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Working in a a challenging environment needs adaptation to change! New ways of work, innovative approaches to the national response in order to expedite the move towards ending AIDS, new ways of partnerships and new partners all required delicate change management. We went through the following stages: identifying the area that needs to change, comparing status que w to -be- situation to show the potential positive impact and also to motivate the actors, map the actors, reach out to the new ones and inspire the the team, connect the traditional and the new actors, share a clear vision on where to go and how to go. Establish the achieved goal. Work w stakeholders to keep up the new way of work.

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Reflecting back on my experience with the UNJT workplans as an adviser, most plans are a collection of siloed actions by each cosponsor within their mandate area contributing in one way or another to the HIV response. However, in my opinion, has lack focus, prioritization and lacking impact. As a UCD, I was able to propose a revised vision for the JT workplan that focuse the few country envelop and UBRAF resources in 2-3 key priority areas. We mobilized resources for consultants to support each cosponsor in the implemenation of the country envelope. Each cosponsor has also been intregrated into the larger support to the government and civil society. The change was initially a challenge for the cosponsors since we pushed for a strong alignment and it represented a shifting of funding to other cosponsors and others not receiving. The change was well received by government and other partners since it now more focused on the gaps identified jointly with partners.

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Work in progress…
Strengthening the capacity of NAC through a functional assessment process.

The NAC in South Sudan was excluded/or absent from many national HIV processes despite their legal mandate to lead the coordination of the national HIV response. The NAC was focusing mainly on implementing HIV programme activities at community level even though that fell outside their legal mandate.  Some of the factors that had driven this situation was the lack of resources for the NAC including meagre salaries and unwillingness of strategic partners to invest in the mandated activities of the NAC, and weak leadership in the organisation. Perhaps the biggest contributor to the status of the NAC was the apparent uncertainties surrounding the status of many national commissions, including the NAC.   In a meeting with the Minister of Foreign Affairs on other matters, he indicated to me that the NAC will not be dissolved like other commissions. Based on that,

1.    I indicated to the NAC the opportunity to make them a stronger entity that will fulfil their legal mandate. The NAC after many negotiations, agreed to the functional assessment.

2.    I sought support from the other partners to back reengineering of the NAC through a process of functional assessment.

The process functional assessment is completed and the process of implementing the recommendations is ongoing.

How I navigated resistance to change:

Partners: I emphasised the critical need for a multisectoral response to HIV which at this time is mainly driven through the health sector and emphasised that the NAC would be the only practical entity to bring about the needed merits of a multi-sectoral HIV response. I also engaged the partners in the development of the tools for the functional assessment as well as consulted them in the process including colleting and including their opinions and suggestions for change.

To reduce the apparent isolation of the NAC, in the meantime, I encouraged and ensured that the NAC was included in many of the national processes even in the health sector.

For the NAC to agree to the functional review, I emphasised that showing a willingness to revamp themselves would be key in getting the confidence of partners back and receiving support from them. In addition, the assessment will provide key recommendation that when implemented will position partners to advocate their relevance on the HIV response, even to government.

I also encouraged/coaxed them to participate in national processes, including helping them to prepare and to be strategic in their engagement in those processes.

After many negotiations with the NAC, they have accepted the recommendations. Planning is now ongoing to implement them.

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Nuha Ceesay, UCD Malawi: Transforming Performance and Building Trust 

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Nuha Ceesay, UCD Malawi: Transforming Performance and Building Trust 

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Building trust within the team and with external partners and creating an enabling environment to improve performance was my primary objective when I arrived in Malawi as UCD in 2019.

I started by assuring colleagues that we are collectively responsible for ensuring the relevance of UNAIDS in Malawi and my role is to inspire the team to work together.

I also assured them as the team leader it is my responsible to ensure that we have a conducive work environment but that cannot be achieved by me alone without their key roles. I did the following:

1.  Having listening sessions with staff and allowed them to share their thoughts around how we can make UNAIDS fit for purpose and responsive to the needs of the partners we served.

2. Sharing information to all staff and ensuring that all are aware of the key issues that the office is responsible.

3. Making my office accessible to staff to work in and discuss issues that affects them or when they feel like they needed guidance and direction.

4.    Empowering staff and encouraging them to be creative and find innovative ways of resolving issues as I stayed away from micromanagement leadership style.

5. Ensuring that the Chairing of the scheduled UCO Monday Morning Meeting is rotated to staff and allow them to lead such meetings.

6. Convening regular check-in meetings with staff and giving them space to share their thoughts on what is working well as well as probe them to share their thoughts on solutions to their work-related challenges.

7. Clearly communicating them on the rationale for any decision I took which may not be in line with their expectations.

8.  Encouraging the team to consult and be supportive to each other.

The approach resulted in increased motivation, trust and a work environment that does not triumph on rumours.

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One of the offices I managed was affected by different situations (including inherited matters, organizational decisio-making and also external factors) and due to this context UCO staff to perform polictical and technical duties was reduced to 2 persons for a long time period. I had manage organizational change and be creative to ensure the office mantain its accountability, productivity, deliverables and reputation during this difficult period. My approach is summarized as follows:
- I discussed with my other colleague on the critical deliverables of all areas and we created a new emergent work-plan.
- I empowered my colleague to delegate him with decision-making authority in the topics related to his job post and also in some otheres where he had expertise from the past (previous jobs).
- I took the leadership in UCD maters and also in SI and some matters related to services.
- I discussed with RC and copsonsors the situation, to asess the situation and explain that some areas will in risk.
- I negotiated support from cosponsors to UCO to implement actions and activities that can not be covered by the lack of staff, empowering techincal staff from cosponsors for decision making.
- This initiative was a game changer in the relationship with cosponsors.
- Since that time all decision making and follow up o HIV related matters was done on team basis including cosponsors.
- Thanks to this approach UCO was able to ensure continuity of business and achieve the expected results.

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Tharcisse Barihuta /Zambia : Implementing HIV/Integrated Biological and Behavioural Surveillance in x Conservative Country 

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Tharcisse Barihuta /Zambia : Implementing HIV/Integrated Biological and Behavioural Surveillance in x Conservative Country 

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Introduction and Implementation of the HIV/ National Integrated Biological and Behavioral Surveillance for General Population, including Key Populations for the First Time in a very Conservative Country.

The Assumption in the X country was that no National Citizens are part of Key Populations particularly sex workers and all LGBTI communities. Assuming that these in Country were all foreigners.

The First step was to come with the Plan with Evidence /Facts that the country not knowing where we stand in terms of Behaviors, Incidence and Prevalence of HIV we cannot plan strategically. With the Plan developed together with my Team and UN Joint Team members and National AIDS Council, I leaded the presentation to the NAC Director and Permanent Secretary of the Ministry of Health. A lot of resistance emerged from the Technical Staff from Ministry of Health and NAC using their scientific Position to reject the proposal. But the real motivation was supported by their religious Believes.  To resolve the Matter, I suggested to have a close door discussion with the Senior Management team leaded by the Permanent Secretary supported by some scientists more progressive. During the Meeting together with WHO colleague we shared the situation in other countries of the region with the same culture and religious norms, shared the International Protocols with clear indication how Findings have guided the HIV/AIDS National response with success. Finally, the Protocol of the Study and the implementation plan were approved by the Management.

The second resistance arise during the implementation when the research Team has to identify the Key Populations members who will participation in the study to mitigate the stigma and discrimination. Proactively I Mobilized resources to Train the Peers of the Key Populations who will be guiding the research Team to reach out to the Members who will participate in the study. The other strategy used was to have regularly update to senior management to ensure they have all the Information in case there is any Political interference in the Process. I have advised also not to involve any media to protect the Key Populations involved in the study.

The last Resistance came when the Results of the study were released by the Research Team to the Senior Management for approval. The Management could not believe that there were Key Populations particularly sex workers among the National Females having the prevalence 10 times high compared to their peers’ foreigners. We explained scientifically that is due to lack of information, stigma and Discrimination blocking them to have access to HIV prevention and Care services. As Way forward I suggested to the team that we develop a Response Plan based on the results and secure a Meeting with the Minister of Health together with the Permanent Secretary and NAC Director. During the Meeting they asked me to present to the Minister the Findings and the response Plan that I did successfully. After a lot of discussion, the Minister approved the results which were an Eye open for the Government and request UN system, in collaboration with cooperating Partners to support the implementation plan. During the Implementation of the Plan, we established a mechanism of keeping the Minister informed and also established a strategy to keep the KPs protected.  Transformational Change is not easy, will be always opposition and the implementation plan has to include interventions based on the 3 areas ( Unfreezing , Change Intervention and Refreezing).

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Rapid HIV testing here has to be done by a health professional. However NGOs / communities have been doing rapid testing by community agents for years. It was not sustainable until the decree on testing is rectified. I have succeeded in advocating and convincing NAP to collaborate with NGOs to launch the first community based training manual for community test agents and elaborate a decree project that was submitted for approval. I was successful by frst promoting community based testing and convincing NAP that it is the way. It was integrated in the actual NSP. I then convened NAP - NGOs meetings to discuss the matter and in parallel UCO supported the elaboration of the new national testing strategy operational plan that recognized community based testing.

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Building a UCO SA culture of effective prioritization of high-impact tasks. As a team we sought to set a few realistic goals to ensure that we were as productive and impactful as possible; and prioritizing staff wellbeing and mental health. I supported collaborative team reviews and prioritization processes to agree on the changes we are trying to achieve in line with organizational corporate priorities.  The challenge was deprioritizing tasks which members felt were important. This required in-depth team discussions and consultations on the barriers we needed to shift to end AIDS in South Africa based on a review of the evidence and a clear understanding of the UCOs value-proposition. This was also informed by consultations with partners including civil society. We agreed as a team to be more intentional and smarter about how we work. Once we agreed on the priorities and a doable workload in line with the team's capacity, the second challenge was guarding against saying yes to a never-ending list of incoming requests from our partners that were stretching the team too thin and taking us away from our priorities. We are still working on bringing about this change and doing small things like cutting down on our to-do lists and continuously practicing deprioritization.

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The situation I managed was during the implementation of the Stigma-index 2.0 study which was supposed to be conducted by people living with HIV (PLHIV). I encountered significant resistance from the National Program staff and the consultants hired to support the work. They stigmatized the community of PLHIV, viewing them merely as patients who had no role to play in conducting studies.

The challenge was twofold: dealing with the stigma attached to PLHIV, and persuading stakeholders that the PLHIV community could and should actively participate in the study.

To navigate and negotiate this resistance, I played a significant role in convincing the Ministry of Health teams to change their attitudes towards the PLHIV community. I emphasized the need for collaboration and inclusivity in conducting the study, arguing that direct involvement of PLHIV would yield more authentic and impactful results.

My strategy involved persistent personal engagement in tough negotiations with the Ministry of Health's teams, the consultants, and the PLHIV community, leveraging the support of Global Network of People living with HIV (GNP+). I worked to convince all parties to sit together, discuss, and collaborate on this crucial study.

Initially, I faced strong resistance, but through constant dialogue and negotiation, I was able to gradually shift their perspective. I stressed that this collaboration was not only beneficial for the research but also important in challenging and changing societal attitudes towards PLHIV.

In the end, my efforts were fruitful. We were able to bring about a change in attitude towards the PLHIV community among the other members involved in the study. This situation served as a significant step in managing change in my organization and highlighted the importance of persistence, negotiation, and inclusion in overcoming resistance to change.

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[Work in progress]

Challenging established practices – e.g. lack of information sharing

- Leading by example

- Challenging the norm (this is how things are done here, i.e. we don’t share information)

- Keep coming back to the bigger picture and larger objective of UNAIDS. Given the growing HIV epidemic (going in the wrong direction) UNAIDS / UCO needs to challenge itself to do things differently. Business as usual will not do.

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Reorganizing the team to work differently and position UNAIDS country office as key convener. A demotivated team working in silo. Changing the way of working of staff was a challenge as they were in their comfort zone and did not want to move. One to one discussion, discussion on their goals and perspectives, presentation of my vision of the UCO and UNAIDS goals and perspectives, and how these goals matched with their own objectives.

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The ability to manage change is more critical than ever, as the pandemic has shown.

Even before the challenges of a world health crisis complicated matters, most change initiatives failed, studies show. A common reason for the failure is that business leaders often don’t involve the human resources team until after the project has launched and employees resist. Having said so, in an international organization, whatever the position you hold, you cannot implement any change bending the rules. You have to go according the established procedures which are equal for all. Therefore, it is sometimes possible to introduce slight way of doing business as far you keep quiet.

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David on India and work with the Joint Team on AIDS

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David on India and work with the Joint Team on AIDS

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A new approach to the UN Joint Programme of Support. Encouraging UCO staff to be more proactive and supportive in shaping the development of the Joint Team Work Plan. Assigning staff to focal point specific co-sponsors, ensuring internal reflection and analysis on what had been undertaken in the past and where the cosponsor was best suited to go into the next year. Regular team touch bases and exploring synergies that we could work together on and approaches to bring more joint work together.

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As a team, we have discussed and agreed on "rules of engagement". The most important aspect is that while there is a lead responsible staff member for each task, everyone has a role to play in different phases of implementation and importantly, everyone has to be aware of what other team members are working on and that updates are shared on a weekly basis in the MMM. The key principle being that at any point of time the work can be picked up and continued by another team member. Another critical change is that program and operations are not mutually exclusive and that both teams need to be closely working together. Program staff should be aware of all operations related issues linked to implementation of work under their responsibilities and vis versa operations staff should be aware of the whole program goals and objectives and outcomes.

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Marc SABA - Managing change in partnership building

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Marc SABA - Managing change in partnership building

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One of the area of change which is critical for the implementation of the Global AIDS Strategy and the 2030 Agenda is the unique role of the UN to foster a broader partnership . In this regard, we have decided to innovate our approach at country level to mobilize the key actors to support the implementation of the decentralized National Strategic Plan (NSP) for AIDS. As different partners work in different regions, we encouraged each region to elaborate its Regional Strategic Plan aligned on the National Strategic Plan and it has done under the leadership of the NAC with UNAIDS technical assistance. This was an important change as each region has the ownership of its plan that reflects their specifics. Based on this regional plan, partners at regional level can commit to support the region to implement their plans. A new division of task has been set up at the UNAIDS country office in a way to better support the region and staff with the given responsibility has to report the progress during the weekly program meeting.

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Change to "Treat all":
Despite changes in WHO ART guidelines over the years from thresholds of 200 to 350 to 500 and eventually to "Treat all", medical authorities in a country X that I worked in were hesitant to change the guidelines. Attempts by WHO to convince them had proven futile. As UCD, I met with the National Control Programme Manager in the Ministry of Health to understand where the resistance was coming from. There was apparently a view from a respected academic at the university that change would result in drug resistance and they had been able to convince the senior technocrats in the Ministry of Health. I undertook to meet the "Resistors" individually over issues not related to the the ART guidelines to first get to know them better. After establishing that rapport, I began the engagement. The Academician appeared convinced but the senior technocrat in the Ministry of Health was apparently determined not to allow for the change. However, she allowed me to discuss the issue with senior management of the Ministry chaired by the Minister of Health. I  saw this as a great opportunity. In the company of the Resident Coordinator, we went for the meeting and after all the courtesies, we delved into the issue. I presented the new WHO ART guidelines, explained their advantage and gave examples of countries that had adapted the new guidance. The senior technocrat approached the discussion by focussing on describing her qualifications, knowledge and experience around HIV and did show a bit of agitation. I maintained my composure and humbly and gently insisted that the experiences from the other countries should be emulated. The Minister was quiet throughout the discussion but at the end, he requested me to send him a written policy brief and gave me his business card. I contacted UNAIDS HQ to assist with drafting the brief, contextualized it and sent it to the Minister. The change in the ART guidelines was implemented almost immediately.

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When I started in Togo, I knew already a lot of different country offices in the WCA region as I was a Regional Program Advisor before and so also a bit about Togo. When I came to Togo in 2019, I knew that as in many countries, they were understaffed, they had a UCD-centralized way of working end therefore we could wait a long time for certain answers or for certain things to be done. I observed a few days what was going on, but rather quickly introduced a few things: (i) brief daily meetings to keep everyone informed; (ii) share all info (it is the recipient who decides what is relevant to him and not the sender); (iii) we agreed upon the limits of the field we are playing on (= prioritization); (iv) once we are playing/working you go for it (copying me on emails and if needed discussing directly with me, but it is not me who communicates on their behalf); (v) credit goes to the one who did the job; (vi) only go to meetings when they are relevant and you (we as UNAIDS) have interest of being there and have something to tell; (vii) reply immediately to most requests, only postpone when  really necessary; (viii) do not work week-ends unless really necessary; …. These seem to be rather small things, but in the end, they bring pleasure back to work and increases productivity. Of course, in the beginning, people are reluctant and find me a strange guy, but after some time people find back that pleasure. When we got Benin added to our portfolio we saw the same thing, but we apply similar rules/agreements amongst us. It seems to be a bit tougher as I am not present myself and they do not see I apply the rules/agreements to myself, but we go in the right direction, I believe. We are all leaders, and everyone speaks for UNAIDS. On 90% of the things, we have a corporate stand that is clear, the remaining things we discuss.

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Results-based funding: The country envelop through the UBRAF fund provides a great opportunity for cosponsors to have catalytic resources to demonstrate positive change and to attract more resources. Some cosponsors, however, saw the country envelop as another stream of project funds to pay for staff salaries. This resulted in non-reporting by some beneficiary agencies. I notified the heads of agencies that the funds were for a specific purpose and tied to results and so without any tangle results it was practically impossible to maintain funding for defaulting agencies. The principle of results-based financing and doing business un-usual were explained at the joint team level and to the heads of agencies as well as how to document results and produce results.

At the end of the year, it turned out that 2 of the 5 agencies could not deliver any results and so i made a recommendation with the support of the RC to defund the 2 agencies and use the resources for the 3 agencies that were doing very well and showing results in addressing human rights, stigma and discrimination and demand creation for HIV testing and linkage to care among key populations. The 2 agencies were obviously not happy about the decision but I stood firm with the decision to reward performance and since then, our grant implementation has been identified as a best practice because we produced a people centered results.

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A new work modality to ensure savings and keep operational the MCO for the countries of the Southern Cone. Albert A Stella

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A new work modality to ensure savings and keep operational the MCO for the countries of the Southern Cone. Albert A Stella

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During the realignment in UNAIDS, due to the cut in financial resources, the Multi-Country Office for the countries of the Southern Cone was at risk of being closed with a view to greater savings in the organization.
The first thing was to write a solid argument for why the Office is not only necessary, but represents a cost-effective model of guaranteeing the presence of UNAIDS in four countries. It was also important to argue the political and social cost of such a decision, since only the savings in financial resources that this decision could represent for the organization were being considered.
The second step was to write a resource mobilization action plan and submit it for senior management approval and implementation. In this phase, it was crucial to advocate with the ExD, arguing the previous point about the importance of the office and negotiating the possibility of reducing costs by leaving the UN-common premise and negotiating space on government premises. This was achieved with government spaces, the possibility of using OCR rooms for eventual meetings and implementing a hybrid work modality, favoring teleworking. Additionally, all the furniture no longer necessary for UNAIDS was sold.
In the implementation of this change, special attention was paid to the reorganization of the team's work with individual support for each staff member of the team. It was also necessary to argue with other colleagues from UN agencies about this modality of work and ensure the support of the regional management.
Finally, we have stabilized this change, monitoring that the whole team is fine with the new way of working, which also allowed a better work-private life balance, a greater commitment to the objectives of our work and a greater motivation of each team member. This, not only because we saved the office, maintaining the reputation built over the years, but also because the team is more solid, it manages to effectively support the four countries and there is a significant saving of resources in the total cost of the office.

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UNAIDS (and broader UN) has always struggled with addressing underperformance.  In the teams I have led I tried to address underperformance first time and did not wait till a formal conversation. " you have to nip it in the bud".
One of the challenges to addressing underperformance in a efficient way, is finding the time to follow up on progress over time.  Resistance to addressing underperformance often came from the mindset that some people have that the issues are skills/knowledge related, but most of the issues were actually behaviour related. I tried to evidence that point using concrete facts and examples of problematic behaviours. Exploring what the person needs from the manager to improve, is also a useful and obvious approach to reduce resistance.