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THE NATIONAL ANNUAL HIV/AIDS STATUS REPORT

2005

Dr David Kihumuro ApuuliDirector General – Uganda AIDS Commission

The 4th Uganda HIV/AIDS Partnership Forum

30th Jan – 1st Feb 2006

Speke Resort Munyonyo

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Background• HIV/AIDS still remains a challenging

pandemic, with nearly 15,000 new infections daily (UNAIDS 2005)

• Globally,over 40 million people are infected of whom 95% are in the developing world

• About 25.8 million of the infected are in sub-Saharan Africa, with an avarege prevalence of 7.2% in this sub-region

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Background cont.

• Uganda has strived to fight the epidemic with visible success; from a national average prevalence of over 18% in the early 1990’s to the current 6.5 %

• From mid nineties, the ANC sentinel sites prevalence rates showed steady decline to 6.1 in 2001

• HIV prevalence has oscillated between 6.1 & 6.5% for period 2001 todate

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The Global ResponseCoordination initiatives/mechanisms• UN Joint efforts through UNAIDS• Global Task Team – “Making the Money Work”• International & regional declarations• Bilaterals & Multilaterals – Different channels for

resource mobilisation

Major Funding Streams• MAP• GFATM• PEPFAR• Bilaterals, Foundations and various civil agencies

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National Status of the Epidemic• The national average prevalence stands at 6.4%

• Prevelance higher among females than adults

• Prevalence higher in urban compared to rural areas

• Longitudinal studies showed subtle increase in HIV incidence between 2002 and 2004

• Sentinel surveillance data show that prevalence among ANC atendees stood at 6.5% as of 2004

• HIV discordancy stands at 48%

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National Priorities Recap

The Goals of the NSF:1. To reduce HIV prevalence by 25%

2. To Mitigate the effects of HIV/AIDS:a) The health effects of HIV/AIDS b) The psychosocial and economic effectsc) The impact on the national development

3. To strengthen the national capacity to coordinate and manage the multi-sectoral response to HIV/AIDS

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Highlights of the 2005 Response

Prevention of HIV Transmission1. Knowledge and Behaviour Change

• 2 Think Tank Sessions held on ABC strategy to discuss issues of prevention

• PIASCY rolled out to all schools & all schools in 71% of the districts have received HIV/AIDS tool kit materials

• Phase II PIASCY underway

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Prevention Cont.

Knowledge and Behaviour Change...

• YEAH National Campaigns initiated, targeting mainly out of school youth

• Coverage of peer education at 45%

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Prevention cont.2. Blood Safety100% of transfused blood screened for HIV• HIV risk among blood doners was 1.9%

compared to 2.2% in previous year

3. Condoms • National Condom distribution plan and guidelines

developed• Procurement guidelines for condoms in place• 95 million condoms procured in the reporting

period (still below the set target of 120 million)• Quality concerns further hampered availability

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Prevention cont.

4. PMTCT

• All old districts providing PMTCT services, compared to 62% the previous year

• A PMTCT social mobilization handbook developed and disseminated to all districts

• Male involvement and infant feeding incorporated in PMTCT programmes

• Training manuals for PMTCT developed and applied in various trainings

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Prevention cont’d

5. HIV Counselling and Testing• Demand for VCT has increased (due to ART

increase and PMTCT)

• Increased VCT services have resulted into inadequate counselling & laboratory facilities and personnel

• Routine Counselling & Testing has been established in some centers

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Initiatives for Hard to Reach Communities

• HIV/AIDS in Emergency Settings– A National Committee was established – A situation analysis has been completed – A priority Action Plan was developed based on the

analysis– Resources have been mobilized for HIV/AIDS

programmes

• The Fishing Communities– Strategy to reduce impact of HIV/AIDS in Fishing

Communities Developed

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Comprehensive AIDS Care and ART

• Guidelines for ccomprehensive HIV/AIDS care for children and adults developed

• A National Coordination Committee for TB/HIV was set up to enhance TB/HIV collaboration

• Policy guidelines for Cotrimoxazole Prophylaxis developed and launched

• A monitoring system for ART has been instituted

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Comprehensive AIDS Care & Treatment

• Training packages for HBC, palliative care & infection control for care takers in place

• Palliative care incorporated into the National Minimum Health Care Package

• Policy & Guidelines for Palliative care in place

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Comprehensive AIDS Care & Treatment con’t

• Guidelines on nutrition for PHAs were developed and disseminated

• Percentage of PHAs on ART increased from 10% – 56%

• ART accredited centers increased from 48 to 114

• A handbook of commonly used medicinal plants was in process of development; spearheaded by THETA

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Psychosocial Support, Protection & Human Rights

• OVC Policy and Strategic Plan disseminated to districts

• The process of developing an AIDS Act finally started.

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Coordination and Institutional Arrangements

• The National AIDS Policy was endorsed by the UAC Board

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Planning, Monitoring and Evaluation

• A National Sero-Behavioural Survey Conducted

• UAC capacity strengthened

• NSF, M & E Framework, Declaration of Commitment, Coordination guidelines, NAP and knowledge management concept disseminated to all districts and SCEs

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Planning

• District strategic planning guidelines were developed

• The Annual Joint AIDS Review was Conducted

• Plan for HIV/AIDS in the Fisheries sub-sector was developed

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• National Stakeholders and service mapping was completed

• Mapping of of some partner organisations was conducted e.g. PHA, UN Agencies

Planning ….

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Resource Mobilization & Management

• Assessment of AIDS funding mechanisms carried out

• A think tank session organized to discuss effects of HIV/AIDS funding on the Macro-economy of the country

• GTT recommendation for aligning AIDS resources was adopted

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Challenges• “Hot spots” of increasing HIV incidence• Roll out and uptake of PMTCT services• ART roll out • HIV/AIDS and children• Functioning of district coordination

mechanism• Macro-economic stability versus increasing

HIV/AIDS funding• Procurement of commodities and supplies• Appropriate funding mechanism for CSOs

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Conclusion

• Innovative strategies to further reduce prevalence

• Provision of comprehensive ART• Harmonisation of resource streams• Renewed advocacy for HIV/AIDS at

all levels• Effective coordination of the national

response