Suth African Civil Sciety Pririties Charter An Advcacy Radmap fr the Glbal Fund t fight AIDS, Tuberculsis and Malaria New Funding Mdel March 2015
Crsscutting issues Participatry frntline service delivery mnitring f HIV and AIDS services. Research (t prvide evidence n effective interventins, knwledge n KPs and als t develp new innvatins). Necessity f enabling envirnments (fr all key ppulatins and especially fr persns with disabilities). Capacity Building f all stakehlders, especially civil sciety and cmmunity structures. Leadership - all levels frm lcal t natinal must be transparent, infrmed and engaged. Cnsultative and cllabrative wrk prcesses (cnsidering bth bttm up and tp dwn influences and needs). Diversity (needs t be recgnised within the SA landscape and thus traditinal vs Western and rural vs urban etc. needs t be cnsidered in all respnses). Key Ppulatins in SA HIV/STIs Peple living with HIV (PLHIV). Girls and yung wmen (10-35 years) and yung men (10-35 years). Sex wrkers, their children, intimate partners and clients. Men wh have sex with men. Lesbian, gay, bisexual, transgender and intersex peple (LGBTI). Persns with disabilities. Peple wh abuse alchl and illegal substances (NSP definitin). Inmates, peple awaiting trial and peple wh leave prisn facilities. Children and especially rphans and vulnerable children (OVC). TB Peple living with HIV and AIDS (PLHIV/AIDS). Inmates, peple wrking in crrectinal facilities, peple awaiting trial and peple wh leave prisn facilities. Miners. Health wrkers including cmmunity wrkers. Diabetics. Farming cmmunity. Timeframe Linked t the Natinal Strategic Plan with an immediate start. Reviews peridically thrugh NSPs (every 5 years). Linked t The Medium Term Expenditure Framewrk (MTEF), and 90 90 90 Plicy where applicable.
Strategic Objective 1: Address Scial and Structural Drivers f HIV, STI and TB Preventin, Care and Treatment Tp Pririty: Cmmunity systems strengthening NSP Links NSP Sub-Objective 1.7: Strengthening the capacity f cmmunity systems t expand access t services is key and requires a systematic and cmprehensive strategy t address capacity, referral netwrks, and crdinatin and feedback mechanisms. All prvinces shuld implement strategies t supprt municipalities and lcal cmmunities t address challenges and strengthen cmmunity systems. Key Prgrammatic Interventins Capacitatin f civil sciety rganisatins (CSOs) including cmmunity based rganisatin (CBOs), nngvernmental rganisatins (NGOs), faith based rganisatins (FBOs), disabled peple s rganisatins, civil sciety grupings, cmmunity wrkers, vlunteers, leaders, cmmunity structures including cmmunity wrkers and leaders frm lcal institutins (Asset Based Cmmunity Develpment (ABCD) apprach) t create and strengthen structures t imprve HIV and TB utcmes. Strengthen gvernance, crdinatin, and cmmunity based mnitring and evaluatin and reprting f CSOs fr imprved service delivery and accuntability. Task shifting: Strengthen the links between health facilities and CSOs t implement task shifting t reduce the burden n health facilities and imprve cmmunity access t HIV and TB screening and referral. Ratinale Pverty, unemplyment and scial nrms are barriers t accessing preventin, care and treatment. CBOs can tackle scial and structural drivers, and can reach key ppulatins prviding greater cverage. Imprved resurce and funding allcatin t these grups will allw them t deliver n CSS. CSS imprves scial cnnectedness and reduces scial islatin and imprves scial capital. Target Grups CSOs, cmmunity wrkers, vlunteers, infrmal grups, cmmunity leaders. Gegraphic cverage High HIV/TB prevalence and incidence wards e.g., mining and peri-mining cmmunities, prisns, infrmal settlements, sex wrk htspts (brthels, shebeens, taverns, truck stps), deep rural cmmunities. Implementing Partners CSO s in partnership with CBOs and gvernment. Capacity building institutins. All ther sectrs, especially at lcal level where a cmmunity centred integrated apprach is critical. Measurable Outcmes Reduced HIV and TB incidence in key and vulnerable ppulatins. Imprved access t cntraceptives fr adlescents. Imprved scial cnnectedness and reduced scial islatin.
Imprved functining f cmmunity-based supprt structures. Imprved gender nrms, equity and equality. Imprved ward level crdinatin f health and scial services delivered by gvernment and civil sciety. Imprved access t services fr key and vulnerable ppulatins e.g. persns with disabilities. Imprved cverage and access t effective HCT, TB/STI screening, diagnsis, treatment and adherence. Increased cure rate fr TB. Strategic Objective 2: Prevent New HIV, STI and TB Infectins Tp Pririty: N New HIV, STI and TB Infectins NSP Links NSP Sub-Objective 2.1: Maximise pprtunities t ensure everyne in SA tests vluntarily fr HIV and is screened fr TB at least annually, and is subsequently enrlled in relevant wellness and treatment, care and supprt prgrammes. NSP Sub-Objective 2.2: make accessible a package f sexual and reprductive health (SRH) services. Key Prgrammatic Interventins NSP Sub-Objective 2.4: Implement a cmprehensive natinal scial and behaviural change cmmunicatin strategy with particular fcus n key ppulatins. NSP Sub-Objective 2.5 Prepare fr the ptential implementatin f future innvative, scientifically prven HIV. STI and TB preventin strategies. NSP Sub-Objective 2.6: Prevent TB infectin and disease. Cmprehensive SRHR services aimed especially at girls and yung wmen (10-35 years) and bys and yung men (10-35) years and ther key ppulatins, especially thse affected by crss cutting issues. Male and female cndm and lube distributin. Cnduct awareness and educatin prgrammes fr key ppulatins (including traditinal/cultural values). Behaviur change cmmunicatin (BCC) develped in a bttm-up apprach. Research and implement new preventin techniques. Ratinale Increase life expectancy, and prmte a healthier lifestyle with a view t reducing vulnerability f key affected ppulatin grups, and ensuring new and emerging technlgies are put int use as sn as viable. Target Grups Girls and yung wmen (10-35 years) and bys and yung men (10-35 years). Peple wh inject drugs. Sex wrkers, their children, intimate partners and clients. Men wh have sex with men (MSM).
Lesbian, gay, bisexual, transgender and intersex peple (LGBTI). Inmates, peple awaiting trial and peple wh leave prisn facilities. Persns with disabilities and in particular persns with cmmunicatin, intellectual and psychscial disabilities. Miners and farm wrkers. Peple living with diseases. Gegraphic cverage Sex wrk htspts such as truck stps, shebeens, taverns and brthels. Mining and peri-mining cmmunities. Infrmal settlements. Educatinal institutins. Scial gathering places. Deep rural cmmunities. Implementing Partners All sectrs f civil sciety. Link with relevant gvernment departments. Allw fr innvatins frm cmmunity level. Measurable Outcmes Increase in access t cntraceptives fr adlescents. Increase in number f girls cmpleting schl. Increase in number f yuth nt cnfrming t hetersexist gender nrms cmpleting schl. Reductin in new infectins (90% in 2030). Reductin f Multiple cncurrent partnerships (MCP). Increase in crrect and cnsistent male and female cndm and lube usage. Standardisatin f freskin remval in safe male circumcisin. Increase in uptake f health services and health seeking behaviur. Decrease in stigma and victimisatin. Increase the uptake f HCT (regular and cnsistent). Increase in access acrss the HIV and AIDS services value chain fr persns with disabilities. Decrease in number f TB cases that are lss t fllw up.
Strategic Objective 3: Sustain Health and Wellness Tp Pririty: Integratin f TB/HIV/STI services with health and wellness NSP Links NSP Sub-Objective 3.1: Reduce disability and death resulting frm HIV, STIs and TB thrugh universal access t HIV and TB screening, diagnsis, care and supprt. NSP Sub-Objective 3.2: Ensure that PLHIV, STIs and TB remain within the health care system, are adherent t treatment and maintain ptimal health and wellness. Key Prgrammatic Interventins NSP Sub-Objective 3.3: Ensure that systems and services remain respnsive t the needs f PLHIV, STIs and TB. Imprved linkage t the cntinuum f are fr PLHIV, TB and STIs. Mbile health services fr key ppulatins and thse mst affected by crss-cutting issues. Adherence supprt e.g. decentralized chrnic adherence clubs. Sensitizatin training fr health wrkers fr nn-judgmental services fr key ppulatins. Psychscial and nutritinal supprt especially fr key ppulatins. Ratinale Access, uptake and adherence remains lw thrugh the diagnstic and treatment prcedures f all three diseases, a mre integrated apprach will ensure better patient experience minimising lw access, uptake and adherence. High prevalence f sexual vilence and gender inequality twards wmen and children cntributes t risk f HIV infectin and undermining sustained health and wellness utcmes. Target Grups HIV/STIs Peple living with HIV (PLHIV) Girls and yung wmen (10-35 years) and yung men (10-35 years). Persns with disabilities. Sex wrkers, their children, intimate partners and clients. Men wh have sex with men (MSM) Lesbian, gay, bisexual, transgender and intersex peple (LGBTI). Peple wh inject drugs. Inmates, peple awaiting trial and peple wh leave prisn facilities. Children and especially rphans and vulnerable children (OVC). TB Peple living with HIV (PLHIV). Inmates, peple awaiting trial and peple wh leave prisn facilities. Miners. Health wrkers including cmmunity wrkers. Diabetics. Farming cmmunity. Gegraphic cverage Fcus n high HIV and TB prevalence wards.
Implementing Partners CSO s in partnership with CBOs and Ministry f Health. Measurable Outcmes Increased healthy lifestyles. Decreased viral lad Increase in number f patients n ART with undetectable viral lads Increase in cure rates fr TB Successful treatment fr HIV, TB and STIs. Imprved health and wellness. Strategic Objective 4: Ensure Prtectin f Human Rights and Imprve Access t Justice Tp Pririty: Address stigma and discriminatin in access and mnitr abuses NSP Links NSP Sub-Objective 4.1: Ensure rights are nt vilated when interventins are implemented and establish mechanisms fr mnitring abuses and exercising rights. NSP Sub-Objective 4.3: Reduce discriminatin in access t services. Key Prgrammatic Interventins Prtectin and respect f human rights. Reducing stigma and discriminatin. Imprving access t justice. Imprving gender inequality, Reductin in gender based vilence. Ratinale Access t human rights is nt a lived reality even thugh the prmtin and prtectin f human rights is entrenched in the SA Bill f Rights f the SA Cnstitutin. Methdlgy Develp and early warning system t highlight punitive laws, plicies, prgrammes and practices in rder t address them and hld gvernment accuntable. Strengthen existing legal aid t ensure imprved access t justice, in varius ways fr example curts, representatin and disabilities. Civil Sciety Frum t identify and lbby fr best practices t be replicated. Mre infrmatin and educatin t cmmunities n human rights in rder t ensure peple exercise their rights.
Target Grups Girls and yung wmen between the ages f 10 and 24 years. Peple living clse t natinal rads and in infrmal settlements. Yung peple nt attending schl and girls that drp ut f schl befre matriculating. Peple frm lw sci-ecnmic grups. Inmates, peple awaiting trial and peple wh leave prisn facilities. Uncircumcised men. Persns with disabilities. Sex wrkers, their children, intimate partners and clients. Peple wh abuse alchl and illegal substances. Men wh have sex with men and lesbian, gay, bisexual and transgender persns. Gegraphic cverage Alignment and cverage at Ward, Lcal, Prvincial, and Natinal Levels. Implementing Partners Civil sciety Gvernment MOE, MOH, MOJ, SAPS, DBE, DOH, DOJ, NPA, DSD. Legal Aid Bard. Chapter 9 Institutins. Measurable Outcmes Imprved access t human rights and justice fr all. Reduced self-reprted stigma. imprved prgress twards legal refrm Reduced stigma and discriminatin thrugh sustainable supprt. Increased level f knwledge f human rights. Increased level f prtectin frm state and cmmunity. Increased access t PEP fr victims f sexual assault Increased cnvictin rate fr perpetratrs f sexual assault Partner Organisatins Disabled Peple Suth Africa Deaf Federatin f Suth Africa SA Natinal Deaf Assciatin QuadPara Assciatin f Suth Africa Dwn Syndrme SA Autism SA SA Federatin fr Mental Health Pririties Charter facilitated by AIDS Accuntability Internatinal I Cver Pht: Nicle Bengiven/The New Yrk Times I Back Pht: Steve Murigi