SANAC has the important task of rallying the nation behind a common National Strategic Plan and raising resources for the implementation of the Plan. The Secretariat not only coordinates and supports, but drives the implementation of the NSP. This is done on a number of levels.
The Secretariat has reformed the Programme Review Committee (PRC) formerly known as the Programme Implementation Committee and rendered it highly effective. The Secretariat has actively managed the planning, logistics and content of the PRC meetings to ensure a high quality of discussions and documentation and the efficiency of the meetings. The civil society co-chair of the PRC, Dr Ramneek Ahluwalia, has been elected and participated in the last meeting. There have been four meetings of the PRC where the following policy and programme issues were considered:
- Department of Basic Education (DBE) HIV and TB Policy.
- Stigma Index Survey: The Stigma Index Committee, consisting of the National Association of People Living with HIV and AIDS (NAPWA), the Treatment Action Campaign (TAC) the Positive Women’s Network and the South African Network of Religious Leaders Living with or personally affected by HIV or AIDS (SANERELA), supported by the HSRC and UNAIDS, presented the proposal to the PRC and has received unanimous approval to undertake the research in 2014. The Stigma Index Survey will measure levels of stigma in at least one district in each province.
- Access to legal services for PLHIV: Legal firm Webber Wentzel, social rights group SECTION 27 and the International Labour Organisation (ILO) had several meetings with SANAC’s Legal and Human Rights Technical Task Team (TTT) and provinces in an attempt to revive the AIDS Legal Clinic with a key emphasis on educating legal professionals on how to register and maintain records (database) of stigma and discrimination cases and facilitate access to legal services. The PRC approved the proposal to conduct provincial dialogues and to pilot the HIV and TB Legal Clinic in four provinces – Gauteng, KwaZulu-Natal, Mpumalanga and the Eastern Cape.
- The PRC also reviewed work on the National Sex Worker Programme, alcohol and HIV, supporting the banning of alcohol advertising, and the National Department of Health (NDoH) HIV prevention strategy.
YOUNG WOMEN
The Secretariat has highlighted the importance of tackling new HIV infections in young women between the ages of 15 and 24 following a presentation to the SANAC Plenary and further work with the Prevention TTT. It should be noted that in the NSP this target group is identified as the most vulnerable. The Secretariat has worked hard to appoint a sixth Principal Recipient for Global Fund money, which will open a new front in this battle. The programme will reach 18 000 young women, mostly in informal settlements with a comprehensive multi-pronged intervention. In addition, the Secretariat has partnered with JHHESA and the Department of Women Children and People with Disabilities (DoWCPD) to implement the ZAZI campaign.
SEX WORKERS
The Secretariat has worked closely with the Sex Worker Sector to design and plan a national sex worker programme that draws from international best practice. The programme has commenced and will reach 33 000 sex workers in all nine provinces through a peer educator led intervention. The programme adopts a human rights approach. The Secretariat has interviewed candidates for a national programme manager position. Funds will be provided from the Global Fund and PEPFAR.
MIGRANT AND MOBILE POPULATIONS
The Secretariat has made substantial progress in terms of coordinating, leading and supporting the country response to migrant and mobile populations. SANAC’s achievements include fostering dialogue between government, civil society and other stakeholders through the establishment of a national forum on migrant and mobile populations and a technical working group. The Secretariat also works very closely with the Department of Transport to strengthen the coordination of their response to HIV within the sector. SANAC has mobilised funds and will be leading a national size estimation study on mobile and migrant populations scheduled to begin this financial year.
RELAUNCHING HCT
The Secretariat has provided extensive support to the NDoH to implement the re-launched HIV Counselling and Testing (HCT) campaign. HCT levels dipped in the last financial year to a four-year low of 8.9 million tests. This slump led to a decision at the SANAC Plenary to revitalise the HCT campaign. The Secretariat has run HCT revitalisation workshops in seven of the nine provinces and also co-chairs the NDoH HCT campaign nerve centre. The HCT campaign was re-launched on WAD 2013 with the Deputy President, Kgalema Motlanthe, publicly taking a test. The NDoH set a target of 13 million tests for the current financial year. This will require a major effort and the Trust will have to increase its investments in time and money to support this campaign.
STRUCTURAL DRIVERS
Progress is being made with respect to addressing the structural drivers of the epidemic. The Secretariat, working with the Social and Structural Drivers TTT, has identified the following six priority areas for policy reform, advocacy and programme implementation:
- Substance abuse, with a particular focus on alcohol
- Mental health and behaviour
- Poverty and sustainable livelihood
- Migration and mobility
- Gender-based violence
- Gender and sexuality (masculinity)
ADDRESSING HUMAN RIGHTS
Progress is being made in respect of Strategic Objective 4 (Human Rights and Access to Justice) and the TTT has proven to be extremely capable. The issues that are being tackled are the following:
- A legal framework for sex work, including a closer working relationship with the police commissioners to stop police brutality against sex workers.
- Access to justice through legal services.
- Weaknesses in the Sexual Offences Act in respect of children.
- Stigma.
- Establish and address the reason for cases being withdrawn from Thuthuzela Care Centres.
MONITORING AND EVALUATION
Progress is finally being made on the M&E front in respect of both staffing and commencement of crucial M&E activities. An M&E Manager has been appointed and further expansion of the team is planned over the next year to include M&E positions at provincial level. Measuring of the internal monitoring of performance against predetermined objectives is in progress.
Work has commenced on supporting M&E in the sectors and in the provinces with a focus on building the M&E structures and enhancing data quality management. M&E tools are developed and are being disseminated to the sectors.
Plans are underway to produce the first Annual NSP M&E report. A contract is being negotiated with a partner to develop this report of the NSP. The report will measure progress made in the achievement of the set NSP impact and strategic objectives indicators. The report is due for completion by March 2014.
SUPPORTING GOVERNMENT
Support to government departments is provided through fundraising and technical assistance. The following technical assistance has been provided to government departments to enhance their implementation of the NSP:
- DoWCPD: SANAC has HIV, human rights and gender review workshops in Mpumalanga, KZN and Eastern Cape. SANAC has also supported the department by providing technical inputs. The young women and girls programme manager from SANAC attended the KZN gender-review workshop. The workshop was chaired by the Deputy Minister of the departmnet and attended by the premiers of the province. SANAC gave a presentation on South Africa’s progress towards, and challenges in, achieving UN Political Declaration target 7 (which focuses on gender inequality and gender-based violence) and assisted with the facilitation of the session and providing inputs into the workshop report.
- DBE: SANAC has provided written technical inputs to the DBE’s HIV and TB policy through the Prevention TTT.
- NDoH: SANAC, through its Prevention TTT, has discussed and provided feedback to the NDoH on their HIV prevention strategy.
- Sexual HIV Prevention Programme (SHIPP): Under SANAC’s leadership, the SHIPP programme recruited and placed technical assistance (costing and budgeting, Monitoring and Evaluation, etc.) to five government departments: DBE, the Department of Social Development (DSD), NDoH, SANAC and the Presidency.
The biggest impact of the Secretariat in the support to government departments has been through the mobilisation of funds through the Global Fund (GF). The GF Grant for Oct 2013 to March 2016 contributes the following (directly and indirectly) to each of the government departments:
- National Protection Authority (NPA): 6,824,129 USD for the Thuthuzela Care Centres and Domestic Violence Courts.
- DBE: 3,282,082 USD for teachers’ survey and programmes to keep girls in school.
- Department of Higher Education and Training (DHET): 3,946,325 USD for programmes for MSM and then to roll out the HIV package of prevention services to all Further Education and Training (FET) Colleges and expand those in universities.
- DSD: 2,179,349 USD directly for the employment of data capturers and 17,442,626 USD indirectly for Orphaned and Vulnerable (OVC) services.
- NDoH: 116,476,916 USD for antiretroviral treatment (ART) drugs, Central Procurement Unit (CPU) and Direct Distribution Centre (DDC) and drug delivery system.
- Western Cape Department of Health (WCDoH): 24,074,921 USD for ART drugs, personnel, M&E.
- NDoH also indirectly supported by 34,745,389 USD through the provision of medical male circumcision (MMC), ART adherence support and drug resistance monitoring testing and 16,515,836 USD for management of multi-drug resistant (MDR) TB.
A total of 154,362,250 USD goes directly to government departments.