1. Tools for HIV/TB Integration and the Civil Society Experience Carol Nawina Nyirenda Executive Director Community Initiative for Tuberculosis, HIV/AIDS & Malaria (CITAM+) IAC Washington DC 2012

2. Outline Role of civil society in HIV/TB integration. Role of Advocacy Communication & Social Mobilization (ACSM) to operationalize integration at local level. ACSM Training Curriculum Conclusions & Recommendations Questions

3. Role of Civil Society in HIV/TB Integration Integration cannot take place only at the global or national level. Success means utilizing all available resources and ensuring that conditions at the local level inform integration policies and interventions. Without direct involvement of the affected communities – at all levels, including decision making levels - our efforts will be futile. “We no longer want to be mere recipients of care but want to take part in the management of our diseases!”

4. Role of ACSM Advocacy to promote integrated programming across sectors. Communication to facilitate better patient/provider interactions, and to ensure that materials are relevant, effective and not stigmatizing. Social mobilization to ensure that communities are active participants in developing solutions and supporting implementation of services. Bring together civil society with national TB and AIDS programs. Engage private-sector providers and community members to monitor and advocate to promote and increase public demand for accelerated and improved TB/HIV services.

5. Examples: Community Initiative for TB, HIV/AIDS & Malaria, Zambia (Patient-led) Goal: To build the capacity, establish and develop a platform of communication for affected communities, and build a grassroots campaign for TB and TB/HIV co-infected patients for proper treatment, care and support. Providing support and solidarity for HIV/TB co-infected patients Advocacy : IPT for PLHIV – create demand Policy analysis – TB policy documents – effective TB screening tools for PLHIV Training: psychosocial, treatment, adherence, DOTS supporters Defaulter tracing, door to door sensitization, TB into HIV community structures Development of IEC material Budget tracking of TB/HIV resources ACSM training in Zambia for CSO and NTP M & E for ACSM activities

6. CITAM+ Activities Training outreach workers Advocacy - partnerships

7. Africa Coalition on Tuberculosis (ACT!) Consolidating communities throughout Africa to advocate for universal access to services by enhancing advocacy skills, knowledge tools and opportunities to contribute to and hold all stakeholders accountable. 6 initial countries: Kenya, Uganda, Nigeria, Malawi, Zambia, Zimbabwe Build capacity of African TB activists – TOT Create a platform for those directly infected and affected (grassroots) in African countries

8. ACSM Training Curriculum Ways to strengthen TB/HIV integration and support community level responses. Provides knowledge and skills to plan, implement, and evaluate effective ACSM interventions linked to specific HIV and TB objectives. Helps countries develop plans to incorporate ACSM interventions in their national health strategies. Training of trainers model. With funding from USAID, developed by PATH and the Stop TB Partnership.

9. ACSM Tools ACSM community of practice online forum In English, Russian, Spanish and Vietnamese

10. Conclusions & Recommendations More involvement of civil society organizations (affected communities) More collaboration on joint HIV/TB ACSM activities and efforts. Support for training, follow up and M&E must be sustainable. Patient and human rights centered approach. Improved planning and coordination with other health sectors. The ACSM training curriculum has been used in every world region and can help operationalize integration at the local level. M & E of ACSM activities

11. Thank you! Questions?