NATIONAL STRATEGIC PLAN FOR HIV, STIs AND TB, 2012 – 2016

1. NATIONAL STRATEGIC PLAN FOR HIV, STIs AND TB, 2012 – 2016 Presentation to the Select Committee on Social Services 14 February 2012

2. SETTING THE CONTEXT • NSP (2007-2011) ended in December • Each province reviewed implementation, achievements and challenges of the NSP • Process of drafting new NSP guided by the Plenary and co-ordinated by the Programme Implementation Committee (PIC) • Significant consultation facilitated by SANAC secretariat at national, provincial and sectoral levels on the development of the NSP

3. PROCESS • On World AIDS Day 2010, the Deputy President announced that the new NSP will be launched on the World AIDS Day 2011; • The process was kicked started by a national think-thank meeting to design the development of the NSP; • All Provinces were provided with the technical support for consultation on the NSP

4. PROCESS CONTD. • SANAC Programme Implementation Committee reviewed and signed off on the NSP drafts; • The final draft NSP was adopted at the SANAC Plenary in Bloemfontein in October 2011; • Further consultation was undertaken with all sector leaders;

5. PROCESS CONTD. • The Draft NSP was presented to the Inter-Ministerial Committee; • The final draft was presented to Cabinet and was approved in November 2011 and was launched on 01 December 2011 during the World AIDS Day

6. NSP IMPLEMENTATION PLAN • The Deputy President requested all Premiers to develop the implementation plan for the NSP; • The Provincial AIDS Councils coordinated the consultations in the Provinces to development implementation plans; • A national meeting was convened to review the implementation plan;

7. IMPLEMENTATION PLAN CONTD. • The Programme Implementation Committee will convene on 08 March 2012 to review the implementation plan; • Plenary will convene on 15 March 2012 to sign off on the implementation plan; • The new implementation plan will be launched on 24 March 2012 during the World TB Day

8. NSP STRUCTURE • Preface by the Deputy President • Acknowledgements • Executive Summary • Introduction • Progress against previous NSP • Epidemiology • International obligations • Development Context

9. STRUCTURE CONTD • Strategic Objectives • Governance and Institutional Arrangements • Monitoring & Evaluation • Research • Costing and Financing

10. NSP APPROACH • Learn lessons from NSP 2007-2011 • Base interventions on what is known about HIV, STIs and TB • Link interventions to development agenda of government • NSP to be strategic and focus on: • Greater coverage • Improved quality • Reconsider activities that don’t make a difference • Introduce new/novel interventions

11. LONG-TERM (20 YEAR) VISION • The proposed long-term vision for the country with respect to the twin epidemics is the four zeros: • Zero new infections from HIV and TB; • Zero preventable deaths associated with HIV and AIDS and TB; • Zero discrimination; and • Zero infections related to mother to child transmission

12. 5 NSP GOALS • Reduce new HIV infections by at least 50% using combination prevention approaches; • Initiate at least 80% of eligible patients on antiretroviral treatment (ART), with 70% alive and on treatment five years after initiation; • Reduce the number of new TB infections, as well as the number of TB deaths by 50%; • Ensure an enabling and accessible legal framework that protects and promotes human rights in order to support implementation of the NSP; and • Reduce self-reported stigma and discrimination related to HIV and TB by 50%.

13. 4 NSP STRATEGIC OBJECTIVES • Address social and structural barriers to HIV and TB prevention, care and treatment; • Prevent new HIV, STI and TB infections; • Sustain health and wellness; and • Ensure protection of human rights and increase access to justice.

14. SO 1: ADDRESS SOCIAL AND STRUCTURAL BARRIERS • Mainstream HIV and TB and its gender and rights-based dimensions into the core mandates of all government departments and all SANAC sectors • Address social, economic and behavioural drivers of HIV, STIs and TB • Implement interventions to address gender inequities and gender-based violence as drivers of HIV and STIs • Mitigate the impact of HIV and TB on orphans, vulnerable children and youth

15. SO 1: ADDRESS SOCIAL AND STRUCTURAL BARRIERS • Reduce the vulnerability of young people to HIV infection by retaining them in schools, as well as providing post-school education and work opportunities • Reduce HIV and TB related stigma and discrimination • Strengthen community systems • Support efforts aimed at poverty alleviation and enhancing food security programmes

16. SO 2: PREVENT NEW INFECTIONS • Maximise opportunities to ensure everyone in South Africa tests voluntarily for HIV and is screened for TB at least annually, and is subsequently enrolled in relevant wellness and treatment, care and support programmes • Make accessible a package of sexual and reproductive health (SRH) services • Prevent transmission of HIV to reduce MTCT to less than 2% at six weeks and to less than 5% at 18 months by 2016

17. SO 2: PREVENT NEW INFECTIONS • Implement a comprehensive national social and behavioural change communication strategy with particular focus on key populations • Prepare for the potential implementation of future innovative, scientifically proven HIV, STI and TB prevention strategies • Prevent TB infection and disease • Address sexual abuse and improve services for survivors of sexual assault

18. SO 3: MAINTAIN HEALTH AND WELLNESS • Reduce disability and death resulting from HIV, STIs and TB through universal access to HIV and TB screening, diagnosis, care and treatment • Ensure that people living with HIV, STIs and TB remain within the health care system, are adherent to treatment and maintain optimal health and wellness • Ensure that systems and services are responsive to the needs of people living with HIV, STIs, and TB

19. SO 4: HUMAN RIGHTS AND ACCESS TO JUSTICE • Recognise the centrality of constitutional values and human rights in line with rights entrenched in Chapter 2 of the Constitution and the obligations these impose on the state including the rights to equality, dignity, life, freedom and security of the person and privacy. • All SOs to address the needs of key populations • Recognising that the legal framework for respecting, protecting, promoting and fulfilling rights is largely in place, SANAC must give special attention to groups that are at higher risk. • SANAC will work with all institutions to address human rights and any form of discrimination with respect to HIV, STI and TB.

20. MONITORING AND EVALUATION • Levels of monitoring • Monitor provincial implementation plans (using largely existing data collection systems) • Monitor sector implementation plans • Develop monitoring system for NSP (focusing on the strategic issues) • Midterm evaluation • End of term evaluation 20

21. CORE IMPACT INDICATORS

22. SO 1 INDICATORS

23. SO 2 INDICATORS

24. SO 3 INDICATORS

25. SO 4 INDICATORS

26. RESEARCH • Surveillance and Vital Statistics • Health Systems and Operations Research • Research for Innovation • Policy, Social and Public Health Research 26

27. COSTING AND FINANCING • Costing done at high level and is indicative • R131 billion over 5 years • Gap analysis • For 2012/13 additional 15% over current spending is projected • Need to ensure sustainable financing especially in current economic climate (all stakeholders to contribute and to ensure efficiency) • Costing of the provincial strategic implementation plans to be completed by March 2012 27

28. NSP LAUNCH AND COMMUNICATION STRATEGY • NSP was launched on 1 December 2011, World AIDS Day, Nelson Mandela Bay Metro, Eastern Cape • All provinces to launch provincial implementation plans on 24 March 2012, World TB Day 28

29. NSP PRODUCTS • Final full NSP • Summary NSP • ‘NSP at a Glance’ (English and Xhosa) • Summary NSP (Braille) • CDs with copies of the full, summary and ‘NSP at a glance’ documents • Documents are available on the SANAC and website

30. PREPARING FOR IMPLEMENTATION – 1 APRIL 2012 • Develop the implementation plan framework and work with provinces and national departments to complete plans for launch on 24thMarch 2012 • Cost provincial implementation plans • Complete revision of governance structures assessment • Establish full SANAC M&E system • Strengthen SANAC secretariat, and Provincial & Districts AIDS Councils

31. NSP IMPLEMENTATION PLANNING - ROADMAP 1ST FEBRUARY 2011 Implementation Plan and M&E framework Development Process with rolling support Period ending 8th March National Consolidated plan writing team & support team Provincial and National Department Implementation Plan Development Processes M&E working group Provincial and National Department costed implementation plans and M&E plans for NSP Year 1 8th March Costing working group Develop costed consolidated national implementation plan 8th March National M&E framework 8th March

32. NSP IMPLEMENTATION PLANNING - ROADMAP 1ST FEBRUARY 2011 Develop costed consolidated national implementation plan 8th March National M&E framework 8th March Provincial and National Department Develop costed implementation plans and M&E plans 8th March Funding gap analysis report Circulate to PIC TBA PIC Discussion and sign-off TBA Sign-off arrangements Launch National Costed Consolidated NSP Implementation Plan Year 1 & M&E framework . 24th March Launch

33. PULLING IT ALL TOGETHER Consolidated National Costed Implementation Plan & M&E Framework Consolidated Provincial l (PCA) Implementation Plan Consolidated National Dept Implementation Plan Provincial Dept Implementation Plans District/ Municipality Implementation Plans Implementation stakeholders Provincial Govt Local Govt Private Sector Civil Society Develop Partners National Govt

34. THANK YOU!!!