South Africa – FY 2010 Approved Funding by Program Area, Agency and Funding Source*
*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.
South Africa has the highest per capita health burden of any middle-income country in the world. South Africa has a highly generalized AIDS epidemic. South Africa is in the midst of a dramatic transformation of its health policies and treatment services following the election of President Zuma in April 2009. President Zuma’s new MOH has repudiated prior denialist positions about the HIV epidemic and has repaired relationships with the donor community. These changes have allowed for new synergy in strategic planning and collaboration between the South African Government (SAG) and the USG at all levels. In addition, the PEPFAR team has initiated a partner rationalization process, moving towards greater alignment with the National Department of Health (NDOH) priorities and epidemiologic burden. These steps will lay the groundwork for the successful negotiation of a Partnership Framework in late 2010, which will define the nature of USG support towards NDOH goals over the next five years.
The PEPFAR team is aligning the prevention portfolio with the epidemiological evidence to address the key drivers of the epidemic, especially multiple concurrent partners, low rates of consistent condom use, and early sexual debut. A new initiative will promote positive male norms through advocacy. In addition, GBV programs will be intensified in 2010. The prevention programs will directly address alcohol and substance abuse issues in relation to increased risky sexual behavior. The 2010 World Cup served as a launching pad for numerous prevention efforts. In FY 2010, PEPFAR will undertake several VMMC activities to support the SAG, which include assistance with policy and guidelines development, communication campaigns, capacity-building of health care workers, and QA systems, and service delivery roll-out.
In FY 2010, PEPFAR will strengthen quality HIV/AIDS care service delivery through a multi-pronged strategy including: strengthening the integration of the basic care package and family-centered services across all care and treatment programs; increasing the number of trained formal and informal health-care providers, building multidisciplinary teams and improving human resource strategies; building active referral systems between community home-based care and facility services; developing Quality Assurance mechanisms; and translating national policy, quality standards and guidelines into action, particularly national adoption of the basic care package. In the area of HCT, FY 2010 funds will focus on strengthening referrals and linkages of HIV stand-alone and mobile HCT services to treatment and care services, increasing mobile HCT to reach rural and hard to access populations, and intensifying the provision of a prevention package to those who receive HCT.
PEPFAR will support NDOH with the development and finalization of TB policies and guidelines, specifically on intensified case finding, isoniazid preventive therapy (IPT), and infection control. In addition, PEPFAR will continue to support the development of appropriate surveillance systems for TB/HIV. PEPFAR will also continue support to the building of laboratory capacity to ensure timely quality-assured laboratory services for TB/HIV, including rapid diagnostics for TB and multi-drug resistant (MDR)-TB.
PEPFAR-supported OVC programs provide age-appropriate interventions that focus on gender issues, reproductive health information and education, HIV prevention information, and life skills programming. In FY 2010, specific attention will be given to strengthening economic and livelihood interventions and building stronger exit programs for 18-year-olds. PEPFAR will provide assistance in strengthening the human resources capacity to address the needs of vulnerable children.
The SAG, in collaboration with PEPFAR, has convened an ART costing working group tasked to complete costing scenarios for treatment programs. PEPFAR will focus on supporting the SAG to finalize policies allowing for task shifting of staff, pre-ART services, and integration of HIV/TB services within other points of care as well as increasing quality and coverage in areas of need. Other activities include strengthening HMIS, M&E systems, and survey and surveillance efforts. In FY 2010, priority will be placed on transitioning from the web-based Data Warehouse to using the District Health Information System (DHIS) or DHIS-compatible system for monitoring PEPFAR results.
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