Mitigating HIV/AIDs in China: Project Design Summary Strategic objective: Mitigate the risk of HIV / AIDS among rural

poor in Henan province, China. Relevant IRs and sub-IRs for this project: IR 1 Improved safety of blood banking system IR 1.3 Blood donors effectively screened IR indicator stated in QQTP terms (refer to slides 7 and 23): PART ONE Mobilization Description: Community organization and outreach will be conducted with blood donors who will potentially utilize high-risk blood banking facilities. This will be accomplished in part by conducting stakeholder analysis meetings both with the rural poor and blood banks respectively. In addition, networking with existing blood banks that are already doing the right thing by screening their donors is also important. Finally, ARC will partner with with GONGOs already operating in the space. Target audience(s): Blood donors, blood banks, GONGOs, rural poor community at large Time of activities (year/quarter): Beginning Q1 Year 1 Frequency of activities (how often): Throughout the three year funding period Duration of activities (how long): Throughout the three year funding period Implementing agency: ARC Rationale: Community organization and outreach activities will help donors understand the actions of the organization and engage them in the decision making process. Networking blood banks will serve to identify organizations that require the fewest resources to bring them into compliance with the ARCs goals and standards. Establishing partnerships with GONGOs will expand the resource base, reputation and legitimacy of the ARCs China operations for the purposes of implementing the blood donor screening project. Additional comments: Will need organize mobilization efforts in a way that create long term sustained interest in the

goals and objectives outlined by the projects. ______________________________________________________________________ Organizational Capacity Development Description: ARC will establish a certification and rating system to assess blood donor screening standards, and encourage consumers to use these blood banks. ARC will initially administer the system and subsequently either create an institution or partner with an existing institution to administer the system once ARC has departed. Target audience(s): Existing local organization(s) (or create a new one if one does not exist); blood banks (for the certification and rating) Time of activities (year/quarter): Start from Day One of project Frequency of activities (how often): N/A Duration of activities (how long): until end of project and into infinity Implementing agency: ARC Rationale: ARC has the expertise to administer the system temporarily, but needs a local Chinese organization(s) to support and continue administration of the system. Additional comments: We only have three years and $3 million to start up this project. In order to keep blood bank accountability, we need a long-term, adaptable organization to take on the task of inspecting and rating once we leave. We hope that in the future, blood banks will automatically include donor screening as part of their standard operating procedure, but until this becomes the norm, we must have a task force to address the problem. ______________________________________________________________________ Supply Improvement and/or Demand Description: ARC seeks to enhance the quality of services at blood banks through the mechanism of implementing a donor screening process. The technology used to screen donors will be publicized to the public, in addition to social marketing campaigns, in order to generate awareness of the new process and the generated benefits among the targeted market population (rural poor in Henan Province). ARC further seek to engage the private sector by specifically targeting distributors of equipment necessary to screen donors. Target audience(s): Blood banks, blood donors Time of activities (year/quarter): 3 years Frequency of activities (how often): Quarterly Duration of activities (how long): 3 years, ongoing Implementing agency: ARC Rationale: The quality of supply translates to improved safety within the blood banking process by scanning donors for the HIV/AIDS disease prior to their participation. After the quality control is carried out, these activities will be publicized in order to generate a more informed and aware

donor population. Doing so will decrease, and ultimately eliminate, the participation of donors who carry HIV/AIDS and risk the transmission of the disease through the selling of their blood. Additional Comments: Once ARC is no longer in China, we will leave the responsibility of marketing to our partner organization(s). ______________________________________________________________________ Knowledge Generation, Management, and Dissemination Description: The ARC will advocate for safer blood banks in Henan Province, China. The ARC will publish and develop materials in order to disseminate this information better to the public. Target audience(s): donors and blood bank staff Time of activities (year/quarter): Q1 Year 1 Frequency of activities (how often): 2 times per month? Duration of activities (how long): Throughout the three year funding period Implementing agency: ARC Rationale: ARCs advocacy will develop an informed blood donor population and thereby increase demand for safe blood programs. Also, the ARC will publish and develop materials ensuring public knowledge about the better quality blood banks and the incentives they provides. Additional comments: After the ARC has advocated for and creates this successful blood donor screening program, a Chinese partner organization would continue this advocacy work, even after the project ends in three years. ______________________________________________________________________ Material Assistance Description: Blood banks earning a certification from ARC or a partner organization based on adoption of donor screening procedures and standards will initially subsidize some meaningful area of blood bank operating costs for those banks with clean blood programs. Target audience(s): Blood banks Time of activities (year/quarter): Three years Frequency of activities (how often): Quarterly Duration of activities (how long): Three years Implementing agency: ARC Rationale: Subsidizing blood bank operating costs will incentivize blood bank operators to adopt donor screening procedures and standards. Additional comments (e.g., linkages to overall strategy for achieving scale, sustainability and

successful exit; innovations): This subsidy will be used initially to encourage participation. Once the standard is set and an informed donor population has been developed, the subsidy will no longer be needed. The standards will thereafter be maintained because the donor population will expect the high standards and will patronize highly rated organizations more than more lowly rated organizations. ______________________________________________________________________ Direct Service Provision Brief narrative description: ARC will inspect and rate blood banks compliance with a uniform set of screening standards. Target audience(s): Blood banks Time of activities (year/quarter): 2015/Q1 Frequency of activities (how often): Twice annually Duration of activities (how long): Three years Implementing agency: ARC Rationale: Inspection and rating services will provide blood banks a way to communicate to donors that the blood bank abides by high screening standards, and, therefore, donors are at reduced risk. This, coupled with initial subsidies, will increase blood bank compliance with effective HIV/AIDS screening standards and increase informed participation on the part of blood donors. Additional comments: ______________________________________________________________________ PART TWO Briefly describe your plans to achieve scale, sustainability and successful exit. Scale Plan: ARC will work with the highest traffic blood banks in Xincai County, Henan province China. ARC anticipates certifying the donor screening practices of approximately ten banks in Xincai county as a pilot project. Educational and advocacy conducted and materials will be disseminated throughout the county. Sustainability: Exit Strategy

To achieve project success, ARC will phase down the subsidy for blood banks and phase over responsibility for administering the inspection and certification exit strategy. The benefits stream will be maintained only by continued local administration of the inspection and certification program. Without regular inspection and certification, blood bank compliance with safe screening standards may decrease, thereby increasing the likelihood of the introduction of HIV/AIDS into the blood supply. The ARC will build the capacity of a local partner organization to administer the inspection and rating program in Henan Province. At a minimum, the ARC will ensure that the local partner organization maintains and, eventually, increases the programs coverage. The ARC will gradually reduce the subsidy for blood banks participating in ARCs inspection and rating program to a level that a local partner organization can sustain and or continue to phase down. If indicators suggest that the subsidy is no longer necessary to maintain blood bank participation, then the subsidy will eventually be reduced to zero.