. (“AIDS Millions for West African Country.” IRIN PlusNews. July 2005.) The World Bank Multi-Country HIV/AIDS Programme (MAP) has allocated $21 million to address HIV/AIDS in Mauritania.

In 2002, a National Strategy for 2003-2007 was developed to fight HIV/AIDS in Mauritania. The government created the Conseil National de Lutte Contre le SIDA (CNLS) chaired by the Prime Minister to act as the lead decision-making body for the national response to HIV/AIDS. This committee has developed and adopted the national HIV/AIDS policy and strategy, and ensures the implementation and mobilization of resources in the fight against HIV/AIDS in Mauritania. The country also instituted the Secrétariat Exécutif National de lutte contre le SIDA (SENLS) to act as the national coordinating body. Overseen by the CNLS, this body is tasked with coordinating multi-sectoral approaches in the implementation of the national response. (Cadre Stratégique National de Lutte Contre les IST/VIH/SIDA 2003-2007. République Islamique de Mauritanie. Aout 2002.)

Definition of the Private Sector

The Mauritanian private sector is represented by the General Confederation of Mauritanian Employers (CNPM), which is divided into eight professional federations regrouping all the major sectors of the country:

• The Commerce Federation
• The National Fisheries Federation
• The Mining and Industry Federation
• The Bank, Tourism and Services Federation
• The National Transport Federation
• The Agriculture and Livestock Federation
• The Housing and Public Works Federation
• The Bakers Federation

For the purpose of accessing MAP funds, the Mauritanian private sector includes these federations as well as any companies legally registered, in existence for a minimum of eighteen months, and currently employing at least ten people. Furthermore, since the Mauritanian informal sector does not meet the above stated criterias, companies from this sector will apply via the federations.

Regarding HIV/AIDS, the mining, fishing, transport and the future oil extraction industries have been declared priority sectors as they represent high-risk populations.

Mission Objectives:

The objective of this initial private sector HIV/AIDS mission was to pursue a dialogue with the SENLS (Secrétariat Exécutif National de Lutte contre le SIDA) and private sector partners on the development of the private sector component of the National Strategy against HIV/AIDS. The discussions included how the HIV/AIDS crisis is affecting business, the possible strategies to engage and provide additional resources to the private sector, and how they, individually or through professional associations, could become more actively engaged in the national response to HIV/AIDS.

The mission looked at:

• The current national strategy to engage the private sector in the fight against HIV/AIDS;
• Ongoing private sector initiatives to address HIV/AIDS as well as financial support available from donors/NGOs;
• Mechanisms to engage the private sector, including application forms, eligibility criteria, eligible expenditures, the review process, and monitoring and evaluation tools;
• The development status of a business coalition against HIV/AIDS;
• Information on the existing legal framework relating to employer social responsibility (and planned legislation);
• Workplace best practices and approaches to HIV/AIDS prevention currently underway;
• Strategies for scaling up private sector involvement in the national response to HIV/AIDS; and
• A short-term action plan to enable effective implementation of the private sector strategy.

In addition, we were asked to:

• Assist the SENLS Private Sector Focal Point (Ms. Waranka Ba) and the private sector consultant (Mr. Yahya Kane) in drafting the terms of reference (TOR) for a national business coalition against HIV/AIDS;
• Identify and suggest resolutions to obstacles impeding first and second phases of funding for private sector initiatives from The World Bank Multi-Country AIDS Program (MAP);
• Work with the SENLS Private Sector Focal Point to draft the TOR for a private sector advisory group (PSAG) and identify and solicit participation from influential private sector members; and
• Assist in the development of a communications strategy for the private sector component of the MAP.

Results:

Proposal process and funding

• We were pleased to find that the strategy for the private sector component of the SENLS MAP was more developed than alluded to in previous reports. Therefore, our primary focus was on the refinement of the existing strategy with the goal of expediting the review and approval processes. The mission and the SENLS revised and simplified the procedural mechanisms for the private sector component of the MAP including the SENLS private sector manual, application form, and eligibility and evaluation criteria. Communication materials were developed to further promote and explain the services offered by the MAP in Mauritania. In addition, private sector procedures were separated from those of the civil society within the private sector manual to improve comprehension of the private sector submission process.
• Regarding the submitted private sector proposals, four projects have been funded, one of which is fully completed (The Agriculture and Livestock Federation), and three of which are still in the implementation phase. Upon our arrival, of the three projects, two were awaiting approval for second tranche funding. During the mission, one of these projects (Tiviski Dairy) was approved and sent to the financial institution associated with the NAC (CAF) for disbursement of funds. The other project awaiting second tranche funding still must provide additional financial documentation in order to be approved (Centre de Gestion de la Pêche Artisanale). Furthermore, four additional proposals were authorized for funding and sent to the CAF for review of financial documentation before final approval (Confederation Generale des Travailleurs de Mauritanie, Federation Nationale des Transports, Association Mauritanienne pour l'Artisanat Traditionnel and Delta Service)
• Private sector targets have been established for the approval and financing of sixteen additional projects by the end of 2006.
• In an effort to streamline the project approval process and more efficiently use limited human resources, future proposals will be reviewed by the Private Sector Focal Point and sent to the monitoring and evaluation officer only for acknowledgement and registration. The registration step of the process should take no longer than one working day. Once reviewed and registered, proposals will be sent to the NAC for approval by the review committee, after which the project will be transmitted to the CAF for procurement (passation de marchés) and disbursement of funds.

Business Coalition and Private Sector Advisory Group (PSAG)

• The mission worked with the appointed consultant to develop the TOR for the business coalition including institutional development and capacity building. In an initial meeting on February 9, 2006, the eight federations and a few representatives from the PSAG reviewed and revised the draft TOR, the mission statement, and the organizational structure of the business coalition. During the February 9 meeting, it was decided that a second meeting to elect the executive secretariat and finalize the TOR would be scheduled for the first week in March. An additional meeting to review and establish a plan of action for the coalition will take place in late March 2006, leading to the official launch of the coalition scheduled for April 20, 2006.
• To facilitate the coordination and implementation of the business coalition’s activities, the mission recommends that the technical working group within the General Confederation of Mauritanian Employers (CNPM), which was established to address social issues within the private sector and with ongoing expertise in workplace activities, be selected as the coalition’s coordinating body.
• The mission and the SENLS identified and met with potential members of the PSAG. Representatives from the following entities have been short listed to form the PSAG: 1) The General Confederation of Mauritanian Employers (CNPM) 2) Tiviski Dairy 3) SEPH (Fishery) 4) SNIM (Mining Company)
  5) The Federation of Mines and Industries. The role of the PSAG will be to assist the business coalition in mplementing a plan of action designed to assist in accessing funding as well as advocate for private sector interests at a national level with the public sector.

Communication Strategy

The following communication materials were drafted for the private sector component of the MAP:

• Brochure;
• Submission form; and
• Submission guide (to accompany submission form) with a list of potential NGO partners.

These materials will be disseminated in upcoming planned workshops in the cities of Nouadhibou, Zouératt and Nouakchott.

 

Action plan

• A three-month action plan for the Private Sector Focal Point was developed.
• The Private Sector Focal Point will submit a quarterly report to The World Bank and CCA detailing progress according to agreed upon action plan.

Next steps:

A follow up mission will be conducted.