Strong leadership is required to ensure a unified U.S. approach to global HIV/AIDS. To that end, at the headquarters level the U.S. Global AIDS Coordinator chairs a weekly policy team of principals from the lead implementing agencies. The Assistant U.S. Global AIDS Coordinator chairs a weekly meeting of deputy principals to manage specifics related to program implementation. To ensure that the Emergency Plan incorporates the most advanced technical thinking, there are interagency technical working groups for care and treatment, prevention, orphans and vulnerable children, human capacity development, and strategic information, as well as a scientific steering committee. Although a Chief Operating Officer has not yet been named, technical working groups are already functioning in human resources and acquisitions and assistance. Each of the technical and operations working groups is co-chaired by representatives from various implementing agencies and includes field representatives. In addition to formulating technical guidance and providing direct support to field programs, these working groups have streamlined differences among agencies on reporting requirements, policies, and regulations.

In each focus country, the U.S. Ambassador leads an interagency HIV/AIDS team that includes all of the implementing departments and agencies in-country. This unified U.S. Government in-country team ensures a unified strategy and voice in working with host governments and local nongovernmental partners. In many of the focus countries, there are also interagency technical working groups that relate to host governments and nongovernmental partners. Thanks to the commitment of U.S. personnel in the field, the implementation of highlyfunctional interagency teams in-country has been a remarkable first-year achievement. Because the U.S. Government now speaks with one voice on HIV/AIDS, interactions with host governments and nongovernmental partners have become more efficient and effective. In many countries, high-level Emergency Plan advisory committees have been formed to ensure a close working relationship between the U.S. Government and host-country counterparts responsible for directing the national strategy. For example, in Nigeria, the Minister of Health and the U.S. Ambassador chair a joint Nigerian-U.S. Emergency Plan working group. In Uganda, the U.S. Ambassador has convened a multisector Emergency Plan advisory group chaired by a former Prime Minister. These relationships complement U.S. participation in donor groups that support national strategies and further ensure that the Emergency Plan is fully coordinated with the national HIV/AIDS strategy.

To ensure constant communication between interagency teams at headquarters and interagency teams in the field, the Office of the U.S. Global AIDS Coordinator (OGAC) has established feedback and exchange processes. An interagency Core Team, with a coordinator in OGAC, serves as a liaison between the field and headquarters. The Core Team structure contributes to the strategy of a unified U.S. Government approach to combating the HIV/AIDS pandemic. The Core Team is fully informed of OGAC policy as well as country programs, facilitating the flow of information between countries and headquarters. The Core Team also provides technical assistance and support in program and management areas, including the identification and provision of specialized technical assistance beyond the scope of the Team members.

In order to share learning and offer feedback across all levels of program implementation and management, country team representatives, led by their Ambassadors, and OGAC leaders met in Johannesburg, South Africa, in June 2004 to take stock and plan next steps. This forum provided the opportunity for a rich exchange on programmatic and management issues and enabled countries and headquarters to learn from each other. Several important actions to improve the Emergency Plan were instituted as a result of this meeting. Countries asked for clearer and more consistent communication from Washington on policy and implementation issues. This resulted in News to the Field, a weekly e-mail that provides the latest information, guidance, and news from headquarters. Issues addressed are often generated from questions from field missions which are raised through the Core Teams.

The Global AIDS Coordinator recognizes that clear and transparent communication outside the U.S. Government is also essential. During fiscal year 2004, OGAC worked with departments and agencies to overcome technical and administrative obstacles to developing a comprehensive, transparent Web site fully accessible to all, with the expectation that the site will be functional in the third quarter of 2005.

A Unified U.S. Government Strategy
On February 23, 2004, one month after the first congressional appropriation of resources for the President’s Emergency Plan, the Coordinator submitted to Congress the U.S. Five-Year Global HIV/AIDS Strategy. The Strategy set forth in detail the goals of the Emergency Plan and strategies for achieving those goals, and it guided the Emergency Plan activities in fiscal year 2004 described throughout this report. All U.S. embassies have received the Global Strategy, and the Coordinator has sent cables to the U.S. Ambassador in every country with a bilateral HIV/AIDS program requesting that their programs be aligned with the five-year strategy. Guidance has also been provided to all bilateral programs to facilitate the incorporation of Emergency Plan goals and strategies in the Department of State Mission Performance Plans.