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Joint Programme of Support of the

United Nations Joint Team on HIV and TB

In South Africa

2013-2017

UNSCF Key Result Area 3: A multi-sectoral and sustainable response to HIV, STIs

and TB developed and implemented at all levels in line with the NSP

A. JPS Result / Outcome 1: Capacity of government, private sector and civil society

to plan, coordinate, implement, monitor and evaluate the HIV, STIs and TB

response strengthened

B. JPS Result / Outcome 2: Universal and equitable access to integrated quality,

prevention, treatment, care and support services for HIV, STIs,TB and SRH

achieved for those in need.

C. JPS Result / Outcome 3: Stigma and discrimination reduced; access to justice

increased; human rights and gender equality promoted for key populations, PLHIV

and other groups at higher risk of HIV, STI and TB infection

National and sub-national partners:

SANAC, Provincial Councils on AIDS, National and provincial government departments,

NAPWA, TAC, PEPFAR, USAID, US CDC, DFID, GTZ/GIZ, Irish Aid

Executive Summary

South Africa has the world’s largest HIV epidemic and the world’s third largest TB

epidemic behind India and China. In recent years the response to both diseases has

accelerated and is beginning to show results, with 1.9 million South Africans on HIV

treatment and early suggestions that TB cases are declining. A widely consulted

National Strategic Plan on HIV, STIs and TB (NSP) for 2012-2016 currently guides the

national response. Effective implementation of collaborative TB/HIV activities has

helped to address the co-epidemic of HIV related TB and rapid scale up of HIV testing

through a massive HIV testing campaign has led to many more South Africans knowing

their HIV status and being screened for TB.

The United Nations Country Team (UNCT) has placed HIV and TB as areas at the top

of its agenda and the United Nations Joint Team on HIV/AIDS (UNJT) has developed a

Joint UN Programme of Support (JPS) on AIDS and TB that includes a results matrix on

AIDS and TB for 2013-2017, an annual work plan for 2013 and a monitoring and

evaluation (M&E) matrix for 2013-2017 resulting in one work plan and one budget.

The substance of the JPS includes strategically prioritized tasks of the South African

National Strategic Plan on AIDS, TB and STIs 2013-2017 that are most aligned with the

comparative advantages of the 15 UN organisations who are members of the UNJT.

The United Nations Joint Team on AIDS in South Africa pledges to be vigilant in our

efforts to contribute towards the reduction of HIV and TB incidence, stabilization of HIV

prevalence and the mitigation of the negative impacts of HIV and TB morbidity and

mortality, including the gender differential impact, and through these efforts to strive

towards gender equity and the protection and promotion of human rights. Towards this

goal, we look forward to continuing our close relationship with the South African

government, civil society including persons living with and affected by HIV and TB, civil

society partners, the Business and Labour sectors and Development Partners

Programme Title: Joint UN Programme of Support on AIDS, South Africa Programme Duration: 2013 - 2017 Fund Management Arrangements – Combination Estimated budget: $9.8 million Allocated resources: $7.8 million

Unfunded budget: $2.0 million

ABBREVIATIONS / ACRONYMS

AEF Aid Effectiveness Framework

AHDPF AIDS and Health Development Partners Forum

AIDS Acquired immunodeficiency syndrome

ART Antiretroviral Therapy

CCM Country coordinating mechanism

DIRCO Department of International Relations and Co-operation

EMTCT Elimination of mother to child transmission of HIV

FAO Food and Agricultural Organisation of the United Nations

GARPR Global AIDS Response Progress Reporting

GIZ German International Co-operation Agency

HIV Human immunodeficiency virus

HOA Heads of Agency

ILO International Labour Organization

IOM International Organization for Migration

JPMS Joint Programme Monitoring System

JPS Joint programme of support

KZN KwaZulu Natal

M&E Monitoring and Evaluation

MDG Millennium Development Goals

MTCT Mother to child transmission of HIV

NSP National Strategic Plan for HIV, STI and TB 2013-2017

ODA Overseas Development Assistance

OHCHR Office of the High Commission on Human Rights

PLHIV People/person living with HIV

RC Resident Coordinator

SANAC South African National AIDS and TB Council

STI Sexually Transmitted Infection

TB Tuberculosis

UBRAF Unified Budget, Results and Accountability Framework

UCC UNAIDS Country Coordinator

UN United Nations

UNAIDS Joint United Nations Programme on HIV/AIDS

UNDP United Nations Development Program

UNFPA United Nations Population Fund

UNHCR United Nations High Commissioner for Refugees

UNICEF United Nations Children’s Fund

UNODC United Nations Office on Drugs and Crime

UNSCF United Nations Strategic Cooperation Framework

WB World Bank

WHO World Health Organization

TABLE OF CONTENTS

1. INTRODUCTION ....................................................................................................................... 8

1.1 Country developmental context ...................................................................................... 8

1.2 UN role in South Africa ..................................................................................................... 8

1.3 Status of the epidemics and national response ............................................................... 9

1.4 Linkages with SANAC and other development partners ................................................ 12

1.5 Process of developing the UNSCF and JPS ..................................................................... 13

2. UN JOINT PROGRAMME OF SUPPORT ON AIDS 2013-2017 ................................................. 15

2.1 Results Matrix on AIDS 2013 – 2017 .............................................................................. 16

2.2 The Joint Programme of Support Annual Work Plan for 2013 ...................................... 20

3. MANAGEMENT ARRANGEMENTS.......................................................................................... 21

3.1 The UN Joint Team on AIDS............................................................................................ 21

3.1.1 Division of Labour within UNJT ............................................................................... 22

3.1.2 Roles and responsibilities of UN partners in the UNJT ........................................... 23

3.1.3 UNJT Management ................................................................................................. 24

3.1.4 UNJT links with national partners ........................................................................... 25

3.1.5 UNJT Funding and Accountability ........................................................................... 26

3.1.6 M&E framework and reporting .............................................................................. 28

3.1.7 Risk analysis ............................................................................................................ 29

4. Signatures of heads of agency, UN COUntry TEam ............................................................... 31

5. Annexes ................................................................................................................................. 32

5.1 Annex 1: Annual Work Plan 2013................................................................................... 33

5.2 Annex 3: NSP 2012-2016, goals, strategic objectives .................................................... 40

5.2.1 Vision and Goals ......................................................................................................... 40

5.2.2 Strategic Objectives .................................................................................................... 40

5.2.2.1 Strategic Objective 1: Addressing Social and Structural Drivers of HIV, STI and TB

Prevention, Care and Impact..................................................................................................... 40

5.2.2.2 Strategic Objective 2: Preventing New HIV, STI and TB Infections ......................... 41

5.2.2.3 Strategic Objective 3:Sustaining Health and Wellness ........................................... 42

5.2.2.4 Strategic Objective 4: Ensuring Protection of Human Rights and Improving Access

to Justice 42

5.3 Annex 4: UN Joint Team members ................................................................................. 44

1. INTRODUCTION

1.1 Country developmental context

Although it is classified as an upper middle income country, South Africa is

characterized by widespread poverty and high income inequality between racial groups,

resulting from high levels of unemployment and underemployment. The political and

social upheaval of the apartheid system exacerbated the inequalities and poverty which

in turn accelerated the spread of HIV. SouthAfrica now has the largest HIV epidemic in

the world, with an estimated 5.6 million people living with HIV and an estimated 270 000

AIDS-related deaths in 2011. The HIV epidemic has largely fuelleda major epidemic of

tuberculosis (TB) and drug resistant TB.South Africa has the third-highest TB incidence

in the world (after China and India), and approximately 70% of TB patients are living

with HIV.

1.2 UN role in South Africa

In 2009 the Government of South Africa and the United Nations (UN) carried out a Joint

Evaluation of the Role and Contribution of the UN System in South Africa Context. The

Joint Evaluation advanced two choices for the UN: wind-down or institute high value

collaboration. In response to the review the UNCT concluded that there was a need to:

Appreciate the policy priorities of an upper middle income nation that receives

but also increasingly dispenses overseas development assistance;

Move from project-based initiatives to upstream policy;

Adopt a mind-set of collaboration within UN system rather than individual agency

programmes;

Undertake a thorough UN System capacity assessment to equip it to support

RSA’s strategic policy priorities.

The Joint UN Programme of Support on AIDS 2013 – 2017 is the entirety of the UN’s

support to the national response to AIDS & TB in South Africa, whether individual, joint

or collaborative between organisations. To develop the programme, the UNJT has

strategically prioritized the tasks of South Africa’s HIV, TB and STI National Strategic

Plan 2012 -2016, most aligned with the comparative advantages of the following 12 UN

organisations present:

Food and Agricultural Organisation of the United Nations (FAO)

International Labour Organization (ILO)

International Organization for Migration (IOM)

Joint United Nations Programme on AIDS (UNAIDS)

Office of the High Commission on Human Rights (OHCHR)

United Nations Development Program (UNDP)

United Nations High Commissioner for Refugees (UNHCR)

United Nations Population Fund (UNFPA)

United Nations Children’s Fund (UNICEF)

United Nations Office on Drugs and Crime (UNODC)

World Bank (WB)

World Health Organization (WHO)

The UNJT has one work plan and one budget.This joint programme aims to make an

even more determined effort than previous UN efforts to achieve:

Greater clarity on roles and responsibilities of individual UN agencies;

Clear definition of accountability lines, mechanisms for enforcing them and

overall greater commitment from agencies;

Improved access of partners to provision of technical capacity through the UN

system;

Operate with a long-term vision and targeted annual activities;

Unifying and integrating UN support within national planning frameworks, so as

to strategically fill existing gaps; and

Greater cohesion and effectiveness in our response to AIDS at the country level

1.3 Status of the epidemics and national response

The country’s HIV response dates to the 1980s, but was beset by controversy and

missed opportunities until relatively recently. Over the past 5 years, political

commitment, funding (especially domestic investment), and the scale and quality of HIV

and TB interventions have increased dramatically. The country has the largest

antiretroviral (ART) programme in the world, with 1.9 million South Africans on HIV

treatment. The programme is supported by a massive HIV testing campaign, which saw

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13.2 million people take an HIV test between early 2010, and mid-2011. More than 2.1

million discovered that they are HIV-positive, and 400 000 of them began ART. In

addition, over 8 million people were screened for TB.1 The TB response has been

considerably longer, with an advocacy and patient support organization (the South

African National TB Association) being formed as far back as 1947. Since then TB

control policy in South Africa has closely follow the World Health Organization

guidelines and TB incidence remained stable up until the mid-1990s when the impact of

HIV became apparent and TB rates spiralled out of control. Effective implementation of

collaborative TB/HIV activities and rapid scale up of HIV testing through the HCT

campaign and access to ART rapidly replaced the AIDS-denialism of the early 2000s.

Figure showing the relationship between TB incidence (per 100,000 population) and

antenatal HIV seroprevalence (%) in South Africa 1990-2010. Source: National

Department of Health

The benefits are increasingly evident. In the past two years, life expectancy at birth has

increased from 56 to 60 years—largely due to the rollout of ART and prevention of

mother-to-child transmission (MTCT) of HIV.2 A recent localized study has found that

1Department of Health presentation to the 19

th International AIDS Conference, 22-27 July 2012, Washington DC.

2Medical Research Council (2012).Rapid mortality surveillance report 2011. August.Medical Research Council of

South Africa.Cape Town, p 16.

every percentage point increase in ART coverage among HIV-positive adults was

associated with a 1.7% decline in the risk of HIV.3 Expansion of programmes to

eliminate mother-to-child transmission (EMTCT) has reduced the rate of HIV

transmission to newborns to less than 3% (at six weeks). Infant and under-five mortality

rates have slowed by 25% in the past two years, and new HIV infections in children

younger than 15 years have decreased sharply (from 78 000 in 2006 to 29 000 in 2011).

HIV incidence among adults (15 years and older) is also decreasing: the estimated 350

000 new HIV infections in 2011 were 34% fewer than the 530 000 estimated a decade

earlier. That trend appears partly related to prevention interventions that have gained

pace in the past few years. A massive condom promotion campaign is underway, and

condom use at first sex increased to 68% in 2012. Improved collaboration between the

HIV and TB programmes has resulted in 83% of TB patients knowing their HIV status

and 44% HIV positive TB patients accessing ART in 2011. 1.3 million newly diagnosed

people living with HIV were screened for TB and almost 400,000 people living with HIV

were prescribed isoniazid preventive therapy in 2011.

The gains also highlight the enormous efforts that are still needed to overcome South

Africa’s HIV epidemic. Due to the lifesaving benefits of treatment, the total number of

people living with HIV is rising, which underscores the need for more effective

prevention efforts. Women (especially young women and girls) face inordinate risks of

HIV infection, a state of affairs that calls for more effective enabling interventions. Other

risk-enhancing factors (including alcohol abuse, violence against women, and

socioeconomic insecurity) require stronger action.

A widely consulted National Strategic Plan on HIV, STIs and TB (NSP) for 2012-2016

currently guides the HIV response. Built around four main strategic objectives, its

targets include having 80% of South Africans know their HIV status, having 3 million

people on ART in 2016, reducing MTCT to less than 2% (at six weeks after birth),

distributing one billion condoms each year, and providing medical circumcision to 4.3

million men.

3Tanser F, Bärnighausen T, Grapsa E, Newell M-L. Effect of ART coverage on rate of new HIV infections in a hyper-

endemic, rural population: South Africa. 19th

Conference on Retroviruses and Opportunistic Infections. 2012. Paper #136LB.http://www.retroconference.org/2012b/Abstracts/45379.htm

South Africa’s HIV response is grounded in a rich stock of strategic information and

analysis. Antenatal clinic HIV surveys have been conducted since 1990, and the country

is unique in having conducted four national, household-based HIV and health surveys

(managed by the Human Sciences Research Council). The first national survey was

done in 2002, and the latest is currently underway4 and will include detailed HIV

infection and sexual behaviour data, along with further baseline information for tracking

the progress and impact of the NSP and for reporting on the Millennium Development

Goals. Supplementing those sources are other national surveys, surveillance activities

and evaluations5, and a host of localized studies, which together enable a textured and

up-to-date understanding of the epidemic’s trends, patterns and main drivers.

Recentnational and provincial “Know Your Epidemic and Response” studies have

synthesized these data and analysis. Processes are being developed to identify high-

value, high-impact activities, including by recording and assessing programme

outcomes more systematically.

These various data collection and analysis exercises make it possible to align HIV

programming and resource allocation decisions more closely with the epidemic’s trends

and patterns, and to pinpoint priorities along with funding gaps and absorption issues.

They are now used routinely to guide and refine decision-making—especially to inform

funding needs, ascertain whether there is sufficient investment in critical enabling

factors, and determine whether national and provincial priorities reflect the interventions

that are found to have maximum impact. The systematic use of data (collected at

multiple levels) in the EMTCT is helping planners refine indicators and identify gaps and

priorities at sub-national levels.

1.4 Linkages with SANAC and other development partners

The South African National AIDS and TB Council (SANAC) governance structure has

been revised to align with the new NSP 2012-2017 and give greater emphasis to

implementation. The core functions of SANAC and the Provincial Councils on AIDS are

to:

Advise government on HIV, STI and TB policy and strategy, and related matters.

4South African Behavioural, Serostatus Survey and Mass Media Impact Survey (SABSSM4)

5Including the Demographic, Health and Nutrition Survey (DHNS) and the South African Health and Nutrition

Examination Survey (SANHANES)

Provide leadership and strengthen partnerships for an expanded national

response to HIV, STIs and TB in South Africa.

Receive and disseminate information on sectoral interventions in respect of HIV,

STIs and TB.

Oversee continual monitoring and evaluation of all aspects of the NSP.

The following diagram confirms the current SANAC structure:

The UNJT is represented on many of the SANAC structures at national and provincial

level and provides direct and indirect support to all the SANAC functions in support of

the NSP. The UNJT provides support to all the Provincial Councils on AIDS (PCA) but

the level of engagement varies province to province. For example in KZN, UNAIDS and

UNDP have observer status in the PCA and there is an on-going process to formalise

UNCT representation on the PCA.

1.5 Process of developing the UNSCF and JPS

The South Africa-United Nations Strategic Cooperation Framework (UNSCF) 2013-17 is

the overall framework for the UN system’s work in South Africa. The SCF has been

developed in a participatory process, coordinated by DIRCO and the UN Country Team.

The SCF includes the presentation of the situation in South Africa overall as reflected in

Sector Leader Forum

IMC

Civil Society Forum

LAC Secretariats

DAC Secretariats

PCA SecretariatsPCAs

DACs

LACs

Regular Plenary

Costing TTT Programmatic

TTT x 4

Programme Review Committee

Secretariat

GF CCM

SANAC Trust Board

Extended Plenary

NSP Financing Committee

the New Growth Path, the Draft National Development Plan and the Medium Term

Strategic Frameworkand the 2010 Millennium Development Goals Country Report

which in turn has led to the identification of four pillars of UN cooperation (i.e. inclusive

growth and decent work; environmentally sustainable development; human capabilities;

and governance and participation). Together with other partners The UNSCF also

considers the role of South Africa on in the continent and globally.

The UN Joint Team on AIDS (UNJT) has developed the joint programme of support

through our annual retreat, mapping our UNJT outputs to the UNSCF key result related

to HIV and TB and through subsequent working group meetings. During the retreat the

UNJT evaluated South Africa’s contribution to the UN High Level Meeting on AIDS and

MDG targets; knowledge of the current epidemiology of and response to HIV and TB in

South Africa; the priorities of the UNSCF, NSP and National Development Plan; and a

review of the UN comparative advantage in the areas of HIV and TB to identify three

key UNJT outcomes in support of the UNSCF.

2. UN JOINT PROGRAMME OF SUPPORT ON AIDS 2013-2017

The Joint Programme of Support(JPS) is the entirety of the UN’s support to the national

response to AIDS in South Africa. These efforts will support the UNSCF Key Result

Area 3: 'A multi-sectoral and sustainable response to HIV, STIs and TB developed and

implemented at all levels in line with the NSP’.

The UNSCF is the common strategic framework for the operational activities of the UN

system at country level. It provides a collective, coherent and integrated UN response to

national and international priorities: South Africa’s National Development Plan, the NSP,

the MDGs and the Millennium Declaration.

Figure: Context of the South Africa UN Joint Programme of Support on HIV, STI and TB

The main elements of the Joint UN Programme of Support on AIDS:

Three outcomes with corresponding outputs: Results Matrix on AIDS 2013 -

2017;

Key results and activities for the first year: Annual Work Plan 2013

Management and funding arrangements for the Joint Programme of Support

A monitoring and evaluation (M&E) Matrix: M&E Matrix on AIDS 2013 - 2017

2.1 Results Matrix on AIDS 2013 – 2017

Through a process of strategically prioritizing the themes of the NSP and targets most

aligned with the comparative advantages of the 12 UN organizations who are members

of the UNJT in South Africa. TheUN organizations, through the UNJT,have identified 3

outcomes towards which they will invest their efforts over the next 5 years. The three

proposed JPS results / outcomes are:

A. JPS Result / Outcome 1: Capacity of government, private sector and civil

society to plan, coordinate, implement, monitor and evaluate the HIV, STIs and

TB response strengthened

B. JPS Result / Outcome 2: Universal and equitable access to integrated

quality, prevention, treatment, care and support services for HIV, STIs, TB and

SRH achieved for those in need.

C. JPS Result / Outcome 3:Stigma and discrimination reduced; access to

justice increased; human rights and gender equality promoted for key

populations, PLHIV and other groups at higher risk of HIV, STI and TB infection

The Results Matrix on AIDS (Annex b) presents each of the 3 outcomes with its

corresponding 8 outputs for 2013 – 2017; a list of the main UN organisations

responsible and accountable for delivering the outputs,including ‘co-convener’

organizations; a list of key implementing partners; and projected financial targets. The

‘convener’ is a single entry and liaison point for governments and relevant stakeholders

and primarily accountable for the provision of quality and timely technical support.

A. JPS Outcome 1:Capacity of government, private sector and civil society to plan,

coordinate, implement, monitor and evaluate the HIV, STIs and TB response

strengthened

• Convening agencies:UNDP and ILO with UNAIDS Secretariat support

• UN Partners: UNFPA, UNICEF, WHO, UNHCR, World Bank, IOM

The UNJT will provide normative guidance, technical support,and share global best

practices with government, civil society and the private sector in order to ensure that

national and sub-national institutions are capacitated to deliver the most effective and

efficient response to the epidemics of HIV and TB, tailored to their needs and to ensure

that adequate resources are mobilised to effect the response.

JPS Output 1.1: By 2016, the capacity of SANAC to plan, coordinate, monitor &

evaluate an evidence-informed, prioritised and inclusive multisectoral HIV, STI and

TB response strengthened

JPS Output 1.2: By 2016, strategic government department’s capacity to plan,

resource, implement and monitor evidence-based HIV and TB strategies and

programmes strengthened

JPS Output 1.3:Non-governmental organisations’ ability to meaningfully participate

in planning, implementation, monitoring and evaluation to improve efficiency and

effectiveness of the NSP enhanced

JPS Output 1.4: South Africa’s leadership role in HIV and TB in the region and

globally strengthened.

JPS Output 1.5: Strategic information to identify trends in incidence of HIV and TB,

access, coverage and use of services generated and used to influence policy and

programming

UBRAF indicators - UNJPS Outcome 1 1. UNAIDS policy guidance documents were used to develop and/or review country policies and

strategies or implement key actions without a formal, written national policy (UBRAF # D1.4.1) 2. Number of community-based organizations and/or networks that have meaningfully participated

in HIV and AIDS joint national programme reviews or evaluations in the last 12 months (UBRAF # D2.2.2a)

3. National Strategic Plans benefited from an external quality assurance/peer review (UBRAF # D2.2.2b

4. Standardised and recognised strategic information tools for NSP reviews are used (UBRAF # D2.3.2)

5. Development or revision of a National/Sectoral HIV and AIDS workplace policy(ies) to implement workplace programmes (UBRAF # A1.3.2a)

B. JPS Outcome 2:Universal and equitable access to integrated quality, prevention,

treatment, care and support services for HIV, STIs, TB and SRH achieved for those

in need.

Convening agencies: UNFPA and WHO with UNAIDS Secretariat support

UN Partners:UNICEF, ILO, IOM, OHCHR, UNODC

The UNJT will support national partners to accelerate towards universal and equitable

access to a comprehensive package of the most effective interventions to prevent and

treat HIV, STI’s, and TB and ensure sexual and reproductive health (SRH) for all people

living in South Africa tailored to specific population needs.

UBRAF indicators - UNJPS Outcome 2

1. Strengthened national capacity among key stakeholders for the design and implementation of quality, comprehensive age-appropriate sexuality education in policy and curricula (UBRAF # A1.1.1a)

2. Strengthened national capacity for the provision of essential Sexual and Reproductive Health (SRH) services to young people (UBRAF # A1.1.1b)

3. Municipal level comprehensive HIV prevention, treatment and care programmes implemented for and with men who have sex with men, sex workers and/or transgender people (UBRAF # A1.2.1)

4. Relevant new technologies have been piloted and/or integrated into HIV prevention programmes, policies and strategies (UBRAF # A1.3)

5. Support provided to countries to translate research on new technologies into implementation and scale up (UBRAF # A1.3.1)

6. Strengthened national capacity in logistics management of commodities (UBRAF # A1.3.2b) 7. PMTCT strategy/plans explicitly address low level and concentrated epidemic settings and access to

services are implemented (UBRAF # A2.1.2) 8. Effective national M&E system for the elimination of MTCT programme has been established for the

collection, analysis dissemination and use of data (UBRAF #A2.1.4) 9. Strengthened national capacity for community-based interventions for family planning (UBRAF #

A2.2.3b) 10. Policy guidance & tools addressing the needs and vulnerability of people who use drugs have been

adapted and implemented in the past 12 months (UBRAF # A3.1.1) 11. Evidence informs public health approaches to HIV prevention, treatment & care services including

drug dependence treatment for people who use drugs, and forpeople living in prisons and other closed settings (UBRAF # A3.1.2)

12. UN joint team provided technical assistance for implementation of Treatment 2.0 (UBRAF # B1.1.1) 13. National health system and plan contains key components to address the HIV epidemic (UBRAF #

B1.2.1) 14. Disaggregated data on treatment is reported (by age, gender and key population) (UBRAF # B1.3.2) 15. TB screening and Isoniazid Preventive Therapy are part of the national health system andplan (UBRAF

# B2.2.1) 16. Strengthened national capacity among key stakeholders for the implementation of TB or dual HIV/TB

workplace policies and programmes (UBRAF # B2.3.1a) 17. National capacity to implement and scale up HIV-sensitive social protection and HIV and child-

sensitive social protection strengthened (UBRAF # B3.1.1 & B3.1.2) 18. UNJT has contributed to the development of written national health financing and/or social

protection strategies(UBRAF # B3.2.1) 19. Percentage of total health expenditure that is paid out-of-pocket is less than 15%(UBRAF # B3.2.2)

JPS Output 2.1: Capacity to plan, implement and evaluate quality integrated,

combination prevention, treatment, care and support services (HIV, STI, TB and

SRHR) especially for young women and their partners strengthened.

JPS output 2.2: Leadership, capacity of government, private sector and civil

society to plan, coordinate, implement, monitor and evaluate programming in

pursuit of EMTCT and reduction in AIDS related maternal mortality strengthened.

C. JPS Outcome 3: Stigma and discrimination reduced; access to justice increased;

human rights and gender equality promoted for key populations,people living with

HIV (PLHIV)and other groups at higher risk of HIV,STI and TB infection

Convening agencies: OHCHR and UNODC with UNAIDS Secretariat support

UN Partners:UNDP, IOM, WHO, ILO, UNHCR

Many social, cultural and structural issues hamper an effective national response to HIV

and TB. The UNJT will support national partners to ensure zero stigma and

discrimination related to HIV or TB; overcome the legal barriers to an effective national

response to HIV and TB;enhance access to justice for those in need and support the

attainment of gender equity in the national response to HIV and TB.

JPS Output 3.1:Capacity and skills of government, private sector and civil society to

produce and use strategic information to design & implement a rights-based and

gender-sensitive HIV, & TB response strengthened.

UBRAF indicators UNJPS Outcome 3

1. National parliamentary discussions and governments actively consider and/or take steps towards the removal of legal barriers hindering access to HIV prevention, treatment and support for key populations (UBRAF # C1.1)

2. National capacity among policy-makers, law-makers, key populations and communities affected to advocate for reforms in country laws and practices strengthened(UBRAF # C1.1.1)

3. National coalitions actively advocate for the removal of legal barriers to HIV prevention, treatment, care and support (UBRAF # C1.1.2a)

4. Stigma Index report published (UBRAF # C1.2.1) 5. Proposals for legal, regulatory or policy reform are tabled in parliament (or relevant national forum)

to remove discriminatory HIV-related travel restrictions (UBRAF # C2.1) 6. National capacity among civil society organizations and networks in promoting gender equality

including to engage men and boys strengthened (UBRAF # C3.1.3) 7. Legislation and/or policies addressing violence against women and gender equality have been

reviewed or developed (UBRAF # C4.2.1)

2.2 The Joint Programme of Support Annual Work Plan for 2013

The JPS Annual Work Plan for 2013 (Annex 1) is a rolling work plan with key results

that contribute to the achievement of the JPS outputs for 2013. Each key result will be

linked to individual and joint UN agency activities with a specific source and amount of

funding. The Work Plan reflects programmes areas where a single agencyis responsible

for a set of activities as well as joint and / or collaborative programme areas supported

by several UN agencies.

3. MANAGEMENT ARRANGEMENTS

3.1 The UN Joint Team on AIDS

In accordance with the 12 December 2005 letter of the UN Secretary General, a UNJT

was established to work under the authority of the UN Resident Coordinator (UNRC)

System, the overall guidance of the UN Country Team (UNCT), and led by the UNAIDS

Country Coordinator (UCC). The UNJT members are listed in Annex 4. The UNCT

provides leadership and focusses on ensuring policy coherence and strengthened

advocacy for national efforts.

The primary purpose of the UNJTis to provide coherent interagency technical inputs to

the UNCT for optimal support of the UN system to the national response to HIV and TB.

Under the leadership and guidance of the UNRC and UCC, the UNJT:

Ensures a strong, coordinated and strategic UN system response in support

of national needs and priorities;

Develops and implements a joint UN programme and work plan in support of

the national response to AIDS and TB reflected in an annual workplan;

Mainstreams AIDS and TB into respective agencycountry programmes,

including through the UNSCF; and

Supports the implementation by the UN system Learning Strategy on HIV

Contributes to mobilizing resources—financial and technical—for a scaled-up

national response by:

o Facilitating timely access by national partners to the collective

technical support within the UN system and outside;

o Supporting the design and development of major grant proposals,

including to the Global Fund on AIDS, TB and Malaria ; and

o Integrating AIDS into broad development instruments, especially the

National Development Plan

Supports an effective, nationally owned and nationally driven multisectoral

response by:

o Facilitating the application and adaptation of the “Three Ones"

principles, especially through providing "space" for joint programming,

policy dialogue and inclusive partnerships with national and

subnational and international stakeholders;

o Facilitating capacity strengthening of national entities and systems;

and

o Facilitating and participating in government-led participatory reviews

Generates and disseminates strategic information on the HIV and TB

situation and the response by:

o Monitoring and reporting on the status of the annual work plan through

the UNRC annual report;

o Monitoring and reporting on the overall national situation and

response, including resource tracking, analysis of programme gaps

and ensuring an investments approach;

o Monitoring and reporting on the status and progress of the “Three

Ones” principles; and

o Collation of lessons learnt and good practices on effective support to

national and sub-national responses, both within the UN system and

outside, to inform policies and programmes

3.1.1 Division of Labour within UNJT

In order to ensure efficient coordination of the joint UN response to HIV country level

allocation of responsibility for key thematic areas of the AIDS response are guided by

the global Division of Labour.(Available to download

here:http://www.unaids.org/en/media/unaids/contentassets/documents/document/2011/

20110304_DoL_GuidanceNote_Summary_en.pdf)

Division of Labour area Conveners Agency Partners Reduce the transmission of HIV UNFPA World Bank UNDP UNHCR

UNICEF ILO UNESCO UNAIDS

Prevent mothers from dying and babies from becoming infected with HIV

WHO UNICEF

UNFPA WFP UNAIDS

Ensure that people living with HIV receive treatment WHO UNHCR UNDP UNICEF WFP ILO UNAIDS

Prevent people living with HIV from dying of TB WHO UNICEF WFP ILO UNODC UNAIDS

Protect drug users from becoming infected with HIV and ensure access to comprehensive HIV services for people in prisons and closed settings

UNODC WHO UNICEF UNDP World Bank UNFPA UNESCO UNAIDS

Empower men who have sex with men, sex workers and UNDP World Bank WHO UNESCO

http://www.unaids.org/en/media/unaids/contentassets/documents/document/2011/20110304_DoL_GuidanceNote_Summary_en.pdf

http://www.unaids.org/en/media/unaids/contentassets/documents/document/2011/20110304_DoL_GuidanceNote_Summary_en.pdf

transgender people to protect themselves from HIV infection and to fully access antiretroviral therapy

UNFPA UNAIDS

Remove punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS

UNDP UNFPA UNODC UNESCO WHO UNHCR ILO UNAIDS

Meet the HIV needs of women and girls and stop sexual and gender-based violence

UNDP UNFPA

UNICEF UNESCO WHO UNHCR WFP UNODC ILO UNAIDS

Empower young people to protect themselves from HIV UNICEF UNFPA

WFP UNHCR UNFPA UNESCO ILO WHO UNAIDS

Enhance social protection for people affected by HIV UNICEF WFP UNDP World Bank WHO ILO UNHCR UNAIDS

Address HIV in humanitarian emergencies UNHCR WHO UNFPA WFP UNODC UNICEF UNDP UNAIDS

Integrate food and nutrition within the HIV response UNICEF WFP WHO UNHCR UNAIDS

Scale up HIV workplace policies and programmes and mobilize the private sector, including UN Cares

ILO UNESCO WHO UNAIDS

Ensure high-quality education for a more effective HIV response

UNESCO UNFPA ILO WHO UNICEF UNAIDS

Support strategic, prioritized and costed multisectoral national AIDS plans

UNAIDS World Bank UNDP UNHCR UNESCO WHO UNODC WFP UNFPA UNICEF ILO UNAIDS

3.1.2 Roles and responsibilities of UN partners in the UNJT

3.1.2.1 TheResident Coordinator

Provides leadership for a strong and coordinated UN system response on HIV

Ensures formation of the UN Joint Team on AIDS

Endorses the Results Matrix on AIDS

Ensures that HIV is high on the UNCT agenda

Ensures that HOA are accountable for organization contributions towards the

joint programme deliverables

Intervenes to provide conflict resolution, sanctions or other decision that will

improve UNJT effectiveness

Monitors and reports on, the UNCT‘s performance through the RC’s annual

report

3.1.2.2 TheUN Heads of Agency:

Approve participation of staff members on the UNJT

May revise job descriptions to reflect participation on the UNJT as a key

responsibility

Work with the RC and UCC to determine appropriate performance evaluation

mechanisms, incentives and sanctions for the UNJT members

Accept overall responsibility for annual deliverables of that organization, including

resource mobilisation at organization level

3.1.2.3 The UCC

As facilitator of the UNJT, ensures its effective functioning by convening

meetings, monitoring and evaluating, synthesizing strategic information,

mobilising partnerships and resources, tracking resources;

Ensures development and periodic review of the joint AWP, and identifies

obstacles and solutions to the agreed outcomes and outputs; informs the RC

when intervention is necessary;

As UNCT member, provides policy and technical advice and advocates for and

mobilises effective action among cosponsors;

Provides regular implementation reports to the UNCT, ensures that policy

directives are carried out and contributes in evaluating the Joint Team;

Ensures the appropriate financial management and secretarial support for the

operation of the UNJT;

Working from a platform of the Three Ones, strengthens the links between the

UN system, government, civil society, people living with HIV and AIDS and all

development partners

Together with the UNCT represents the Joint UN Programme and Team to govt.

and external partners as needed

3.1.3 UNJT Management

The UNJT includes all UN staff working full or part-time on AIDS in South Africa.

Currently, this represents 35 professional staff. As outlined previously in the document,

consensus was reached that each of the three results areas will be convened by two

lead co-convening agencies with UNAIDS Secretariat support. Conveners will be

expected to call and chair meetings to finalise the JPS annual workplan and monitor

implementation of the workplan.

The full UNJT meets monthly chaired by the UNAIDS Country Coordinator to share

information, discuss strategic issues and monitor implementation of the annual work

plan. The co-convenors of each group report back on progress and challenges in

implementation. Minutes will be taken and shared with the UNCT on a monthly basis.

The co-convenors are responsible for meeting with the individuals working under the

respective outcome.The co-conveners are responsible for coordinating annual reporting

through the Joint Programme Monitoring System (JPMS)

Joint Team meetings are convened by the UCC. As to theUNJT outcome area working

groups, their meetings will be chaired and managed by the co-conveners.

3.1.4 UNJT links with national partners

The UNJT is represented by UNICEF, WHO and UNAIDS Secretariat on the Official

Development Assistance (ODA) Working Group which is coordinated by the Directorate

of International Relations in the National Department of Health (NDOH). The terms of

reference for Development Partners to engage with NDOH are captured in the Aid

Effectiveness Framework (AEF) which is based on the Paris Declaration and guidelines

from National Treasury. The AEF guides on processes for alignment of ODA with

NDOH processes in order to make planning and implementation more efficient, reduce

transaction and administrative costs and improve the alignment of aid and mutual

accountability. The UN drafts the agenda for the quarterly ODA meetings with the

Director General for NDOH and for the annual ODA meetings with the Minister of Health

to contribute to and monitor progress towards the NSDA, MDGs and HLM targets.

In response to the Aid Effectiveness Framework, development partners formed the

AIDS and Health Development Partners Forum (AHDPF) in 2011 to improve the

coordination and accountability of ODA. The UN, represented by WHO, was elected as

the first co-chair of the Forum with GIZ, representing the European Union.

The UNAIDS Secretariat provides key technical support to South Africa National AIDS

Council Secretariat on the monitoring and evaluation of the national response, the

Global Fund Country Coordination Mechanism (CCM) governance including support to

the CCM, development and implementation of the CCM oversight plan, policies and

guidelines and has the responsibility of supporting grant application, renewal,

implementation, monitoring and evaluation. Three development Partners from the

AHDPF are nominated members of the CCM: The UCC representing the UN, PEPFAR

/US Government and EU represented by GIZ. The WHO representative serves as the

alternate member for the UCC. The UNJT provides technical guidance to Government

departments and various sectors of SANAC such as civil society, PLHIV, business

sector, Health Professionals and Institutions of Higher Learning which includes the

review and development of their HIV and TB work plans and M&E frameworks to align

with the NSP.

3.1.5 UNJT Funding and Accountability

The majority of UN funding for the global response to HIV is channelled through the

Unified Budget, Results and Accountability Framework (UBRAF), the JointProgramme’s

measurement and accountability instrument that aims to maximize thecoherence,

coordination and impact of the UN’s response to AIDS by combining theeffort of the UN

Cosponsors and a Secretariat. It provides a structure for the UN toreports on its

response to AIDS.The UBRAF is guided by the 2011 High Level Declaration targets and

the UNAIDS 2011-2015 Strategy. It aims to achieve the UNAIDS long term vision of

zero new HIVinfections, zero AIDS-related deaths, and zero discrimination.The UBRAF

incorporates three components:

A Business Plan that provides a framework to capture the contributions of the

Joint Programme to support the operationalization of UNAIDS 2011‐2015

Strategy.

A Results and Accountability Framework that will measure the achievements of

the Joint Programme and provide a clear link between investments and results,

guided by the UNAIDS Division of Labour.

A Budget to fund the core contributions of the Cosponsors and Secretariat in

2012‐2015 to translate the goals of UNAIDS Strategy into action.

The UBRAF reflects the UN‐specific contribution, results and accountability to the

globaland national HIV response. Conversely the Global AIDS Response Progress

Reporting(GARPR), which is undertaken every two years, monitors the progress of the

global andnational HIV response and is completed by government officials.The UBRAF

is designed as a framework rather than a workplan, ensuring

decentralizedaccountability which focuses on countries. The framework aims to

strengthen andcontribute to the work of the UNJT by:

Supporting existing monitoring and reporting mechanisms such as UNAIDS

Country Office (UCO), Cosponsor and GARPR reporting;

Providing a consistent yet flexible foundation to support joint planning and

implementation; and

Targeting resources for priority areas.

Significant efforts have been made to harmonize reporting processes and

informationneeds from different UN agencies. As a result, the UBRAF M&E framework

draws on datafrom multiple reporting processes, such as the GARPR (information

provided bygovernments); the UNAIDS Secretariat reporting (performance monitoring);

UNAIDSCosponsor reporting & reporting from thematic groups (global level monitoring);

andUNAIDS Joint Team reporting (UN country level operations monitoring).Countries

are expected to report consistently over time on the 36 UBRAF indicators, thusserving

as the basis for annual reviews and evaluations. It will allow UNJT contribution tobe

reviewed in a more systematic and consistent way to ensure the most appropriateand

timely responses.

Individual members will be held accountable for fulfilling their assigned roles and

responsibilities within the UNJT. Individual performance assessment will take into

account time and technical contribution to the UNJT. The RC and respective HoA will

use existing accountability frameworks and individual organization processes.

Specifically:

Through the HoA, Joint UN Team members’ agreed annual key deliverables

under the joint AWP will be reflected in their respective agency performance

appraisal system

The UCC contributes to the annual performance assessment review of UNJT

members vis-a-vis the AWP.

The UCC assessment of Joint UN Team members’ performance will be part of

their annual institutional performance appraisal system

3.1.6 M&E framework and reporting

Progress towards the achievement of Joint Programme of Support of the United Nations

Joint Team on HIV and TB in South Africa (2013-2017) results will be monitored both at

outcome and output level based on the indicators defined in the results matrices for

each of the main thematic areas. For the outcome indicators, which are fully aligned

with national indicators in the National Strategic Plan on HIV, STI and TB (2012-2016),

sector-specific plans, the data will be drawn from national sources. In order to assess

the impact of the UN contributions on the HIV and TB epidemics in South Africa, the

UNJT will furthermore monitor a selected number of impact indicators.

Unified Budget, Results and Accountability Framework: 2012-2015 (UBRAF) is the Joint

Programme’s measurement and accountability instrument that aims to maximize the

coherence, coordination and impact of the UN’s response to AIDS by combining the

effort of the UN Cosponsors and a Secretariat. The UBRAF is the instrument that is

used to report on UN country level action in response to AIDS.

The UBRAF Monitoring & Evaluation framework provides the structure within which the

UNJT will report on the results based on a set of 38 indicators which will be reported

through the Joint Programme Monitoring System Reporting Tool.

3.1.6.1 Joint Programme Monitoring System Reporting Tool

The UN Joint Team will report on the JPS on an annual basis through the online Joint

Programme Monitoring System (JPMS). The tool includes key indicators and data fields

the Joint Team is expected to report on and provides entry fields for qualitative

information to complement the quantitative data. Upon collection of the data and entry

into the reporting tool, the UN Country Team should review and endorse the

consolidated report prior to submission to UNAIDS Secretariat.

3.1.6.2 Responsibilities:

The monitoring of the implementation of the UN JPS will be undertaken by the UNJT

against the established indicators of the outcome and outputs. UN agencies will

individually monitor the activities that are implemented by them as part of the UN JPS

and periodically report the progress to the convening agency for the particular outcome

area. The convening agency will provide regular updates at monthly UNJT meetings.

Each convening agency will also be in charge of reporting against the financial delivery

rate under its respective outcome area. The mid-term review and annual review of a

joint programme of support will be done collectively by participating UN agencies. It will

serve as the main mechanism for monitoring and analyzing progress towards the

achievement of JPS results and taking stock of lessons learnt and good practices. The

UNAIDS Secretariat will be responsible for ensuring that the UNJT monitors the JPS

and appropriately completes the JPMS reporting tool.

Key Principles that will Guide the Monitoring the Joint Programme of Support • Focus on results-based reporting

• Demonstrate how all funds (core and non-core) are used as well as links between investments and results

• Identifying contributions of each Cosponsor and the Secretariat towards the goals of UNAIDS 2011-2015 Strategy and the 2015 global AIDS targets.

• Reflect on challenges and obstacles in key areas, i.e. showing where UNJT is not achieving results; the reasons why, and proposals to mitigate actions

• Show the added value of joint working more clearly

3.1.7 Risk analysis

Risks are serious threats which are, by definition, outside of the control of the Joint

Programme of Support (JPS). Although beyond programme control, it is useful to

document these risks as it alerts the United Nations Joint Team on HIV and TB (UNJT)

to events which would seriously affect the attainment of desired results. The UNJT has

identified the following risks that may impact on implementation of the JPS and

associated mitigation strategies.

3.1.7.1 Potential Risks to the UN Joint Programme of Support:

RISKS MITIGATION STRATEGIES Changing political, economic, and social stability

environments, undermining or compromising JPS

implementation efforts.

Sustained support and leadership of the South

Africa Government as regards HIV and TB

response

The current uneasy global economic outlook, and

domestic macroeconomic instability may pose

The UNCT will continue to support and advocate

with the Government of South Africa to maintain

difficulties in realizing South Africa’s development

aspirations, and also have the potential to

undermine efforts to finance the HIV and TB

response

political will to allocate and maintain levels of HIV

and TB expenditure and support the development

of country-specific financial sustainability plan

In light of the current global economic uncertainty,

an important risk to implementation is a reduction in

financial support to the UNJPS available from

global, regional and local sources. Associated with

this is the risk of changes in the extent and level of

political and institutional support for the UNJPS at

both global and country level.

The UNCT, government and donors will continue

to advocate for strengthened, consistent and

predictable institutional and financial support for

the JPS at a national and global level. A key

mitigation strategy will be reviewing policy, results

and resources on a regular basis, taking full

account of and adapting to changing levels of

available resources.

As a lower middle-income country, South Africa

has an ambitious agenda to manage the changing

official development assistance (ODA) landscape

and ensure HIV and TB related ODA is managed

and used effectively and responsibly. As the ODA

management system evolves over time, these

reforms will need to keep pace with the changing

global and national context and may result in

corresponding changes in the nature of UN

support, which may need to be adjusted.

The UNCT will continue to work very closely with

the Government of South Africa and development

partners, including via the ODA Forum, to support

and ensure development partners meet existing

commitments and with long-term and

predictable commitments that are aligned with

South Africa’s priorities

Natural disasters and climate change impacts are

likely to accelerate over the coming period.

Economic and social impacts of natural disasters

and climatic events are already very significant.

The UNCT will continue to work closely with the

Government to ensure effective responses to

climate change and natural disaster management,

including by supporting coordination across

government institutions and sectors.

Local authorities’ capacity for planning,

management and monitoring and evaluation

insufficiently strengthened to effectively and

efficiently implement mandate.


Government to strengthen national, civil society

and local governmentinstitutions to facilitate

effectiveimplementation of JUPSA activities

Strong traditional beliefs and values and gender

stereotyping could hamper acceptance of and

progress in achieving gender equality in society at

large.


Government to enhance the protection of human

rights, access to justice, inclusion and gender

equality and further development of systematic

approaches to redress imbalances and violations.

Free Trade Agreements used to pressure developing countries to adopt clauses on intellectual property aimed at limiting the use of Trade-Related Aspects of Intellectual Property Rights (TRIPS) flexibilities that have so far allowed countries to restrict patenting of life-saving medicines and produce or import them in generic forms. This could impact on pharmaceutical price or availability.of lifesaving antiretroviral treatment and other essential medicines

The UNCT will continue to work closely with the Government to to develop mechanisms to strengthen their capacity to negotiate lower prices of medicines. For instance, by setting up joint or “pooled” procurement or developing innovative mechanisms to stimulate

local production.

4. SIGNATURES OF HEADS OF AGENCY, UN COUNTRY TEAM

________________________________ Dr.AgostinhoZacarias UN Resident Coordinator/ UNDP Representative ________________________________ Dr. Tobias Takavarasha Representative, FAO ________________________________ Mr. Vic Van Vuuren Representative, ILO ________________________________ Mr. Eric Ventura Regional Representative, IOM ________________________________ Ms. Yanine Poc Regional Representative, OHCHR ________________________________ Dr. Catherine Sozi Country Coordinator, UNAIDS ________________________________ Mr.Rajendra Joshi Chief Security Adviser, UNDSS ________________________________ Prof. Alaphia Wright Representative, UNESCO

________________________________ Dr. Julitta Onabanjo Representative, UNFPA ________________________________ Ms. Clementine Nkweta-Salami Regional Representative, UNHCR _______________________________ Mrs.Aida Girma Representative, UNICEF ________________________________ Mr.MandiayeNiang Regional Representative, UNODC ________________________________ Ms.NomceboManzini Regional Programme Director, UN Women ________________________________ Dr. Sarah Barber Representative, WHO ________________________________ Mr. Marco Scuriatti Representative, World Bank

5. ANNEXES

5.1 Annex 1: Annual Work Plan 2013

UNSCF Key Result Area 3: A multi-sectoral and sustainable response to HIV, STIs and TB developed and implemented at all levels in line with the NSP

JPS Result / Outcome 1: Capacity of government, private sector and civil society to plan, coordinate, implement, monitor and evaluate the HIV, STIs and TB response strengthened

JPS Output 1.1: By 2016 the capacity of SANAC to plan, coordinate, monitor & evaluate an evidence-informed, prioritised and inclusive multisectoral HIV, STI and TB response strengthened Activity

Indicators Result Lead UN org. & UN partners

National partner(s)

Budget

Planned (required)

Funded

UBRAF Regional UBRAF

Gap

Activity 1.1.1: Strengthen the capacity of SANAC structures at national, provincial and district level to coordinate, resource, implement and monitor evidence informed strategic plans

No. of functional SANAC structures.

Reports from partners and sectors on implementation of the NSP

UNAIDS policy guidance documents were used to develop and/or review country policies and strategies or implement key actions without a formal, written national policy (UBRAF # D1.4.1)

National Strategic Plans benefited from an external quality assurance/peer review (UBRAF # D2.2.2b

Standardised and recognised strategic information tools for NSP reviews are used (UBRAF # D2.3.2)

UNAIDS UNDP, IOM, UNFPA, UNICEF, UNODC, WB, WHO

SANAC; PCAs; National & Provincial depts; CSOs

155,000 45,000 0 0 110,000

Activity 1.1.2: Provide technical assistance to operationalize the Investment Approach in South Africa through policy dialogue on critical issues and undertaking analyses to influence budget allocations



Investment Approach used in development of advocacy materials and strategic information for provinces, civil

Strengthened application of the investment approach at national and provincial levels

UNAIDS World Bank

SANAC NDOH Treasury Provinces CSOs

195 000 195 0000

society and the AIDS Parliamentary Committee

Country case studies on cost effective funding allocations and efficiencies in AIDS and TB prevention, treatment care and service delivery

JPS Output 1.2: By 2016, strategic government department’s capacity to plan, resource, implement and monitor evidence-based HIV and TB strategies and programmes strengthened

Activity 1.2.1:Support government departments and structures to implement and monitor the NSP




NSP implemented timeously and annual targets achieved

UNDP, ILO, UNAIDS

PresidencyAllgovt depts.

185,000 100,000 85,000

JPS Output 1.3: Non-governmental organisations’ ability to meaningfully participate in planning, implementation, monitoring and evaluation to improve efficiency and effectiveness of the NSP enhanced

Activity 1.3.1: Support and include PLHIV networks in advocacy, planning, implementation and M&E and optimal utilisation of resources for NSP

Number of community-based organizations and/or networks that have meaningfully participated in HIV and AIDS joint national programme reviews or evaluations in the last 12 months (UBRAF # D2.2.2a)

Greater participation of civil society in the AIDS and TB responses at all levels Enhanced capacity of sectors

UNAIDS UNDP IOM ILO

CSO sectors, SANAC NGO sector PLHIV Sector

155,000 105,000 10,000 40,000

Activity 1.3.2: UNJT activities coordinated, monitored and evaluated

Standardised and recognised strategic information tools for NSP reviews are used(UBRAF # D2.3.2)

UBRAF annual multi‐stakeholder review of the Joint Programme of Support conducted(UBRAF # D3.1)

UNJT workplan implemented timeously

All UNJT member agencies

17,400

UNAIDS Division of Labour is formally reviewed, adapted and endorsed(UBRAF # D3.1.2)

Joint UN Team on AIDS is functional(UBRAF # D3.2a)

Joint UN Programme of Support on AIDS (JPS)(UBRAF # D3.2b)

JPS Output 1.4: South Africa’s leadership role in HIV and TB in the region and globally strengthened.

Activity 1.4.1: Technical support provided to strengthen and document South African leadership role in HIV and TB globally and regionally




1.71m 1.53m 190,000

JPS output 1.5: Strategic information to identify trends in incidence of HIV and TB, access, coverage and use of services generated and used to influence policy and programming

Activity 1.5.1 Strategic information generated to monitor, evaluate and guide HIV and TB programme implementation for maximum impact

Number of sectors using evidence informed planning

Number of sectors reporting the use of strategic information tools for implementation and review of the NSP.

903,450 830,000 37,450 36,000 0

JPS Outcome 2: Universal and equitable access to integrated quality, prevention, treatment, care and support services for HIV, STIs and TB achieved for those in need. JPS Output 2.1: Capacity to plan, implement and evaluate quality integrated, combination prevention, treatment, care and support services (HIV, STI, TB and SRHR) for young women and their partners strengthened. Activity Indicator Budget

Result Lead UN org. & UN partners

National partner(s)

Planned (required)

Funded


Gap

Activity 2.1.1: Access to integrated prevention, treatment, care and support services (HIV, STI, TB and SRHR) monitored, evaluated and increased

1.Strengthened national capacity among key stakeholders for the design and implementation of quality, comprehensive age-appropriate sexuality education in policy and curricula (UBRAF # A1.1.1a) 2.Strengthened national capacity for the provision of essential Sexual and Reproductive Health (SRH) services to young people (UBRAF # A1.1.1b) 3.Relevant new technologies have been piloted and/or integrated into HIV prevention programmes, policies and strategies (UBRAF # A1.3) 4.Support provided to countries to translate research on new technologies into implementation and scale up (UBRAF # A1.3.1) 5.Strengthened national capacity for community-based interventions for family planning (UBRAF # A2.2.3b) 6.UN joint team provided technical assistance for implementation of Treatment 2.0 (UBRAF # B1.1.1) 7.National health system and plan contains key components to address the HIV epidemic (UBRAF # B1.2.1) 8.Disaggregated data on treatment is reported (by age, gender and key population) (UBRAF # B1.3.2) 9.TB screening and Isoniazid Preventive Therapy are part of the national health system and plan (UBRAF # B2.2.1) 10.National capacity to implement and scale up HIV-sensitive social protection and HIV and child-sensitive social protection strengthened (UBRAF # B3.1.1 & B3.1.2)

UNFPA UNAIDS WHO ILO

UNICEF UNESCO

DoH DRT DBE, DSD SANAC Social Economy OrganizationsCAHI South African Youth Council Childline CJCP CSOs

1.81m 1.35m 60,000 20,000 408,000

Activity 2.1.2 Most at risk and key

1. Comprehensive HIV prevention, treatment and care programmes implemented for and with men

UNFPA ILO

SANAC SWEAT

1.69m 1.74m 50,000

populations identified, monitored and integrated services targeted to their needs

who have sex with men, sex workers and/or transgender people (UBRAF # A1.2.1) 2.Policy guidance & tools addressing the needs and vulnerability of people who use drugs have been adapted and implemented in the past 12 months (UBRAF # A3.1.1) 3.Evidence informs public health approaches to HIV prevention, treatment & care services for people who use drugs, and for people living in prisons and other closed settings (UBRAF # A3.1.2) 4.Disaggregated data on treatment is reported (by age, gender and key population) (UBRAF # B1.3.2) 5.Strengthened national capacity among key stakeholders for the implementation of TB or dual HIV/TB workplace policies and programmes (UBRAF # B2.3.1a)

UNAIDS WHO UNODC IOM UNHCR

DRT Social Economy Organizations NDoH Local Municipalities

JPS output 2.2:Leadership, capacity of government, private sector and civil society to plan, coordinate, implement, monitor and evaluate programming in pursuit of EMTCT and reduction in AIDS related maternal mortality strengthened

Activity 2.2.1 Capacity of government, civil society and private sector strengthened to lead, coordinate, implement, monitor and evaluate EMTCT Action Framework and the national blueprint for action

1.PMTCT strategy/plans explicitly address low level and concentrated epidemic settings and access to services are implemented (UBRAF # A2.1.2) 2.Effective national M&E system for the elimination of MTCT programme has been established for the collection, analysis dissemination and use of data (UBRAF # A2.1.4)

A2.1.1 - Global plan and monitoring framework for eMTCT/keeping mothers alive A2.1.2 - Maternal and child health systems with PMTCT integration into SRH A2.1.4 - PMTCT M&E systems in place A2.2.2 - Paediatric HIV treatment and child health care integrated

UNICEF WHO, UNAIDS, UNFPA

DOH 1.75m 1.50m 270,000

JPS Outcome 3: Stigma and discrimination reduced; access to justice increased; and gender equality promoted for key populations, PLHIV and other groups at higher risk of HIV, STI and TB infection JPS Output 3.1: . Government, Private Sector and Civil Society Organization have the capacity and skills to produce and use strategic information to design and implement a rights based and gender sensitive approach to HIV & TB response. Activity Indicators Budget

Result Lead UN org. & UN partners

National partner(s)

Planned (required)

Funded


Gap

Activity 3.1.1: Strengthen social, legal, justice and law enforcement systems to increase access to justice and decrease stigma and discrimination towards PLHV and other key populations

1. National parliamentary discussions and governments actively consider and/or take steps towards the removal of legal barriers hindering access to HIV prevention, treatment and support for key populations (UBRAF # C1.1)

2. National capacity among policy-makers, lawmakers, key populations and communities affected to advocate for reforms in country laws and practices strengthened(UBRAF # C1.1.1)

3. National coalitions actively advocate for the removal of legal barriers to HIV prevention, treatment, care and support (UBRAF # C1.1.2a)

4. Stigma Index report published (UBRAF # C1.2.1)

5. Proposals for legal, regulatory or policy reform are tabled in parliament (or relevant national forum) to remove discriminatory HIV-related travel restrictions (UBRAF # C2.1)

6. National capacity among civil society organizations and networks in promoting gender equality including to engage men and boys strengthened (UBRAF # C3.1.3)

7. Legislation and/or policies addressing violence against women and gender equality have been reviewed or developed (UBRAF # C4.2.1)

Reduced stigma and discrimination and increased access to justice

UNAIDS OHCHR UNODC UNDP UNHCR IOM ILO UN Women

SANAC Presidency DJCD SAHRC DWCPD CGE DJCD (Gender unit). Justice Institute Gender and human rights institutions HRI ALN NAPWA Section 27, Probono.Org, Webber-Wentzel PAC’s

660,000 263,713 15,000 45,000 336,287

Activity 3.1.2 Technical support provided to monitor, evaluate and

1.Policy guidance & tools addressing the needs and vulnerability of people who use drugs have been adapted and implemented

Lead: UNODC Partners: OHCHR,

DSD, DCS,NDOH,CDA, CDC,

500,000 56,510 77,800 0 365,000

strengthen the response to injecting and other drug use

in the past 12 months (UBRAF # A3.1.1) 2.Evidence informs public health approaches to HIV prevention, treatment & care services including drug dependence treatment for people who use drugs, and for people living in prisons and other closed settings (UBRAF # A3.1.2) 4.Disaggregated data on treatment is reported (by age, gender and key population) (UBRAF # B1.3.2)

UNAIDS,UNDP, IOM,ILO, UNHCR

USAID, MRC, Drug Use TWG

Activity 3.1.3. Provide technical support for programmes promoting the rights of women and girls in the context of HIV and address intersections between gender inequality, GBV and vulnerability to HIV

National capacity among civil society organizations and networks in promoting gender equality including to engage men and boys strengthened (UBRAF # C3.1.3) Legislation and/or policies addressing violence against women and gender equality have been reviewed or developed (UBRAF # C4.2.1)

Gender inequalities and GBV addressed in the context of HIV

UNAIDS OHCHR UNODC UNDP UNHCR IOM ILO UN Women

SANAC DWCPD DOJCD NPA Sonke Gender MRC Justice Presidency

50,000 10,000 40,000

5.2 Annex 3: NSP 2012-2016, goals, strategic objectives

5.2.1 Vision and Goals

The NSP is driven by a long-term vision for the country with respect to the HIV and TB

epidemics. It has adapted, as a 20-year vision, the three zeros advocated by the Joint

United Nations Programme on HIV and AIDS (UNAIDS). The vision for South Africa is:

„„ zero new HIV and TB infections

„„ zero new infections due to vertical transmission

„„ zero preventable deaths associated with HIV and TB

„„zero discrimination associated with HIV and TB.

In line with this 20-year vision, the NSP has the following broad goals:

reducing new HIV infections by at least 50%, using combination prevention

approaches

initiating at least 80% of eligible patients on antiretroviral treatment (ART), with

70% alive and on treatment five years after initiation

reducing the number of new TB infections and deaths from TB by 50%

ensuring an enabling and accessible legal framework that protects and promotes

human rights in order to support implementation of the NSP

reducing self-reported stigma related to HIV and TB by at least 50%.

5.2.2 Strategic Objectives

The plan has four strategic objectives, which will form the basis of the HIV, STI and TB

response.

5.2.2.1 Strategic Objective 1: Addressing Social and Structural Drivers of HIV, STI

and TB Prevention, Care and Impact

Strategic Objective 1 (SO 1) is focused specifically on addressing the structural, social,

economic and behavioural factors that drive the HIV and TB epidemics. The sub-

objectives are:

mainstreaming HIV and TB and its gender- and rights-based dimensions into the

core mandates of all government departments and all other sectors of the South

African National AIDS Council

addressing social, cultural, economic and behavioural drivers of HIV, STIs and

TB, including the challenges posed by socialisation practices; living in informal

settlements, as well as rural and hard-to-reach areas; migration and mobility; and

alcohol and substance abuse

implementing interventions to address gender norms and gender-based violence

mitigating the impact of HIV, STIs and TB on orphans, vulnerable children and

youths

reducing the vulnerability of young people to HIV infection by retaining them in

schools, and increasing access to post-school education and work opportunities

reducing HIV- and TB-related stigma and discrimination

strengthening community systems to expand access to services

supporting efforts aimed at poverty alleviation and enhancing food-security

programmes.

5.2.2.2 Strategic Objective 2:Preventing New HIV, STI and TB Infections

Strategic Objective 2 (SO 2) is focused on primary strategies to prevent sexual and

vertical transmissionof HIV and STIs, and to prevent TB infection and disease, using a

combination of prevention approaches.

Combination prevention is a mix of biomedical, behavioural, social and structural

interventions that willhave the greatest impact on reducing transmission and mitigating

susceptibility and vulnerability to HIV,STIs and TB. Different combinations of

interventions will be designed for the different key populations.

The following sub-objectives are included for HIV, STI and TB prevention:

Maximising opportunities for testing and screening to ensure that everyone in

South Africa istested for HIV and screened for TB at least annually, and

appropriately enrolled in wellness andtreatment, care and support programmes.

Increasing access to a package of sexual and reproductive health (SRH)

services, including thosefor people living with HIV and young people, and

conducting prevention activities in non-traditional outlets. The package includes

medical male circumcision (for adults and neonates), anemphasis on dual

protection, the provision of both male and female condoms, the terminationof

pregnancy and the provision of contraception.

Reducing transmission of HIV from mother to child to less than 2% at six weeks

after birthand less than 5% at 18 months of age by 2016. This includes

strengthening the management,leadership and coordination of the prevention of

mother to child HIV transmission (PMTCT) programmeand ensuring its

integration with maternal- and child health programmes. TB screeningwill be

integrated into the PMTCT programme. In addition, screening and treatment of

syphiliswill be strengthened to eliminate neonatal syphilis.

Implementing a comprehensive national social and behavioural change

communication strategy with a focus on key populations. This aims to increase

the demand and uptake of services,promote healthy behaviours, and address

norms and behaviours that put people at risk for HIV,STIs and TB.

Preparing for the potential implementation of future innovative, scientifically

proven HIV, STIand TB prevention strategies, such as pre-exposure prophylaxis

(PrEP), new TB vaccines andmicrobicides.

Preventing TB infection and disease through intensified TB case finding, TB

infection control,workplace/occupational health policies on TB and HIV, isoniazid

preventive therapy (IPT),immunisation, prevention of multidrug-resistant TB

(MDR-TB), and reducing TB-related stigma,alcohol consumption and smoking.

Addressing sexual abuse and improving services for survivors of sexual assault.

5.2.2.3 Strategic Objective 3:Sustaining Health and Wellness

The primary focus of Strategic Objective 3 (SO 3) is to achieve significant reduction in

deaths and disabilityas a result of HIV and TB. This will be accomplished by universal

access to affordable and goodquality diagnosis, treatment and care.

The sub-objectives of SO 3 are:

Reducing disability and death resulting from HIV and TB. This includes annual

testing/screeningfor HIV and TB, particularly for key populations; improved

contact tracing; early diagnosis andrapid enrolment into treatment; increased

access to high-quality drugs; improved access totreatment for children,

adolescents and youth; early initiation of all HIV-positive TB patients onART;

strengthened implementation of a patient-centred pre-ART package; early

referral of allpatients with complications; appropriate screening and treatment for

cryptococcal infection;and strengthened screening and treatment of pregnant

women for syphilis.

Ensuring that people living with HIV and TB remain within the healthcare system,

are adherentto treatment and maintain optimal health. The means to achieve this

include the establishmentof ward-based public healthcare (PHC) teams and

regular communication using all appropriatemedia.

Ensuring that systems and services remain responsive to the needs of people

living with HIVand TB. This includes integrating HIV and TB care with an efficient

chronic-care delivery system;expanding of operating hours of service delivery

points; ensuring a continuum of care acrossservice delivery points; strengthening

quality standards; and adequate monitoring of drugresistance.

5.2.2.4 Strategic Objective 4: Ensuring Protection of Human Rights and

Improving Access to Justice

South Africa’s response to HIV, STIs and TB is based on the understanding that the

public interest is bestserved when the rights of those living with HIV, STIs and/or TB are

respected, protected and promoted.The NSP 2012 – 2016 recognises the need to

continuously assess barriers to access to services and instancesof stigma and

discrimination and provides the framework for addressing such issues.It aims to ensure

that rights are not violated when interventions are implemented, and that

discriminationon the basis of HIV and TB is not only reduced, but ultimately eliminated.

It has the following sub-objectives:

ensuring that rights are not violated when the interventions under the other three

strategicobjectives are implemented, and that functioning mechanisms for

monitoring abuses and vindicatingrights are established

reducing HIV and TB discrimination, especially in the workplace

reducing unfair discrimination in access to social services.

Targeted interventions, which are identified in respect of each of these sub-objectives,

may have to beimplemented in different spheres or levels. In respect of government

entities, this may be at the national,provincial and/or local sphere of government. In

respect of civil society, business, private sector and nongovernmentalsectors, this may

be at a sectoral, organisational and/or community level.

5.3 Annex 4: UN Joint Team members

Members of UN Joint Team on AIDS in South Africa

Name Agency

HlengiweMdletshe FAO

KolekaMbande FAO

SimphiweMabhele ILO

Mohamed Hassan IOM

DabeaGaboutloeloe IOM

Patience Sizani IOM

Tendayi Muteerwa IOM

Jacqueline Nzoyihera OHCHR

Nelly Mwaka UNDP

Sakhiwo Nkayi UNDSS

Awaiting confirmation UNESCO

Tlangelani Shilubane UNFPA

Patterson Njogu UNHCR

Sanjana Bhardwaj UNICEF

Heidi Loening UNICEF

Nokuthula Prusent UNICEF

David Makapela UNODC

Catherine Sozi (Chair) UNAIDS

Miriam Chipimo UNAIDS

Nancy Fee UNAIDS

Eva Kiwango UNAIDS

Olga Lyan UNAIDS

Nkhensani Mathabathe UNAIDS

Hellen Odido UNAIDS

Alasdair Reid UNAIDS

Natalie Ridgard UNAIDS

Dado Sy Kagnassy UNAIDS

Eric Verschueren UNAIDS

Alti Zwandor UNAIDS

Susan Kimbathi UN Women

Awaiting confirmation World Bank

Augustin Ntilivamunda WHO

Sanni Babatunde WHO

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