NATIONAL EXPANSION PLAN FOR HIV/AIDS PREVENTION AND TREATMENT

1. NATIONAL EXPANSION PLAN FORHIV/AIDS PREVENTION AND TREATMENT SANAC and National Department of Health

2. Background World AIDS Day 2009 • President announces new approach in the fight against HIV and AIDS • All public health facilities (fixed and mobile) must provide HIV testing • All PHC facilities to provide ART • Directs that the announcement will be with effect from 1st April 2010

3. National Strategic Plan on HIV and AIDS, 2007-2011 Goals • To reduce the rate of HIV infection by 50% by 2011 • 80% of people that need treatment to be provided with antiretroviral treatment

4. Implementation of World AIDS Day Announcements Prevention Strategy Package for HIV/AIDS Information, education, mass mobilisation STI detection and management Know your status – HIV testing and counselling Widespread provision of condoms (male and female) Prevention of mother to child HIV transmission (PMTCT) Safe blood transfusion Post-exposure prophylaxis Life skills educationMedical male circumcision

5. HIV Counselling and Testing (HCT) Campaign HCT is moving from voluntary testing, to a service delivery model to offer HCT to all patients at their entry point in the health system. Objectives • Mobilize people to know their status. • Support people with key prevention messaging in order to take proactive steps to a healthy lifestyle irrespective of HIV status • Increase incidence of health seeking behaviour; and • Increase the access to treatment, care and support

6. Components of the HCT Campaign • National Launch • Provincial launches (all 9 provinces) • Mass social mobilisation • Communication and advocacy • Health systems strengthening • Ongoing monitoring & evaluation

7. Campaign Theme – Continuation from World AIDS Day I AM RESPONSIBLE... I must take responsibility for my own health and HIV status i.e. if I am HIV negative, to stay negative, if I am HIV positive, to seek support and services to ensure I am healthy and don’t spread the virus to others, be they partners or children

8. Campaign Theme – Continuation from World AIDS Day WE ARE RESPONSIBLE I must take responsibility for enabling those in my sphere of influence to make healthy choices (be they my children, my sexual partners, my employees etc.)

9. Campaign Theme – Continuation from World AIDS Day SOUTH AFRICA IS TAKING RESPONSIBILITY Government is taking responsibility to ensure quality services are available when people present to test

10. Target Population, June 2011 15 million people targeted for HCT by June 20011 • 3.8 million people in 9 initial launch districts • 9.9 million in phase II (July 2010 – March 2011) • 1.2 million in phase III (April – June 2011) • Paying specific attention to 18 health priority districts (poorest districts) Location • Health facilities • School campaign • Outreach in the community (mobile units)

11. HCT Rollout Plan

12. HCT Targets – Initial launch districts

13. HCT Targets- Provinces

14. HCT Campaign National Launch Proposal: • Venue: Gauteng Province • Date: 15th April 2010 • Target person: President / Deputy President

15. National Campaign • Mass media – national radio, television, video snippets, personal journeys and testimonials of range of South Africans (Includes Prevention messaging) • Cell phone outreach to encourage testing • Use of new technologies for outreach and monitoring

16. Provincial Launches • The event will be simultaneously launched in the other 8 provinces by the National Ministers and Deputy Ministers on 19 April 2010 • The provincial launches will take place at the largest and most accessible hospital/health facility in the selected district (next slide) • Form: health and wellness fairs, offering visitors access to a range of health tests available through the health facility. Mobile testing will also be offered by partners

17. HCT Campaign Provincial Launches - 19th April 2010 (As selected by Provinces) Province District • Eastern Cape OR Tambo • Free State Motheo • Gauteng Ekurhuleni • KwaZulu-Natal Ugu • Limpopo Capricorn • Mpumalanga GertSibande • Northern Cape JT Gaetsewe • North West Dr. Kenneth Kaunda • Western Cape City of Cape Town

18. District social mobilisation interventions (all SANAC sectors) • Door to door campaigns • Taxi rank/malls/public gathering activations • Education Institution events • Community events • Engaging the religious sector • Linking HCT to existing community events, health and wellness days

19. Health Systems Strengthening Health facility readiness includes: • Recruitment of health workers: • Retired nurses and other cadres of health workers • Orientation of health care workers in the new HCT guidelines

20. Health Systems Strengthening Health facility readiness includes: • Forecasting and quantifying test kits and commodities up to June 2011 • Procurement of test kits and commodities – national tender in place

23. Flow Diagram – HIV Positive

24. Flow Diagram – HIV Positive Pregnant Women

25. Full range of services to be provided by HCT sites • HIV counselling and testing (HIV) • Blood pressure (Hypertension) • Blood sugar (Diabetes mellitus) • HB (Anaemia) • STI screening (questions and referral) • TB screening (symptomatic screening, 5 questions) • Full clinical TB screening if yes to any of the 5 questions (sputum, culture, x-rays)

26. HIV Testing Capacity

27. Condoms

28. Medical Male Circumcision

29. INH Prophylaxis for TB Prevention

30. ART for Pregnant Women

31. TB-HIV Co-infected Patients

32. Infants accessing ART

33. Total ART Patients

34. ART Provision 4,300 PHC Facilities providing Full package ART by March 2011

35. Human Resources

36. Additional Health Workers • Lay counsellors – 9,000 to be trained, in facilities • Nursing Council – 9,385 letters sent to retired pharmacists, social workers, SA Retail Association • 50 testing sites to be set up in 50 malls by April 2010, increasing to 500 sites in 3 years

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