TASO BACKGROUND

1. TASO BACKGROUND TASO was established in 1987 out of a need to provide care, counseling and support for PLWHA The founders were either afflicted or affected by HIV/AIDS TASO provides direct services in 22 districts; supports programmes in 21 other districts; and trains staff from other countries

2. TASO MISSION • Restore hope • Provide care and support • Promote positive living • Provide social support (children, IGA, food) • Advocate for people living with HIV/AIDS • Prevent the spread of HIV

3. CLIENTS SERVED • 72,000 cumulative clients (HIV+) • In 2001, 8,703 new clients (~30% of total clients served) • 65% of clients female • 90% of clients are living below the poverty

4. TASO SERVICES Counseling Medical care Home based care, visits and counseling Social support – child support, food assistance, social/economic training AIDS education and advocacy Training and capacity building(national and international) Community mobilization

5. COST OF TASO SERVICES • Running costs of a TASO centre per year (serving 3000 clients) = US$ 300,000 - $100/client/year • counselling/medical visit - $10 • Home care visit - $ 30 • Child support per year - $300 • Nutritional support per year/family - $150 • Training of counsellor - $500 • Training of Community Health Worker - $50

6. KEY LESSONS - 1 • There must be the vision and mission to scale up and improve access and care. • Scale up does not occur accidentally –good planning and organization are necessary. • The organization must accept the responsibility of responding to the challenges of scale up. • Good ideas attract resources. The reverse is not necessarily true!

7. KEY LESSONS -2 “Scale up cannot occur without an enabling environment in place to facilitate both the provision and utilization of services.” Components of an enabling environment include:- • Political vision and leadership • Peace and security • Poverty eradication • Empowerment of both genders • Eradication of discrimination and stigma • Good quality VCT services

8. KEY LESSONS -3 “Scale up cannot occur without the mobilization, involvement and support of PLWHA. Scaled up services can be created that are not utilized by PLWHA either due to inaccessibility, inappropriateness, unaffordability or unacceptable services”

9. KEY LESSONS - 4 “The majority of care and support occurs within the family,surrounding households and communities. Unless these grass root structures are empowered to become AIDS COMPETENT, then there can be no meaningful scale up of both quality and quantity of care and support.”

10. KEY LESSONS - 5 “Communities and PLWHA need to have their capacity enhanced to become AIDS COMPETENT. Successful scaled up organizations have a strong capacity building unit to provide scaled up training and other capacity building activities.”

11. AIDS COMPETENT COMMUNITIES • üDemystification of HIV/AIDS by education on basic knowledge of prevention and transmission • üCreation of hope in both the afflicted and affected that there can be a positive life after an AIDS diagnosis • üMove the locus of control for the persons life from external parties like government to their own/families control • üProvide a basic minimum package of care in the form of knowledge of basic counseling; basic home care as well as a home care kit. • üInvolvement of traditional support structures like extended families, traditional healers and religious structures • üUtilization of local health facilities for management of common opportunistic infections including Tuberculosis. • ü Ability and confidence to transfer their knowledge on prevention, care and support to other communities

12. KEY LESSONS - 1 • There must be the vision and mission to scale up and improve access and care. • Scale up does not occur accidentally –good planning and organization are necessary. • The organization must accept the responsibility of responding to the challenges of scale up. • Good ideas attract resources. The reverse is not necessarily true!

13. KEY LESSONS -2 “Scale up cannot occur without an enabling environment in place to facilitate both the provision and utilization of services.” Components of an enabling environment include:- • Political vision and leadership • Peace and security • Poverty eradication • Empowerment of both genders • Eradication of discrimination and stigma • Good quality VCT services

14. KEY LESSONS -3 “Scale up cannot occur without the mobilization, involvement and support of PLWHA. Scaled up services can be created that are not utilized by PLWHA either due to inaccessibility, inappropriateness, unaffordability or unacceptable services”

15. KEY LESSONS - 4 “The majority of care and support occurs within the family,surrounding households and communities. Unless these grass root structures are empowered to become AIDS COMPETENT, then there can be no meaningful scale up of both quality and quantity of care and support.”

16. KEY LESSONS - 5 “Communities and PLWHA need to have their capacity enhanced to become AIDS COMPETENT. Successful scaled up organizations have a strong capacity building unit to provide scaled up training and other capacity building activities.”

17. KEY LESSONS - 6 “ Structures and institutions like TASO and others that provide quality care and support in a resource poor environment do make a real difference to peoples lives and encourage PLWHA to come out in the open enabling the demand and provision for more services.”

18. KEY LESSONS - 7 In order to reach communities, services cannot be facility based only. Services need to incorporate: • vHome based care • vHome based counseling • vOutreach clinics for VCT and care • vUse of AIDS community workers

19. KEY LESSONS - 8 “ HIV/AIDS service organizations on their own cannot provide all the scaled up services required and needs to work in partnership and collaboration with other partners” e.g. vGovernment health services vMissionary health services vPrivate health services vTraditional healers vAlternative medicine vOther AIDS service organizations

20. KEY LESSONS - 9 “Scale up requires a large amount of resources especially human and financial. A critical mass of human resource need to be mobilized and trained to provide counseling, medical services etc.”

21. KEY LESSONS - 10 “Any scale up operation has to incorporate prevention as well as care and support. Either strategy on its own does not work. As scale up proceeds more intensive monitoring and evaluation needs to be carried out to ensure that small-scale successes become large-scale successes.”

22. KEY LESSONS - 11 “Scaling up services both in quality and quantity can increase the administrative support structures required e.g. vehicles, office expenses, management staff. One must consciously ensure that the organization does not become overly bureaucratic to the point that the majority of resources do not support direct care and support for PLWHA and affected population groups.”

23. KEY LESSONS - 12 Scaling up must be ready to encounter and respond to the challenges that HIV keeps presenting e.g. • vChild and orphan support • vNutritional support • vSocio-economic training and support • vGreater access to preventive therapies v Greater access to ARV’s

24. CONCLUSION • The current demand for care and support far exceeds the supply available. • Communities need to be empowered to use their resources and coping strategies to provide care and support for their very own. • Governments and HIV/AIDS service organizations need to complement communities efforts by providing accessible and affordable counseling, medical and social support services particularly to vulnerable communities. THANKYOU!