Continuing activity. FY08: During 2007 DOD funded a rehabilitation of a military facility to be converted into

a new day hospital in Tete province. The FY08 funds will be used to train staff who will provide HIV care

and treatment services at this and other DOD supported military facilities.

In addition the funds will be used for the procurement of supplies and equipment for military ART facilities.

Fy07: DOD will fund HIV/AIDS related international courses for military and police health care

providers.This activity focuses on developing the capacity of health providers responsible for ARV roll-out at

the Military Hospital because, an effective response to the HIV/AIDS epidemic requires expertise,

experience, and training in the prevention and management of people infected with HIV. Therefore, part of

the mozambican military medical staff will be trained in San Diego - California through the Military

International HIV Training Program (MIHTP) is a collaboration of the Naval Medical Center San Diego

(NMCSD) and two San Diego, California universities - the University of California, San Diego (UCSD) and

San Diego State University (SDSU). The Naval Health Research Center (NHRC) provides operational

support through the US Department of Defense (DoD) HIV/AIDS Prevention Program (DHAPP).The MIHTP

was established to use the HIV expertise in three closely associated San Diego institutions namely, the

Naval Medical Center San Diego (NMCSD), the University of California, San Diego (UCSD) and San Diego

State University (SDSU). It provides training of medical military personnel actively caring for HIV-infected

patients. Supporting prevention and treatment programs in military forces of countries requesting DOD

assistance, we provide clinical training in HIV-related patient management, epidemiology, and public

health.The mission of the Military International HIV Training Program is to provide flexible training in support

of prevention of HIV transmission and management of infected persons in military organizations. Its top

priority is to train key medical personnel (clinicians in practice) both in San Diego and abroad with the goal

of transferring appropriate knowledge and technology to each country. The training programs and projects

are developed in collaboration with each military organization to meet specific needs. Emphasis is placed

on training, consultation, and operational support for prevention and clinical management of HIV and its

complications as well as courses in epidemiological surveillance and laboratory diagnosis from a clinical

physician perspective. A large emphasis is placed on the experiential part of the program to understand the

military's policies and procedures regarding service members with HIV/AIDS.

Other medical staff will attend training courses at the Infectious Diseases Institute (IDI) on the campus of

Makerere University, Kampala, Uganda.

The primary goals of the training program in Uganda is to:

1. Review the latest HIV/AIDS diagnostic and treatment approaches.

2. Discuss major issues concerning comprehensive HIV/AIDS care.

3. Discuss military-specific issues related to HIV/AIDS care.

4. Enhance the clinical skills of practitioners dealing with patients who are infected with

HIV and associated illnesses.

These goals will be accomplished through featured expert speakers on a range of HIV/AIDS topics,

interactive assignments, and practical demonstrations. The lectures will be presented by faculty from

Makerere University as well as one international trainer from the Infectious Diseases Society of America.

The method of instruction will include a combination of lectures, case discussions, journal clubs, and clinical

experience. Lectures will be delivered in a classroom setting to the group as a whole, followed by inpatient

and outpatient clinical sessions that will include bedside teaching rounds, an overview of systematic

HIV/AIDS patient care and

management, and exposure to community-based HIV/AIDS care and prevention programs.

This is a continuing activity from last year's DOD plan which mostly targeted military doctors and nurses

from the Maputo Military Hospital, intending to increase knowledge of HIV/AIDS care and treatment of the

medical staff selected. This year, responding to the increasing number of uniformed services treatment

facilities DOD will select medical staff from the Ministries of Defense and Interior working in treatment health

facilities located in other provinces, including Sofala where there are military and police hospitals. More

qualified nurses will be able to perform relatively complex tasks without the need of the doctor's presence

which will, therefore have more time to look after the most critically ill patients. The military will train 4

doctors and 6 nurses and the police will train 2 doctors and 4 nurses.

Continuing activity - Narrative Update for FY08: This continuing activity is comprised of two components:

1) Analysis, dissemination, and utilization of data from the prevalence and behavioral study conducted

within the military forces ($100,000) and

2) Surveillance in new recruits and peacekeeping forces ($75,000)

1) Analysis, dissemination, and utilization of data from the prevalence and behavioral study conducted

within the military forces ($100,000)

This activity is is a continuation of activity 8586 in COP 07. Utilizing FY08 funding, PEPFAR will support

training Mozambican Armed Forces (FADM) SI officers in data collection, analysis and dissemination for

use policy makers, clinical staff and prevention programming. PEPFAR funding will also support the FADM

Public Health Surveillance system integrating HIV data with malaria, TB, STI, and other health indicators.

FADM is working closely with the MOH on PH Surveillance systems. Presently this is a completely paper

based system. Strengthening the PH surveillance system will have wide-ranging benefits for the FADM to

better respond to health threats. DOD (NHRC) will provide some assistance with trainings related to the

database, data processing and analysis, report writing, etc.

2) Surveillance in new recruits and peacekeeping forces ($75,000)

This activity is is a continuation of activity 8576 in COP 07. Since 2007, the military doubled the recruits'

annual intake from 2000 to 4000 people being trained in two training centers (Manhiça and Montepuez).

Aware of this change in numbers and expecting that the military will make official their HIV policy, DOD will

provide funds to be used for HIV testing for recruits. Under the new policy, these new recruits will be tested

for HIV for the first time in the Mozambican military and procedures will be followed accordingly. The tests

are expected to be linked and all potential recruits will receive pre and post test counseling and, if

necessary be, referral for care and treatment will be given.

We will need $50,000 for supplies and logistics required to implement this activity.

DOD will also support HIV mandatory testing for the Mozambican military (including the peace keeping

force) every two years. The HIV testing will be part of a general check up of the troops to access their health

status and determine their readiness. The check up will include TB screening and STIs among other health

and mental problems.

This activity is estimated to cost $25,000 that will cover supplies and logistics.

FY07: This activity is linked to the two rounds of the prevalence and behavioral study previously conducted

within the military forces (activities # and # - COP 05 & 06). DOD will support the analysis and use of the

data collected during both phases of the prevalence and behavioral study conducted within the military

forces countrywide. The analysis and use of this data includes presenting and discussing the results with

the FADM through reports and workshops and finally re-orienting the prevention activities based on the

study results. Military personnel have been trained in data entry and there will be ongoing training in data

analysis and report writing.

When both rounds of the study data are available, the results will be used by the FADM to make evidence

based conclusions and recommendations to evaluate and re-orient its prevention activities focusing on the

real risks for HIV infection within their population, and to plan appropriately for HIV/AIDS care and

treatment.

DOD requested funds will cover one FSN's PEPFAR management activities directed to the fight of

HIV/AIDS in the Mozambican Armed Forces. The activities include supervision trips to the provinces where

activities are taking place, national and international workshops and conferences, DOD orientation trips,

salary & benefits package, office costs and supplies including new furniture and $28,000 for International

Cooperative Administrative Support Services (ICASS).