The document summarizes Rwanda's experience in consolidating its HIV/AIDS programs and projects under a centralized organization. It describes how between 1987-2000 Rwanda established separate organizations to coordinate its multi-sectoral HIV response and biomedical research initiatives. In 2011, in an effort to improve aid effectiveness, Rwanda consolidated its many HIV project management units into a newly formed Rwanda Biomedical Centre, which absorbed all related institutions and programs under one organization. This centralized the country's HIV coordination and clinical services while aiming to reduce management burdens and improve capacity across the health system.

1. Rwanda’s Experience

2. A bit of history
• Between 1987 and 2000: the Rwandan Government
set up the National Program to Fight against AIDS
(PNLS), based within the Ministry of Health.
• From 2000: the government divided the PNLS into two
organizations,
– a National AIDS Control Commission (CNLS – with
responsibility to coordinate the multi-sectoral response,
focusing on policy development, partnerships and M&E)
and
– TRAC Plus (an MOH department focused on HIV biomedical research and response initiatives).
• 2006: Decentralisation led to set up of District AIDS
Commitees in 106 districts.

3. And then. . . .
• 2011: President of Rwanda called on Ministers to reduce
the number of project management units across
government to improve aid effectiveness
– Vertical programmes were putting a strain on limited
management capacity across country, especially at
decentralised levels
– Similar issues with clinical capacity, having clinicians
dedicated to just one disease instead of the suite of health
problems facing Rwandans
• Ministry of Health was the first Ministry
– Had the most PMUs compared to other Ministries, 14
autonomous departments or institutions.
– Minister of Health had been the NAC Director previously,
with strong working relationship with her successor, who
agreed with government analysis

4. Solution
• National review and consultation led to absorption of NAC
into a newly formed Rwanda Bio-Medical Centre (RBC),
with.
– Absorbed all 14 institutions and programmes including AIDS,
with corresponding legislation passed by the Assembly in 2011
– AIDS coordination put into the Institute of HIV/AIDS, Disease
Prevention and Control (IHDPC), whose director is the former
NAC Director.
• The RBC has the statutory status as the CNLS before it, as
an autonomous public sector organization that reports to a
Board of Directors. However, the RBC does sit within the
Ministry of Health and the Minister is a member of the
Board

5. MINISTRY OF HEALTH
Overall Structure of the
Rwanda Biomedical Centre
BOARD OF
DIRECTORS
1
DG (1)
Medical
Research
Center
DG (1)
Medical
Maintenan
ce Center
Deputy
DMD(1)
King Faisal
Hospital
RWANDA
BIOMEDICAL
CENTER MD (1)
Deputy
MD(1)
Institute of
HIV/AIDS,
Disease
Prevention
and
Control
(IHDPC)
Deputy
MD (1)
Medical
Production
and
Procureme
nt
Rector
[DMD] (1)
Rwanda
University
of
Medicine
and Health
Sciences
(RUHMS)
DG (1)
Rwanda
Health
Communic
ation
Center
DG (1)
Corporate
Services
5

6. 1
RBC OFFICE OF THE MD
Total staffing:
34
MANAGING
DIRECTOR RBC (1)
Administrative Assistant (2)
Personal Assistant (1)
INTERNAL AUDIT UNIT (8)
M & E SPECIALISTS (5)
BUSINES
DEVELOPMENT UNIT
(10)
PLANNING &
COORDINATION (4)
Public Relations (2)