Conceptual Outline for developing

KZN Provincial HIV & AIDS and TB Plan 2012

- 2016

KZN Background

KZN Province with 21.4% of SA population accounts for 33% of national adult PLHIV burden Consistently recorded highest ANC HIV prevalence since 1990KZN’s HIV epidemic is at the top end of levels of HIV dissemination into the general population ever seen in the world. HIV epidemic expanded fastest between 2002 and 2005, largely in young women (7.5% HIV+ in 2002, 23.3% in 2005)Life time HIV risk of about 78% at age 55 (males) and 75% (females), such that some people in KZN believe HIV is inevitable.faces worst dual epidemics of HIV and Tuberculosis (xxx provide HIV/TB data )In 2009 highest health district HIV prevalence of 46.4% was recorded in uThukela and only 1 out of 11 districts had prevalence below 30% General population HIV prevalence at 25.8% compared to 17.8% nationally

Background 2 KZN

HIV infections are clustered in Africans – in 2008, 26.2% were HIV+

Highest risk groups: adults in urban informal areas (33.8% HIV+) and rural formal areas (29.8%),

never married but sexually active high-risk women (31.8%) and sex workers (60%)

High prevalence in towns along major highway routes

Some positive results emerging: HIV prevalence and incidence data suggest higher education

has a protective effect. School attendance protects against early first sex Decrease in reported multiple partnerships in the past year (but

not those in the past month)

Comparison SA and KZN data from 2009 ANC survey

SA KZN

HIV prevalence 15 – 49 years 29.4% 39.5%

No. health districts recording HIV prevalence > 40%

5 5

No. health districts recording HIV prevalence between 30 - 40%

14 5

HIV incidence rate - adult population 1.5% 2.3%

New infections 15 – 49 years 335700 98600

New infections 0 – 14years 48481 14235

No. AIDS related deaths

No. orphans due to AIDS

In need of PMTCT services 214000

Drivers of KZN’s HIV epidemic The level of male circumcision is low (27%), Highest frequency of reported multiple sexual

partners in the country, Marriage occurs later in life, Transactional sex is comparatively frequent, Relatively short partnerships of between 7 months

to 2 years are more common than in other areas of South Africa

KZN Response

Three Ones institutionalized Coordinating structures – multisectoral and at Province,

Districts and local levels (some not so functional) Provincial plan (2007 – 2011) and being implemented M&E plan

However: Major expenditure is on treatment BCC activities receive very little funds Limited efforts on combination prevention MMC low despite its proven benefits

Future focus

MMC Communication on partner reduction Communication on Risks of age-disparate sex (often

transactional) as key components of combination prevention More investment in prevention Better disaggregation of prevention spending Education sector has a critical long-term role in HIV prevention

and vulnerability reduction for children and youth as a complementary measure to what other sectors can provide

Why new PSP

The current NSP (2007-11) expires this yearFramework to include new medical evidence of what works and reflect new policy directionUrgent need to develop the new NSP 2012 – 16The Deputy President also announced that the new NSP will be launched on December 1st , 2011

PSP development process and Approach

Results based planning approach to facilitate implementation accountability and ownership of resultsEvidence informed - use KYE/KYR and othersProcess will facilitate stakeholder alignment and harmonize with national planning cycles (Paris Declaration on aid effectiveness )The PSP development process will be forward looking It will acknowledge the progress so far realized through implementation of the current NSP2007-2011Take into account ongoing initiatives and processes

Objectives of the planning processTo conduct an assessment of the provincial and / district responses To capture emerging issues and incorporate them in the new PSP (2012-2016) To identify and agree on key priorities and milestones for the next five years in line with signed National Service Delivery Agreements. To develop provincial and national strategic plans for 2012 – 2016 aligned to the NSDAsTo identify technical capacity gaps and develop a costed Technical Support Plan To document best practices in the response to the HIV and TB epidemics To develop costed operational plans of the new PSP in line with existing planning cycles. To develop a Resources Mobilization Plan for the national and provincial plansTo develop harmonised and integrated M&E Plans based on objectives, targets and expected outcomes of the PSP

NSP development process deliverables

Assessment report of the provincial and district responses Have the current NSP targets been met?Multisectoral participation in the implementation of the NSP – how was it?Role of SANAC , PACs, DACs and LACs in the national response

Costed Provincial & National Strategic Plan for HIV/AIDS, TB and STIs and Provincial Strategic Plans for the period 2012-2016, Costed multi-sectoral Implementation Plans at national and provincial levels, Costed comprehensive M&E Plans 2012-2016, Costed demand-driven Technical Support Plans 2012-2016 and Resource Mobilization Plans.

Guiding Principles..

Supportive leadership, especially political – at all levelsStrong coordinationEffective communicationEffective partnerships including people living with HIV and AIDS at all levelsPromote Greater Involvement of People living with HIV at all levels Sustainable programmes and financingPromoting social change and cohesionGender equity Response is guided by ethically sound, current scientific and evidence-informed research

Guiding principles

Promotion and protection of human rights– people centred and culturally sensitive; promotion of good governance, transparency and accountability

Comprehensive and participatory multi-- sector engagement

Local ownership and focus on local capacity development

10 1 2 3

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8Outputs

P R O V I N C E

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6 57

Outputs /Outcome Outputs /Outcome

/ Outcome

Establish structures:•Steering Committee•TWG•TORs•Core Working Team•Appoint Process Administrator•Consultant TORs

Work Plan PreparationConsultants Orientation/ BriefDocument / Desk ReviewsOrientation of TeamsDocument / Tool preparationsRBM Training/Gender

Stakeholder Workshop•RBM /Gender•Reviews•Prioritasation•Draft

•Priorities•Targets•Thematic

Priorities

Conduct Stakeholder MeetingCapacity BuildingOrientationWork plan preparationSharing ToolsReviewNational priorities TargetsDrafting of Provincial StrategyTA Plan

Work PlanWorkshop Agenda

Disseminate Draft for Comments

2nd Provincial Stakeholder Validation Workshop

Output •T.S. Plan

Output •Draft Priorities•Targets??

Output

•Draft Operational Plan - 2 (3) Years

•M&E Plan

Output

•Refined Costing Priorities

Output •Strategic Plan•M&E Plan

Output •T A Plan •Plan

Consolidated Provincial Strategic Plan

National Strategic FrameworkM&E TA PlanC.P

National Validation Meeting

Aproval

NSP Launch

NSP 2012 – 2016 Development Process Summary

Structures 1. Provincial steering committee

The Provincial Council on AIDS will be the Provincial steering committee that will provide strategic direction and oversight for the

whole process 2. Provincial Coordinating committee (PCC)

The Interdepartmental Committee shall serve as the Provincial Coordinating committee that will provide technical and operational leadership for the whole process. Co-opted members will be drawn from CSOs - FBO, Men, Women, Youth, Children, Private sector and PLHIV organization, academia, traditional leadership and traditional health practitioners

3. The PCA Secretariat

The secretariat - administrative and logistical arrangements

Structures Technical Working Groups / Technical Task Team (TTT)

the present PSP Priority areas to ensure review of all the priority

areas.

Priority areaChair 1: Prevention - Biomedical (DOH)

Social (DOE/DAC)

Chair 2: Treatment, Care and Support

Treatment, Care(DOH) and Care and Support (DSD)

Structures Chair 3. Priority area 3: Management, Monitoring, Research, and

Surveillance of the response Co-ordination, Management, Monitoring of the response (OTP)Research and Surveillance of the response (DOH Academia and

research institution)Chair 4. Priority area 4: Human rights, Access to Justice and Enabling

environment Human rights (OTP) Access to Justice (DOJ)Enabling environment (CSO)

Recommendation

The approval of the formation of the structures

The approval of the PSP Development process.

The chairs of the all structures including the technical working group.

Thank you