Under its cooperative agreement with the MOH, CDC will support the continued strengthening of the

national PMTCT program to effectively screen patients and prevent the transmission of HIV and provide

adequate care and support. HIV screening will be integrated into the ante-natal care system which also

includes screening for other STIs. Pregnant women who qualify by national guidelines receive HAART

during their pregnancies. Appropriate infant feeding methods will be promoted at PMTCT sites including

provision of breast milk substitute when appropriate. The program will encourage consistent family planning

for HIV positive mothers.

Through the Cooperative Agreement CDC will continue to provide rapid test kits, laboratory supplies,

counseling and referrals for family planning services, contract staff support, technical guidance, quality

assurance and strong links to care and treatment. Supported areas will include MOH data collection and

utilization, supervision of field implementation, educational materials and programs, and contract nurses for

providing and supervising services, including counseling, at health facilities. Funds will also support related

staff training and travel. Psychological support will be provided for PMTCT counselors. USAID/GHARP will

continue to provide the core PMTCT training for MOH staff.

CDC/GAP will also continue to support the Maternal Child Health Unit and MOH Strategic Information Unit

for data collection and utilization (including data entry staff and computers), supervision of activities at the

field level, and quality assurance. To improve the environment for HIV services in small health centers, CDC

will support upgrades to ensure areas for confidential counseling and testing and adequate facilities for

family counseling and education.

The Ministry of Health through its Adolescent Health Program have been targeting young people in and out

of school on the coastland and in the more remote areas using the secondary school system and health

clubs to educate young people about HIV prevention and the value of VCT. It is clear that there will be

great benefit to extend this program to the primary school level so as to encourage delay in sexual initiation.

This program embarked on during FY07 will continue during FY08. It is aimed at increasing the knowledge

of primary school children about HIV prevention by supporting the HIV component of the Health Promoting

Schools Strategy (HPS) and designing child-friendly and age sensitive HIV/AIDS materials for that program.

Primary school teachers will be taught how to use the materials and there will be periodic evaluation to

ensure the effectiveness of the program. Community support will be garnered for the school based

activities to ensure that behaviors taught at school are reinforced in the home. The MoH Co-Ag will also

include funds to carry on work to expand youth-friendly health services and health club programs that

emphasize AB education, counseling, and inter-personal communication sessions. This activity was

previously funded through the Global Health Fellows Program/CSDS, but will transition to MoH in July 2008.

These activities will complement those being undertaken thorough the MARCH initiative. USAID has been

supporting the unit technically and financially for several years through grants and the placement of a

prevention fellow in the Ministry of Health. In FY08 the program will graduate to financial support alone, and

thus will be allocated through the CDC cooperative agreement to the MOH.

Targets include youth reached through the youth friendly health services initiative.

The MoH Co-Ag will include funds to carry on work to expand youth-friendly health services and health club

programs that emphasize OP education for high risk youth, counseling, and inter-personal communication

sessions. This activity was previously funded through the Global Health Fellows Program/CSDS, but will

transition to MoH in July 2008. These activities will complement those being undertaken thorough the

MARCH initiative. USAID has been supporting the unit technically and financially for several years through

grants and the placement of a prevention fellow in the Ministry of Health. In FY08 the program will graduate

to financial support alone, and thus will be allocated through the CDC cooperative agreement to the MOH.

Targets include youth reached through the youth friendly health services initiative.

CDC supports counseling and testing (C&T) services in Guyana through its cooperative agreement with the

Ministry of Health (MOH). This support includes counselor-testers at the MOH who serve the PMTCT

program; in FY08 this program will emphasize couples counseling in order to increase the number of men

seeking C&T. Other activities supported through the National AIDS Program Secretariate (NAPS) will

include provider-initiated counseling and testing in the Family Health program and at clinical facilities.

Contract staff including drivers, phlebotemists, clerks and counselor-testers. CDC-supported staff will target

youth through the Adolescent Health Program; both in-school and out-of-school youth will be encouraged to

know their status and to reduce risk behavior through improved access to youth friendly counseling and

testing sites. NAPS will continue to provide C&T services to the hinterland areas through its mobile unit.

CDC also supplies rapid test kits and quality assurance for testing as detailed under laboratory

infrastructure activities.

Through its Cooperative Agreement with the Ministry of Health (MOH), CDC supports the National AIDS

Program Secretariat (NAPS) for treatment services in Guyana. NAPS provides services at the Genito-

Urinary Medicine clinic, the primary out-patient treatment facility and other coastal facilities. In addition a

mobile unit accesses remote regions of Guyana for treatment, counseling and testing services (See

separate activity under VCT). The mobile unit is staffed by a PEPFAR-supported UN Volunteer physician. In

FY08, the MOH will contract the services of this physician through the Cooperative Agreement directly. The

mobile unit provides ART services, phlebotomy services for treatment monitoring, and utilizes the national

patient monitoring system so all patients are accounted for and treatment progress is well-documented.

NAPS will coordinate all activities related to treatment services to ensure non-duplication of services

between program areas and regional health authorities. The CDC Cooperative Agreement also supports

NAPS in its role as the national authority for treatment guidelines and coordination of treatment linkages

with other services.

Over the last three years, MOH has implemented HIV rapid testing on labor and delivery wards, PMTCT

and VCT sites, provided infrastructural support for CD4 testing, provided technical and policy support for the

establishment of the NPHRL, and in collaboration with the EU project has strengthen the laboratory Quality

Assurance (QA) program. In FY08 MOH will continue to design and implement the virtual NPHRL during

construction, with support from CDC and other in-country partners to ensure that there are clear plans for

staffing and maintenance of the lab in the near and far term. The NPHRL will require staff not currently

listed on the public service establishment. This may require the MOH to hire contract staff to fill key

positions until they can be put on the establishment. MOH will work closely with CDC and the Care and

Treatment Partner (CoAg TBD) to develop a transition plan to assume management of the CD4 testing

system in FY08 and to review and approve all testing protocols related to the treatment program. The

management of the CD4 testing will be moved to the NPHRL when it is completed. In collaboration with

CDC and ASCP MOH will continue to roll out training in hematology and chemistry to the regional

laboratories. Additionally, MOH will be working closely with ASCP to establish local certifying board exams

which will pave the way for local technologist to acquire the International ASCP certification. This will involve

review of the Medical technology curriculum at the University of Guyana which will be a continuous

collaboration among ASCP, MOH and the University of Guyana. In FY08 MOH with assistance from CDC

will continue to maintain and improve the laboratory TB program developed by CSIH. This will involve

training and procurement of reagents. MOH will expand the range of OI to PCP, HSV and Cryptococcus in

FY08. CDC will expand its current system of funding 25% of required reagents at Georgetown Hospital and

provide this benefit to the four expanded treatment sites as well. The reagents will be purchased and

distributed to the MOH through SCMS. MOH in collaboration with the Clinton Foundation and CDC has

designed a protocol for pediatric testing that will include a system for shipping of specimens to an external

reference lab initially until DNA PCR technology is available in Guyana. The procurement of the DNA PCR

equipment was negotiated by the Clinton Foundation on behalf of the MOH and will be installed and

operational by FY08. The MOH will also be responsible for maintenance (including service contracts) of

laboratory equipment used in support of HIV/AIDS care and treatment.

Through Atlanta and country-based technical assistance and financial assistance through a cooperative

agreement, CDC will work to improve the MOH capacity for internal SI and M&E. A portion of the funds

from the 2007-2008 cooperative agreement has been obligated to provide contract staff, equipment, travel,

supplies and contractual services related to SI activities.