Global Fund approves $17 million for new HIV programmes in Africa

The Global Fund to Fight AIDS, TB and Malaria has granted around US$17 million to two consortia of organisations focussing on key populations most affected by HIV, to combat the disease across eastern and southern Africa.

The Global Fund to Fight AIDS, TB and Malaria has granted around US$17 million to two consortia of organisations focussing on key populations most affected by HIV, to combat the disease across eastern and southern Africa.

This is the first time so many regional and national partners have come together in this way to put the focus firmly back on strengthening community and civil society organisations to support the HIV response among those most affected.

The southern Africa programme, ‘Key Populations – Representation, Evidence and Attitude Change for Health Impact’ (KP REACH), with a budget of US$11.4 million will be implemented over three years in Botswana, Zimbabwe, Namibia, South Africa, Lesotho, Swaziland, Zambia and Malawi.

With a budget of US$5.5 million, the eastern Africa proposal focuses on reducing the risk of HIV infection among people who inject drugs and will be implemented in Ethiopia, Burundi, Kenya, Mauritius, Seychelles, Uganda, Tanzania and Zanzibar.

The two proposals bring together existing regional networks of key populations (people most at risk of HIV), regional and national civil society organisations, the private sector and research institutions. The Kenya AIDS NGO Consortium (KANCO), a linking organisation of the International HIV/AIDS Alliance, will lead the programme in eastern Africa, whilst Hivos Southern Africa will lead the programme in southern Africa.

Why these projects now?

According to Dr Gemma Oberth, a consultant who worked with Hivos and the Alliance on developing both regional proposals, the programmes will focus on strengthening networks through a strong commitment to community-led responses. Both programmes emphasise the importance of marginalised groups being able to collect good data, share information and demand better services from their governments.

Dr Oberth notes that the HIV and harm reduction programme in eastern Africa programme is direly needed in the region, for several reasons. “The statistics are alarming,” she says. “The average HIV prevalence among people who inject drugs in the region is almost 25 per cent – more than seven times the prevalence of the general population. The programme targets the eight countries in east Africa that are home to 83 per cent of all people who inject drugs in the region.”

Rhoda Lewa, the lead consultant for KANCO, said a network of existing organisations would implement the programmes at the country level, contributing to efforts to create an “enabling policy environment to support harm reduction interventions in east African countries.”

Drug use on the rise

Lewa said that injecting drug use is a small but increasingly serious problem in the region, and is fuelling a concentrated HIV epidemic. In Mauritius, for example, it is estimated that more than half of the new HIV cases being recorded annually are among people who inject drugs. Currently the region has a handful of grassroots programmes to promote safe needle use and other activities to mitigate risk behaviour but there are few national-level policies to support wider harm reduction interventions.

According to Dr Oberth, the highest HIV prevalence among drug users in the region has been documented in Mauritius (44.3 per cent) and Tanzania (34.8 per cent). By contrast, much lower rates have been recorded in the Seychelles (5.8 per cent). Similarly, there is a large discrepancy in terms of available services in the region. Mauritius and Tanzania are the only countries with both needle and syringe programmes as well as opioid replacement therapy, while Burundi, Ethiopia, Uganda and Zanzibar have neither of these services available.*

Dr Oberth says the regional approach proposed by the programme will add value to the HIV response. “By leveraging the successes of countries like Kenya, Mauritius and Tanzania, where strong national networks of injecting drug users are making real progress, the programme aims to create a regional policy on harm reduction which will support similar gains in the other neighbouring countries.”

In eastern Africa, the groups involved in delivering the programme include the Kenya Harm Reduction Network, Ethiopia’s Organisation for Support Services for AIDS and Community Health Alliance Uganda. Many of these groups are linking organisations, accredited by the International HIV/AIDS Alliance.

Representing key populations

While Hivos is the prime recipient of the Global Fund grant for the KP REACH programme in southern Africa, it will involve existing key population networks in the region (ASWA, AMSHeR, CAL, Gender Dynamix) representing men who have sex with men, sex workers, transgender communities and women who have sex with women, who are sub-recipients of the grant.

Positive Vibes, a linking organisation of the International HIV/AIDS Alliance in Namibia, which has specific expertise in key populations and human rights will also be a sub recipient.

KP REACH aims to strengthen existing and nascent key population networks, improve data collection, knowledge management, innovation, and help scale up and replicate best practices. The funding will also tackle stigma and discrimination as a barrier to HIV prevention, testing and treatment using targeted messaging and innovative approaches to change mind-sets and bring about social change.

Daughtie Ogutu, regional coordinator/executive director of ASWA, says: “We are thrilled to be a key partner in the KP REACH consortium. This means a great deal to the community of African Sex Workers not only for the southern Africa region, where KP REACH will be implemented, but for the wider Africa regional network. This shows that the Global Fund is committed to developing communities and reinforcing the human rights of key populations.

“We hope this will be the beginning a fruitful relationship between key populations and the Global Fund.”

*Statistics from KANCO concept note

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