UNAIDS INTERCOUNTRY TEAM EASTERN AND SOUTHERN AFRICA TB/HIV UNAIDS INTERCOUNTRY TEAM EASTERN AND SOUTHERN AFRICA Good afternoon UNAIDS-ICT/ESA, Pretoria, SA 23 countries in this sub-region Others in Abidjan, Bangkok, Cairo, Carribean 1st Global WG on TB/HIV Apologies from the Secretariat 14/6/02October, 2001

CONTEXT GLOBAL EMERGENCY, SUB-REGIONAL TB MOST COMMON OI GAP IN CARE & SUPPORT OF PLWHAs HUMAN RIGHTS DECLARATIONS INCREASED RESOURCES UNAIDS PAST CARE AGENDA UNAIDS RE-ALIGNMENT Global HIV/AIDS emergency: 2000, 36m PLWHAs men, women and children 70% in this sub-region HIV/AIDS fuelling the TB epidemic in this region. In some countries nearly 70% of TB patients are co-infected with HIV. TB remains the most common OI with the highest morbidity and mortality in this region Large gap in care and support of PLWHAs, men , women and children and their families - from diagnosis, prevention and treatment of OIs to treatment with ARVs and for palliative care Individuals living with HIV/AIDS have the right to access quality care and support Several declarations: Abuja summit on HIV/AIDS, TB and other infectious diseases, UNGASS Increased requests for resources by countries - GFATM, and increased resources coming to countries - MAP & GFATM - Not near enough but still battling with the absorptive capacities of these countries April 2001, UNAIDS re-alignment began. A process which is still being undertaken. As a consequence, key personnel involved at the secretariat in care issue moved to WHO. Plans are currently in place to address this issue. However, as a result of this, better and increased country support is being provided directly to countries. Mt presentation will therefore be on what we , at the sub regional level, are doing with relation to TB/HIV 14/06/02

UNAIDS SUB-REGIONAL SUPPORT TO TB/HIV Southern African Tuberculosis Control Initiative, SATCI - TB/HIV coordinator - TB/HIV treatment guidelines - Linking with existing and new regional support and initiatives: GTZ, DFID, JICA Best Practice documentation: “HIV Voluntary Counselling and Testing: a gateway to prevention and care” The ICT has been supporting SATCI - the Southern African TB Control Initiative. Been in existence since 1995. Initially technical support but more recently, in order to promote TB/HIV activities at country level, we have supported the position of a TB/HIV co-ordinator based in the SADC Health Sector Coordinating Unit - to do just this. Within the last year, SATCI which is composed of the TB managers of the SADC countries, have written a booklet TB/HIV pocket guide targeted for the health care worker. This is currently in the early stages of production. The guidelines recently adopted yesterday will go along way to help them in this process. Linking with DFID, GTZ and JICA for possible continued support VCT BP - key thematic areas: PMTCT, TB and young people TB/HIV pilot project in East Cape. Experiences, lessons learnt and continuing challenges documented. Barcelona 14/06/02

COUNTRY SUPPORT to TB/HIV Advocacy - Policy - HIV/AIDS National Strategic Plans - UN theme group on HIV/AIDS Resource mobilisation - UNTG Programme Acceleration Funds - Global Fund on AIDS, Tuberculosis & Malaria - Others: MAP, SIPAA At the country level: ADVOCACY: All countries , apart from Angola, have an NSP on HIV/AIDS. However, only 4 of these are costed and budgeted. ICT in process of assisting countries to do just this. All of them have care and support as a priority , with the prevention and treatment of Ois as paramount. UNTG on HIV/AIDS - support to country via UN system is through this mechanism. Co-sponsors and other UN agencies. CPA secretariat for the UNTG. Joint workplan. Prioritise along the lines of the NSPs. Resources: For the UNTG; PAF available from the UNAIDS secretariat as start-up funds to do activities in support of the NSP. For a lot of these countries, VCT and CARE, have been major foci. Need to advocate for TB/HIV GFATM: SA, Zambia, Rwanda, Tanzania received funding. Countries that attended the Nairobi meeting on TB/HIV appreciated the meeting and helped countries put togther proposals that were funded. Others: DFID-Action-AID, and the MAP funds 14/06/02

CHALLENGES TB/HIV remains leading cause of morbidity, mortality Dual programming at country level is still not strong enough Greater Involvement of People Living with HIV/AIDS & youth, Faith Based Organisations Greater involvement of co-sponsors & partners in programming for TB/HIV care plans Challenges: GIPA still not enough. As key advocates for issues related to their well-being, PLWHAs can be powerful advocates for not only prevention and treatment with ARVs, as demonstrated by TAC, but also for non-HAART care Co-sponsors, partners, increasingly deveopling care proposals related to their key advantage. Example: ILO and the workplace. Focus has been up to now on prevetion and some VCT. But now some care work is coming out and working out how they can push forth with this remains a challenge 14/06/02

PLANS (1) - ICT/ESA Continuing advocacy - Regional political bodies - SADC, NEPAD, CHRHS - Regional co-sponsors: ILO - Regional bilaterals: DFID - UN country teams on HIV/AIDS, CPAs - GIPA - NAP+ - Regional ASOs: AFRICASO, SANASO Gap areas: workplace, uniformed services, youth, FBOs Tools: TB/HIV strategic framework and guidelines Continuing advocacy with regional political bodies, co-sponsors, bilaterals. We are in the process of supporting NAP+ as leading advocates for all aspects related to HIV/AIDS, including TB/HIV and other care, non-HAART related too. Tools that will be used include the WHO/UNAIDS TB/HIV strategic framework, the guidelines on developing TB/HIV collaborative activities and the UNAIDS BP on HIV VCT: Gateway to prevention and care 14/06/02

PLANS (2) - ICT/ESA Resource mobilisation Case study “Best practice” documentation Communication strategy - TB/HIV (WHO-AFRO) Continued resource mobilisation, with partners in the region for TB/HIV activities Continue to document BPs and if there are any that need to be done right away please do let me know Developing a communication strategy with WHO-AFRO on TB/HIV Encourage use of the ICTs in the various regions as they have direct contact with the country’s. Will disseminate meeting report and contents to those concerned at the different ICTs Many thanks 14/06/02