1. CHAZ Profile & Transition Status Profile & Transition Status CHAZ Profile and Status on the Transition 8th Annual CDC/HRSA Track 1.0 ART Program Meeting Avenida Hotel, Maputo Mozambique 9 th August 2010

2. CHAZ Background Information “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Formation & Membership Formed in 1970 ( Catholic and Protestant Medical Committees) Interdenominational (Catholic and Protestant) umbrella organisation for 146 CHIS in 9 Provinces and 56 Districts (out of 72): 36 Hospitals (including AIDSRelief Sites) & 81 RHCs & 9 Training Schools 29 CBOs: 20 Community Based Programmes & 9 Catholic Dioceses Health Services Coverage National Coverage: 30% and over 50% in Rural Areas MoU with the MoH: 75% Grant- Staff – Drugs Principal Recipient Status PR for the Global Fund Mechanism in Zambia for all the 3 disease components: HIV/AIDS (including ART), Malaria & TB. CHAZ has successfully managed a grant value of $124 million out the total 159 million signed to date in the last 6 years.

3. CHAZ Departments & Sources of Funding “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 CHAZ Departments implement a number of Programmes funded by different Partners, e.g. Global Fund JFA AidsRelief/PEPFAR CDC/PEPFAR Dan Church Aid/ Danida CORDAID/EU Beit Trust Fred K.

4. ART Programme Achievement (Global Fund) As @ March2010 “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 ART Services in 50 Site Services in 50 SiteART Media Trained in ART 541 vs. 545 99% Media Trained in ART 541 vs. 545 99% CHWs trained in ART 11,863 vs. 13,129 90% CHWs trained in ART 11,863 vs. 13,129 90% Nutritional Supplements 4,385 vs. 7,000 63% Nutritional Supplements 4,385 vs. 7,000 63% Awareness Campaigns 722,337 vs. 734,957 98% Awareness Campaigns 722,337 vs. 734,957 98% ART Reach Static & Mobile 34,142 vs. 30,000 144% ART Reach Static & Mobile 34,142 vs. 30,000 144% Sites ART: 50 vs. 50 PMTCT: 56 vs. 50 100% Sites ART: 50 vs. 50 PMTCT: 56 vs. 50 100% OIs Treatment 52,131 vs. 31,675 165% OIs Treatment 52,131 vs. 31,675 165% Active: 34,142 Viral SR(≤ 500): 86% Survival Rate at 12 months: 87% Lost to follow up: 3%

5. CHAZ Role and Transition Model in Zambia “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 CHAZ : Prime Local Partner The transition Model –  Phased transfer of AIDSRelief units and site management to CHAZ.  Human Resource – AR Staff hired by CHAZ  Continue with technical expertise in AIDSRelief through Sub-Granting to selected areas within CRS, IHV and Futures Group for long term support. Key to this process: The integration of the AIDSRelief Program into CHAZ’s existing structures

6. Current Status of Transition “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 1.Leadership Forum established. Transition Road map developed and CHAZ Board approval obtained 2. A total of 4 Sustainability sub committees have been put in place Developed and implementing respective unit workplans. Sub committees: –Clinical Technical Area (Clinical, Community Based Treatment Services and Laboratory support strengthening) –Supply Chain Management –Grant Management (Finance and Compliance) –Strategic Information. 3. Working toward initial transfer of 5 sites to CHAZ by Oct 1, 2010. Concurrent with movement of additional AR staff to CHAZ. 4. Work plan based on recommendations from HRSA visit developed and being implemented.

7. Current Status of Transition Cont’d “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Hiring of AR Staff  AR Supply Chain Function now conducted by CHAZ  AR Senior Medical Advisor now CHAZ ART Coordinator  M&E Advisor hired Training of CHAZ Staff in: –Site Capacity Assessment Tool (SCAT) –USG Fund Management (CDC, USAID Policies and procedures) –Strategic Information (SI) –Pharmaceutical Management of ART Commodities Exchange Visits: – to South Africa visit the AR program to learn about their transition model. –AR-CHAZ joint sites visit initiated;

8. Challenges “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Sustainability Model The sustainability model is open to new ideas. No documented lessons to learn from Initially, different understanding of sustainability from Consortium members Managing different models of care (AR: GF) Human Resource Staffing: Hiring vs. Secondment vs. Employment Financing of Program How long term is funding assured? How much? Scale-up in a situation of flat-lined budget Competitive process

9. Lesson learnt on Transition “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 1.Equal Partnership between AR and Local Partners fosters open dialogue in dealing with emerging/difficult issues. 2.The Transition Model needs to be consensual, flexible. 3.The establishment of an inclusive “Leadership & Governance Forum” is key in providing direction to the transition process 4.Functional inclusive “Sub Committees” - Clinical, Supply Chain Management, Grant Management and Strategic Information – is key for the design of the Transition Road Map and Detailed Work Plans. 5.The development of the Communication Strategy and the involvement of all Stakeholder at the very beginning – Board, HFs Managements, Partners’ Staffs, is a key to a smooth transition.

10. Promising Practices “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 To enhance country ownership and Sustainability, the Integration of Programs being transitioned in the already existing Local Partners’ holistic programs

11. “He sent them to preach the Kingdom of God and heal the sick” Luke 9:2 Thank you God bless