Business Case For Southern Africa Regional Programme for hiv prevention Evidence Draft

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Business Case


Southern Africa Regional Programme for HIV Prevention Evidence

Draft 16-Apr-16
ART anti-retroviral treatment

ARV anti-retroviral (medicine)

BCC behaviour change communication

CEGAA Centre for Economic Governance and AIDS in Africa

CSO Civil Society Organisation

GFATM Global Fund to fight AIDS, Tuberculosis and Malaria

IDU intravenous drug user

KYE Know your epidemic (study)

KYR Know your response (study)

MARP Most at risk population

MDG Millennium Development Goal

MMC Medical male circumcision

MSM men having sex with men

PEPFAR American President’s Emergency Plan for AIDS Relief

PLHIV People living with HIV/AIDS

PMTCT Prevention of mother-to-child transmission

PrEP Pre-exposure prophylaxis (someone without HIV taking antiretroviral drugs on the assumption that they are going to have sex with someone who might be HIV positive

RATN Regional AIDS Training Network

REPPSI Regional Psychosocial Support Initiative

SADC Southern African Development Community

SAT Southern Africa AIDS Trust

SBCC Social and behaviour change communication

SIDA Swedish International Development Cooperation Agency

SSA Sub-sahara Africa

UNGASS United National General Assembly Special Session on HIV/AIDS

VMMC voluntary medical male circumcision

Business Case and Intervention Summary
Intervention Summary

Title: DFID Southern Africa Regional Programme for HIV Prevention Evidence

What support will the UK provide?

How much funding does the UK expect to provide?

£10.7 million

Period of funding

4 years (FY 2013/14 to 2016/17)

Why is UK support required?

  • What need are we trying to address?

DFID Southern Africa HIV prevention programme 2013/14 to 2015/16 aims to strengthen the evidence for effective interventions to fight HIV transmission in the Southern Africa region, focussing on two selected vulnerable populations: adolescents and prisoners.
The countries of Southern Africa have some of the highest HIV prevalence rates in the world, and the region remains the global epicentre of the epidemic. Eight countries in Southern Africa continue to bear a disproportionate share of the global AIDS burden, all having HIV prevalence greater than 10%. The Southern African region is home to 11.3 million people living with HIV/AIDS (PLHIV), an increase of nearly one-third (31%) compared to the 8.6 million in the region ten years previously. The region accounts for 34% of all PLHIV worldwide and 34% of AIDS deaths.
Despite the increasing numbers on treatment, the number of people becoming newly infected each year still exceeds the number of new people treatment. HIV prevention is insufficient in terms of evidence generation and taking proven interventions to scale. In addition, some of the most vulnerable populations, such as adolescents and men having sex with men, continue to be highly stigmatised and with their rights neglected. Their contribution to the epidemic is widely ignored.
The economic burden of HIV poses enormous challenges to the region. The long-term cost per each additional HIV infection is equal to GDP per capita in South Africa, and 7 times GDP per capita in Swaziland. Effective prevention of HIV infection exceptionally important. Structural and social drivers of the epidemic and specific populations who are at higher risk of contracting or transmitting the virus (vulnerable populations) must be better understood to expand interventions with proven efficacy.

  • What will we do to tackle this problem?

This Programme aims to mount a more effective and efficient prevention effort in the region through generation of evidence of what works and why, and through improving the skill-set of policymakers in utilising this evidence. The programme will focus on two of the most vulnerable populations, adolescents (with a focus on young women) and prisoners. The programme thus takes on a catalytic function in the region, to establish ‘good practice’ for evidence based HIV prevention. This will be achieved through a number of complementary interventions:

  • Generating evidence on innovative HIV prevention methods through a regional fund for operations and innovation research with the Swedish International Development Cooperation Agency (SIDA).

  • Supporting large scale assessments of known efficacious interventions in various countries of the region, co-funded with the World Bank;

  • Improving the skills of programme planners and policy makers to analyse, interpret and utilise routine and research data for defining and implementing policies on HIV prevention through long-term mentoring and strengthening linkages between academic and policymaking institutions;

  • Addressing the socio-structural drivers of HIV transmission adolescent women and prisoners through political dialogue, advocacy and direct engagement through Civil Society Organisations.

  • Who will be implementing the support we provide?

The UNAIDS regional team will provide the secretariat for the oversight steering committee and be responsible for monitoring and evaluation of the programme. A Service Provider contracted by DFID will coordinate the programme and will subcontract specialised institutions to manage the work on research and innovation, the regional exchange of best practice and capacity building, and the political dialogue and advocacy work. The World Bank will implement the output on effectiveness and efficiency studies in a number of countries of the region with a focus on the two vulnerable groups.

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