This is a New activity

AIDSRelief is a consortium comprised of Catholic Relief Services (CRS), the University of Maryland School

of Medicine's Institute of Human Virology (IHV), Constella Futures, Catholic Medical Mission Board and

Interchurch Medical Assistance. AR works primarily in faith-based institutions in 9 countries (Kenya,

Uganda, Rwanda, Tanzania, South Africa, Zambia, Nigeria, Haiti and Guyana) and is seeking to expand

this support to Ethiopia. Consortium partners anticipated to provide HIV services in Ethiopia under

AIDSRelief are CRS, IHV and CF.

The goal of AIDSRelief is to support local partners to provide quality HIV care and treatment to PLWHs. The

program successfully reached 98% of its target, and as of August 2007 is providing ART to 82,000 patients

and care for 200,000 people at 140 local partner treatment facilities (LPTFs) as well as at least 100

decentralized sites across 9 countries Outcomes from the AIDSRelief continous quality improvement

program which is an integral part of activities, have shown high levels of treatment success. Out of a

sample of almost 1000 patients who have been on ART for longer than 9 months, 90% are virologically

suppressed (defined as <400 copies/ml). At the end of August 2007, the total lost to follow up across all

countries was 3.69% and mortality was 8.26%.

CRS, the prime funding recipient of the AIDSRelief consortium, has been in Ethiopia for over 40 years and

currently has an extensive program portfolio, including PEPFAR funded palliative care, OVCs and

prevention activities. Expansion in providing care and treatment will create synergistic programming and

maximize the impact of wrap-around funding.

AIDSRelief has experience in providing ART in resource-constrained settings. Under COP09 funding,

AIDSRelief in Ethiopia will work in partnership with the Catholic Church, Makaneyesus Church, the

Adventist Development Agency (ADRA) and the Ethiopian Orthodox Church to provide comprehensive

ART services through selected faith based health facilities primarily in rural areas reaching1114 patients

with ART and 2050 with palliative care,10% of which will be children.

AIDSRelief has the capacity to make a significant input to treatment programs in Ethiopia through

implementing a comprehensive family centered care and treatment approach which builds upon the

presence of faith-based institutions within communities. The AIDSRelief approach incorporates ART

initiation and scale-up ranging from diagnosis, clinical mentoring, diagnosis and treatment of OIs, patient

monitoring, and maintenance of medical records, patient treatment preparation, community mobilization and

education, with strong links into communities to ensure excellent adherence. AIDSRelief will ensure that all

patients coming for care and ART are routinely screened for TB, and LPTF providing TB services will have

patients tested for HIV. There is also a key role for patients themselves to provide ongoing adherence

support to each other which AIDSRelief incorporates as the backbone to our community support and

adherence activities. AIDSRelief will work in collaboration with CDC/MOH/ENHRI to support the

laboratories within the identified health institutions.

AIDSRelief promotes a family-centered approach to HIV care and treatment and is committed to ensuring

that at least 10% of its' patient load is comprised of pediatric patients. Establishing linkages with MCH,

ANC PMTCT, in-patient and out-patient services and encouraging provider-initiated diagnostic testing will

contribute to this goal. It has also been AIDSRelief's experience that as ART becomes more accessible

and communities strengthen their involvement, the number of people coming forward for C&T also

increases. With the objective to reduce mother to child transmission of HIV in AIDSRelief supported

facilities, the program will follow the new national PMTCT guidelines and promote an essential package of

PMTCT services which includes provider initiated HIV testing in ANC, encouraging mothers to deliver in a

health facility, CD4 testing of all pregnant HIV+ mothers, DBS for babies, the provision of ARV prophylaxis

to mother and infant and referral for HAART as required. The PMTCT program will be underpinned by

strong community outreach and follow-up of all HIV positive mothers and their babies. AIDS Relief will

follow national guidelines for management of HIV exposed infants . The program will also strengthen

linkages between other services within the health facilities.

Strengthening human capacity to deliver quality services is essential. Over and above the hands on

mentoring, AIDSRelief will train 56 people in clinical care, pediatric care, finance and compliance.

AIDSRelief, will work in partnership with the African Network for Children affected by HIV/AIDS (ANECCA) .

The Consortium is also dedicated to working with local partners and the Government of Ethiopia to

develop models of care and treatment that are most appropriate to their Ethiopian context. AIDSRelief fully

supports the Ethiopian national guidelines and strategy for ART roll out.

AIDSRelief will link with the Government of Ethiopia and the Partnership for Supply Chain Management for

procurement of ARVs, laboratory equipment and reagents. The program will work to strengthen systems at

the LPTFs to forecast and procure ARVs and laboratory reagents to ensure a stable and uninterrupted

supply.

AIDSRelief will integrate into the National strategic information framework that is promoted and supported

by the Ethiopian and US governments.

Sustainability lies at the heart of the AIDSRelief program, and is based on durable therapeutic outcomes to

first line regimens. AIDSRelief focuses on strengthening health facility systems through human resource

support, financial training and improvements in health management information. As faith based institutions

are embedded in communities, AIDSRelief harnesses these opportunities to involve motivated PLWAs for

disseminating antiretroviral literacy, addressing stigma and promoting consistent adherence to therapy.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

Health-related Wraparound Programs

* Child Survival Activities

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.09: