HIV/AIDS in Africa:
What Works
Sophia Mukasa Monico
Voluntary Counselling and Testing as an entry point
for HIV prevention and Care
Planning for the future
Behavioral change facilitation
Preventive therapy(TB
and bacteraemia)and
Contraceptive Advice
Referral care,to Social and
Peer Support
Acceptance of sero status
and coping
Early Management of
opportunistic infections
and STD'S
Reduction of mother to child
Transmission
The AIDS Information Center (AIC)
Community
AIDS Information Centre
HIV+
Referral
Centres
HIV-
PTC
PTC Activities
MEMBERS RECIEVE
Medical
Care
Supportive
Counselling
Social
Club
HIV
Education
Family
Planning
Food
MEMBERS GIVE
Drama
Community
AIDS Education
Peer
Support
Condom/FP
Promotion
The AIDS Support Organization
(TASO)- Support System
’80.000
TASO
Mission
cumulative
clients (HIV+)
’In 2002, 10.000 new
clients
’65% of clients female
’90% of clients are living
below the poverty line
HIV/AIDS PREVENTION AND CARE-TASO MODEL
TASO has Seven centers - Average cost to run a center - $300K
:
HIV/AIDS COUNSELLING
COMPLEMENTARY
MEDICAL CARE
Pre-&post test
counselling(done else where)
Treatment of opportunistic
infections,preventive therapy,
Family planning services
&Health education. $10
Crisis,Prevention
Family,Couple
Bereavement,Spiritual
Treatments
$10 (per session)
COMMUNITY
CAPACITY BUILDING
Home care -$30 (per visit)
SOCIAL SUPPORT:
Day care centers:
OVC $300(PER CHILD annually)
Material assistance-nutritional support
$150 (per family
Mrs.Sophia Mukasa Monico,Executive Director
Advocacy & Mobilization
Exchange of information/
experience;Networking&
collaborating with other ASOs &
Govt. referral/link establishments
Training of volunteers in
basic HIV/AIDS
counselling & education I $50
NSTITUTIONAL CAPACITY
BUILDING
Training of AIDS personnelNationally &
Internationally,HIV/AIDS
counselors &CAWs- $500 per
person
TASO CLINIC/HOME BASED CARE MODEL
COUNSELLING
TRAINING
MEDICAL
SOCIAL
SUPPORT
PAC
ACWs
PE
CD’s
PHA
SUPPORT
GROUP
HU
CCAs
FAMILY
MEMBER
PLW AIDS
(Home)
Community Care
PWA
Support
Groups
NACWOLA
Religious
institutions
Referral
Health
Facilities
C.B.H.C
(FLEP)
TASO
HIV Testing
Facility (e.g. AIC)
Other AIDS
organisations
Social, political
and economic
securities
USAID/CDC SUPPORT
9
9
9
9
9
9
9
9
9
Since 1989 > $15m for core programs
Child support and skills training - LIFE
Food assistance through TITLE 2
Operational research by CDC including
safe water for PLWHA using a water vessel
Prevention & Rx of opportunistic infections – Septrin
(co-trimoxazole) prophylaxis
improved management of TB
Support to MIS systems and staff training in software and
use of data to improve services
USAID/CDC = 25% of TASO budget.
CHALLENGES
♦ Despite the intensive AIDS education there remains the big
challenge of community compliance to the AIDS knowledge
E
♦ There is need for renewed effort to expand activities that are
likely to be most cost-effective, and efficient to control the
epidemic
♦ While HIV prevention efforts are slowly yielding results, women
and girls still remain vulnerable to HIV infection.
♦ Ugandans have been extensively prepared to administer and
use HAART, one of the new challenges raised is, affordable
treatments and the assurance of equitable distribution.
Given the current state of the Ugandan economy, it is not realistic
to expect that the government without external support will be
able to provide accessible, affordable and efficient health
services offering an acceptable standard of care within the next
ten years
The massive expansion of the HIV/AIDS epidemic is not
inevitable. 21 years in the epidemic has provided us with enough
knowledge and the world has a wealth of resources at its disposal
to stop the HIV/AIDS pandemic
LESSONS LEARNED AND CONCLUSIONS
Contextual
♦ Political Leadership and openness re: HIV/AIDS is pivotal to a
meaningful response
♦ It is a national responsibility to design, implement and coordinate the response to HIV/AIDS at the country level. The role of
the external partners is to support and build on national action.
♦ A Multi-Sectoral response to HIV/AIDS can be best achieved
through creative and effective partnerships.
♦ Government in collaboration with, external funding agencies and
NGOs, have implemented intensive, extensive and contextually
appropriate programs, some of which have had demonstrable
impact.
LESSONS LEARNED AND CONCLUSIONS
♦ Early investment in HIV/AIDS prevention reduces the negative
social economic impacts
E
♦ Effective care and support system demystifies AIDS = decline in
stigma, discrimination and denial
♦ An effective response requires societal and structural change to
reduce the vulnerability of individuals and communities
♦ Young people learn from one another, but their behavior will
depend largely on the information, skills and services that the
current generations of adults choose to equip their children with.
The behaviors they adopt now and those they maintain through
out their sexual lives will determine the course of the epidemic
for so many years to come.
LESSONS LEARNED AND CONCLUSIONS
Programmatic
♦ Caring for persons living with AIDS promotes HIV prevention
♦ The awareness of personal risk has increased the demand for
HIV testing.
♦ Comprehensive program including voluntary testing,
counselling, medical care, economic assistance is needed
♦ Integrated services for AIDS care, prevention, family planning,
and STDs are feasible and beneficial
♦ 3 pronged prevention strategies - ABC is feasible and
interchangeable according to circumstances
LESSONS LEARNED AND CONCLUSIONS
♦ Communities can be mobilized to share the responsibility for
AIDS care and HIV prevention at the local level.
♦ PHAs are instrumental partners in the planning, implementation
and evaluation of care and prevention interventions
♦ Efficient management systems and financial and programmatic
accountability are the cornerstones for successful programs
♦ Data based decision making facilitates efficient and effective
program planning and implementation
LESSONS LEARNED AND CONCLUSIONS
♦ Sustained external funding agencies’ support is indispensable
in the face of overwhelming and increasing poverty
♦ Personal commitment to a positive response to the AIDS
epidemic is essential among staff, clients, volunteers, donors
and government.
♦ Collaboration is critical among all stakeholders