Brief on the HIV Global Fund Round 10 proposal
In the past Kenya received Global Fund HIV grants from Rounds 1 and 2 which were fully implemented. In 2009 Kenya received the Round 7 grant which is currently being implemented. The Round 8 proposal was rejected as was the National Strategy Application of the First Learning Wave (NSA FLW)/Round 9. The HIV Round 10 proposal was recommended for funding (as a Category 2b conditional upon addressing the weaknesses mentioned to the satisfaction of the TRP during the clarification process.)
Firmly grounded in KNASP III, the proposal was guided by a thorough financial and programmatic gap analyses which fully recognized ongoing efforts and support from core actors such as PEPFAR, CHAI, UN and others. The request for support herein therefore complements the package of prevention, treatment, care and support services being delivered, and aims to accelerate the achievement of Universal Access targets for key interventions including ART, PMTCT and HTC.
The proposal also takes an innovative focus on priority geographical areas with regards to other critical interventions. This recognizes two things: i) the mixed nature of the epidemic in the country calls for responses that are sensitive to local context and situations rather than being generic; and ii) that developing the relevant organizational and infrastructure for effective decentralization is costly and takes time. Consequently, for majority of the interventions included in this proposal, focus will be on the 50 districts that have the highest number of PLHIV. These 50 districts account for 71% of all PLHIV in the country. Dedicated resources to scale up interventions within those settings will therefore have greater impact. This proposal applies lessons learned from previous challenges and has a strong focus on improving the technical and programmatic capacity of all grant implementers. This includes Principal Recipients, Sub recipients and Sub-Sub recipients on both the Government and the NGO side, and is intended to have lasting benefits long beyond the grant period.
In summary the proposal scales up the number of people under anti-retroviral therapy (ART) and introduces the new World Health Organization (WHO) guidelines. It also contains a new component on PMTCT that also targets to improve skilled delivery in the 50 high prevalence districts. It also intends to target most at risk populations (men who have sex with men, sex workers and injecting drug users). It contains a special focus on strengthening community systems through investments in creating linkages between grass-root CBOs and health facilities offering HIV services. It also contains a component designed to improve the technical and programmatic capacity of the implementers.
The proposal has one overarching goal that disaggregates into 3 Objectives and 7 Service Delivery Areas as summarized below:
To contribute to the reduction of new infections and AIDS-related morbidity and mortality for an HIV-free society
Objective 1: Expand care and treatment services to reach universal access by 2013 and maintain the cohort through 2016.
SDA 1.1. Anti-retroviral therapy and monitoring
SDA 1.2. Care and support for the chronically ill
Objective 2: By 2016, increase the coverage of prevention of mother to child transmission (PMTCT), HIV testing and counseling (HTC), most at risk populations (MARPs) and post-exposure prophylaxis (PEP for rape victims)
Interventions by at least 25 percent each.
SDA 2.1. Prevention of Mother to Child Transmission
SDA 2.2. HIV Testing and Counseling
SDA 2.3. Most at Risk Populations
SDA 2.4. Post-Exposure Prophylaxis
Objective 3: Strengthen management and administration of Global Fund grants
SDA 3.1: Leadership and Governance
This proposal is valued at USD 345, 103, 870 and there will be 2 Principal Recipient(s) namely the Ministry of Finance (Government) and Kenya Red Cross Society (Non-Governmental Organization).
Brief on the HIV Global Fund Round 7
Kenya submitted the HIV Round 7 proposal to the Global Fund and was successful. The grant was signed in November 2008 and implementation of this grant began in June 2009. The total funding approved for this grant is $130 million for a period of 5 years. The Ministry of Public Health through the National Aids and STD control program and the National Aids Control Council is implementing grant worth $94million while Care Kenya working with the Civil Society organizations is implementing part of the grant worth $36million.
The grant has 3 main objectives:
• To scale up and maintain antiretroviral treatment for people living with HIV and AIDS
• To increase access to HIV testing and counseling services
• To increase uptake of HIV/AIDS prevention and treatment services
Through the support of the Global Fund Round 7 grant, NASCOP is maintaining 130,000 patients every year on life prolonging antiretroviral treatment. It is also helping to treat opportunistic infections through supporting cotrimoxazole for 200,000 patients. To ensure that the quality of life of these patients is improving, Global Fund is supporting CD4 testing for 200,000 patients to monitor their immune status.. Recognizing that nutrition is key to improving the health status of people living with HIV, the Global Fund is funding a nutrition project in Suba district in Nyanza province. This district has a high HIV prevalence of over 30%. Through these funds, NASCOP will provide nutritional supplementation to those PLWHIV in HIV care in Suba district as well as therapeutic feeding for children who are severely malnourished.
Since only 36% of Kenyans know their HIV status, NASCOP hopes to support counseling and testing of close to 2 million people. To build the capacity of health workers to counsel and test, 1500 health workers will be trained.
Through the Global Fund, the program has recruited 20 data management assistants to aid in data management and data quality improvement. 54 motorcycles have been procured to support the provincial health records officers in hard to reach areas to collect data and improve reporting to the HMIS.
Through the National Aids Control Council, several media campaigns and IEC materials developed to promote HIV prevention and also increase ART uptake. The Civil society, Faith based organizations and the private sector will also undergo training on HIV prevention and treatment.