1 / 26

NAC: HOW TO COPE WITH COMPETING AND NUMEROUS PRIORITIES: WHERE DOES TB/HIV FIT? By

NAC: HOW TO COPE WITH COMPETING AND NUMEROUS PRIORITIES: WHERE DOES TB/HIV FIT? By. Dr.Biziwick Mwale Presentation at the 2 nd Global TB/HIV Working Group Meeting Durban, South Africa 14 th to 16 th June 2002. MALAWI DEMOGRAPHIC AND HEALTH OVERVIEW.

ernestjones
Download Presentation

NAC: HOW TO COPE WITH COMPETING AND NUMEROUS PRIORITIES: WHERE DOES TB/HIV FIT? By

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. NAC: HOW TO COPE WITH COMPETING AND NUMEROUS PRIORITIES: WHERE DOES TB/HIV FIT? By Dr.Biziwick Mwale Presentation at the 2nd Global TB/HIV Working Group Meeting Durban, South Africa 14th to 16th June 2002

  2. MALAWI DEMOGRAPHIC AND HEALTH OVERVIEW • Land locked country located in Southern Africa • Eleventh poorest country (Human Development Report 2000) • Population 9.8 million with 1.9% growth rate (1998 census) • Poor health indicators

  3. HIV/AIDS Situation in Malawi • HIV/AIDS has reached devastating proportions in Malawi • Prevalence 15% among adults 15-49 years of age • One million Malawians are living with HIV • About 500,000 have died since the start of the epidemic • Has created 500,000 Orphans

  4. HIV/AIDS Situation in Malawi • On average 25% of urban and 13% of the rural population are HIV positive • HIV/AIDS mostly affecting young productive Malawians aged 15-49 years • Projections indicate that a minimum of 25% and as much as 50% of the people currently employed in the Urban based sectors will have died of AIDS by 2005

  5. HIV/AIDS AND TB • Upsurge of TB since 1985 • Annual reported TB cases 1985 5,000 TB cases 2001 27,000 TB cases • Largely due to HIV • Over 60% of the TB patients are HIV positive • TB common opportunistic infection in HIV patients

  6. IMPACT OF HIV/AIDS IN MALAWI • Malawi is loosing key professionals in all sectors • The public sector is one of the affected sectors

  7. THE HIV/AIDS IMPACT STUDY ON THE PUBLIC SECTOR IN MALAWI • In 2001 government with financial and technical support from UNDP Conducted an HIV/AIDS impact study in the public sector • The aim of the study was to asses the impact of HIV/AIDS on human capital development, supply and productivity in the public sector • Assumption was that a significant proportions of the deaths in the public sector have been related to HIV/AIDS

  8. THE HIV/AIDS IMPACT STUDY ON THE PUBLIC SECTOR IN MALAWI • Key findings: • High employee attrition • Death is the leading cause of attrition followed by retirements and resignations respectively. • Most deaths are due to AIDS related illnesses • High mortality rates are noted mainly among frontline staff and professionals

  9. THE HIV/AIDS IMPACT STUDY ON THE PUBLIC SECTOR IN MALAWI • Female employees die at an earlier age than the Male employees • High vacancies largely due to employee attrition • High government costs for training, funerals and payment of premature terminal benefits • Reduced public sector productivity

  10. IMPACTS OF HIV/AIDS IN MALAWI • Increased morbidity • Increased mortality • Increase in orphans • Resurgence of tuberculosis (TB) • Reduction of life expectancy • Reduced productivity in all sectors

  11. MULTSECTORAL NATIONAL HIV/AIDS RESPONSE • In 1999, Malawi developed the National HIV/AIDS Strategic Framework (2000 – 2004) • The Framework was costed at US$160 million over 5 years • At the March 2000 resource mobilisation roundtable conference – about US$110 million was pledged

  12. MULTSECTORAL HIV/AIDS RESPONSE • Funding gap estimated at US$50 million • Most of this money was already programmed money

  13. RESTRUCTURE OF THE NACP TO NAC Government decided to restructure the NACP because: • NACP link with the MOHP • NACP was a biomedical implementation arm of MOHP • NACP was more involved in implementation than coordination • High staff turn over- Government structure

  14. THE NATIONAL AIDS COMMISSION (NAC) • Established in July 2001 • Largely through restructuring the NACP • Has a board of 19 Commissioners representing the public sector, private sector and the civil society • The chairperson of the NAC reports to the Cabinet Committee on HIV/AIDS and Health through the Minister of Health and Population

  15. ROLE OF THE NATIONAL AIDS COMMISSION Coordination of the multsectoral HIV/AIDS response • Resource mobilization • Technical support • Policy development and interpretation • Research • Monitoring and evaluation

  16. CHALLANGES • NAC is a new institution with very high expectations • How to coordinate the various partners with different funding flow channels (consultancy on coordination underway) • How to achieve national coverage (importance of the SWAP or basket funding) • Absence of an HIV/AIDS Unit within the Ministry of Health and Population

  17. CHALLANGES • Greater reliance on donor funding for the implementation of the National HIV/AIDS Strategic Framework (Budget line for HIV/AIDS created for each ministry in the 2002/2003 fiscal year) • Weak district Assemblies (Decentralisation underway). • Absence of full time District AIDS Coordinators

  18. CHALLANGES • Monitoring inflow of the pledged resources with different funding channels(Data base created) • How much of the pledged resources have come into Malawi (Review of resource flows under way) • To what extent has the National HIV/AIDS Strategic Framework been implemented (review of the implementation of the strategic framework under way)

  19. CHALLENGES Need to define and agree on: • The role of the NAC Secretariat • The role of the Board of Commissioners • The role of the Ministry of Health and Population • The role of the Donors • The role of the Minister of Health and Population • The role of the Cabinet Committee on HIV/AIDS and Health

  20. COLLABORATION BETWEEN TB/HIV • Resurgence of tuberculosis (TB) since 1985 • Strong link between HIV and TB • Over 60% of the TB patients are HIV positive • Steady increase of PTB and EPTB • High case fatality in TB patients is a result of the strong link with HIV

  21. COLLABORATION BETWEEN TB/HIV • The risk of developing TB or getting recurrent TB is increased in HIV positive people • TB is largely treatable

  22. WHERE DOES TB/HIV FIT? • The ProTEST project has catalysed collaboration between TB and HIV • Both programmes are now working together including developing joint implementation plans • At district level, the ProTEST Project has brought together key HIV/TB stakeholders in joint programme planning and implementation

  23. WHERE DOES TB/HIV FIT? • There is a focal point for HIV/TB in each of the two programmes • There is an active TB/IV Technical Working Group • The two programmes have developed a joint three year HIV/TB implementation plan.

  24. CHALLANGES • Whether the TB and HIV programmes should remain distinct programmes or should be integrated particularly at District level • How to integrate and scale up the ProTEST project to all districts with the current limited resources in the MOHP • Absence of an HIV/AIDS unit within the Ministry of Health and Population

  25. CHALLANGES • Government support to create the necessary staff positions to integrate the programme • Absence of full time District AIDS Coordinators • Availability of resources for HIV/TB activities to sustain the current level of the programme (Hope for the GFATM, MAP and CDC support)

  26. THANK YOU FOR YOUR ATTENTION

More Related