Global fund update to the

Provincial council on AIDS

Meeting

7 March 2018

It is an independent public-private partnership ofgovernments, multi and bilateral agencies and civilsociety, the private sector and the communities livingwith the diseases founded in 2002.

The Global Fund is a financial institution, not animplementing agency,

The mandate of the fund is to raise additionalresources and disburse them in a transparentmanner

What is Global Fund?

Main purpose is to attract and disburse additional resourcesto prevent and treat TB, Malaria and HIV/AIDS

The 3 diseases account for 6 million deaths per yearworldwide

They impede economic and social development especially inmost developing countries

Since its creation it has grown to be the largest financier ofprograms to fight the three diseases and had raised US$ 33bnby end of 2015 and disbursed US$27bn as at Sept 2015

Why Global Fund?

RSA Concept Note 2016 - 2019

• Objective 1: Addressing social and structuraldrivers of HIV and TB prevention, care and impact.

• Objective 2: Preventing new HIV, STI and TBinfections.

• Objective 3: Sustaining health and wellness.

• Objective 4: Ensuring protection of human rightsand improving access to justice

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Principal Recipient/ Sub-Recipient Programmes Districts

• KZN TREASURY - • YW&G

• Key Populations (SR - TBD)

• King Cetshwayo – UMhlathuze & UMfolozi

• TBD-after hotspot mapping

• AIDS Foundation SA (AFSA) • TVET Colleges • GBV• CSS

• TVETS – All 11 Districts.• Gender Based Violence - EThekwini

District, UGu District, ILembe District, King Cetshwayo District, UMgungundlovu District.

• Community Systems Strengthening -King Cetshwayo District, Zululand District and UMkhanyakude District.

• CSS - Capacity building training and mentorship. – All 11 Districts.

• Right to Care • MSM • PWID

• EThekwini• UThukela

• Kheth’Impilo • Adherence • UGu• UMgungundlovu,• EThekwini• ILembe

• NACOSA – MIET, Humana People to People, Childline

• YW&G • Zululand• Nongoma & Abaqulusi 5

Report

Principal Recipient/ Sub-Recipient

High Level Successes High Level Challenges

KZN TREASURY - 1. Been able to appoint SR’s for: Cash plus care, one of the two SR’s for Vulnerable population, service provider for: cash plus care impact evaluation, process evaluation HTS

2. Finalised and approved by TGF 5 district plans for VP.

3. Hosted all PR’s and Global Fund team on Economic empowerment.

4. Established 1 district steering committee and 5 to be completed before PCA in all implementing district

1. Slow appointments of SR’s and service providers delayed implementation of programmes ( Supply Chain management process).

2. Turnover management – 2 vacant posts (Acting Programme director in place + 2 TA’s and recruitment process initiated for vacant post).

3. Unable to meet HTS targets

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P Report

Principal Recipient/ Sub-Recipient

High Level Successes High Level Challenges

Right To Care – ANOVA, LGBTI Centre and TB/HIV Care.

1. Introduction of PrEP in selected areas has helped program to reach its clientele

2. Implementation of SMART catch-up plans and additional resources saw results improving (over-performance) in Yr 2 –additional resources invested

3. Successful review period saw most SRs gaining momentum in Year 2.

4. Program deep dive session helped fine tune program delivery

5. To date 55 clients have been screened for OST and 47 are

1. Compared to a leaky pipe (e.g. those reached never actually go for an HIV test, those who are HIV- may test once or infrequently and those diagnosed HIV+ may leave without referral to care and treatment, loss to follow up) – see diagram below.

2. Identifying and reaching KPs.

3. KPs not enrolling in care and treatment as expected – refusal to enrol in care.

4. KPs not testing for HIV affecting HCT yield.

5. Program sustainability –

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Report

Principal Recipient/ Sub-Recipient

High Level Successes High Level Challenges

AIDS Foundation SA (AFSA) –HEAIDS, Lifeline Durban, Childline S.A, Lifeline Zululand and Lifeline PMB, KRCC, QTFT

1. The continuation of social community mobilisers and implementation of catch up plans for GBV SRs implementing the IPV component has assisted with reaching IPV clients through awareness campaigns in the period reviewed ( October –December 2017) in Ethekwini and King Cetshwayo districts.

2. Integration of TB screening,Improvement in the uptake of modern contraceptives including condom distribution and provision of emergency contraceptives

1. Integration of TB screening services for the IPV programme, there is still a gap in providing TB screening and successful referrals to ART.

2. A gap with facilitation of follow-up for clients that are on PEP to track the completion rate of PEP within the TCCs (. A good working relationship within the TCC remains critical in providing a comprehensive service to victims of sexual violence and there have been significant improvements relating to data access and availability

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Report

Principal Recipient/ Sub-Recipient

High Level Successes High Level Challenges

Soul City Institute 1. Recruiting school based clubs

2. Drugs & HIV Awareness in partnership with the municipality.

3. 16 days of activism march4. Completing club activities in

clinics.5. Collaboration with rotary

HIV awareness.6. Increasing the number of

members in clubs, ensuring that the club has not less then 17 members.

1. Difficulty working with clinics.

2. Forming relationships with some municipality special programmes.

3. We did not have a Jamboree

4. Monitoring or sustaining all the clubs.

5. October November and December, attendance decreases .

6. Cutting off other municipalities.

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Report

Principal Recipient/ Sub-Recipient

High level Success High level

Challenges

NACOSA – MIET, Humana People to People, Childline

1. World Aids Day - 4 Local doctors addressed and answered questions from 57 SW’s.

2. Driving Adherence through song with a focus on Nutrition and exercise ( 69% of our SW’s are HIV+)

3. Sifiso Cele from HAST Team demonstrated the Female Condom as we push to increase distribution

4. NiMart Mentorship and practicals for PN with Broadreach

5. 16 days of Activism –picture and slogans through Wats App to Peers.

1. RN Municipality reported in a local newspaper, Eyethu, about installing CCTV cameras in Mtwentweni and Margate to expose and arrest SW’s and their clients

2. Referral feedback from clinics on linkage to care is not working as planned. Clinicians not following process we put in place.

3. Drugs and alcohol continues to be a big problem and seems to worsen.

4. Lack of information on the SW’s seen by the DoH

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Report

Principal Recipient/ Sub-Recipient

High level Success High level

Challenges

KHETHIMPILO- THINK, Nompumelelo Institute, South Coast Hospice, Khethimpilo

1. Decongestion of stable patients from facilities in support of the differentiated model of care (community adherence clubs) 987 clubs to date with 19253 club members.

2. Managed to reach 102 504 which is 73% of overall total of 140 545 through enhanced adherence counselling services.

3. Extending Treatment Care and Support to ILembe(KDC and Mandeni) post KZN treasury geospatial mapping outcomes.

1. Reach in meeting the target due to co-support of the same programme in the same facilities hence the support for iLembe.

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Recommendations –for PCA to assists PRs

1. Availability of community structures for adherence clubs.

2. Chairs available in community structures to be able to facilitate community adherence clubs.

3. Support from PCA for application of new grant

4. Maximum support from District champions of current implementing programmes.

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