The goal of this project is to develop and strengthen the pre-ART surveillance system and improve access to care and treatment. It will be built on the newly created platform of the HCT campaign mobilizing all South Africans to get HIV tested. The project activities will monitor disease progression, reduce morbidity through a package of preventive interventions, prepare patients for ART and assist clinicians to identify patients who are eligible for ART. The project will support the PF goal that seeks to prevent new HIV infections through linking persons who test HIV positive to treatment, care and prevention services. It will support and strengthen surveillance and the use of quality epidemiological data to inform policy, planning and decision making. GAPS analysis will be performed in all 52 districts and all government levels to determine policy and practice gaps by assessing: the existence of policies for pre-ART care surveillance, data collection tools , scope of data collection on pre-ART care by facility type, the competence of data collectors, existing data flow structures, type of information system, data management and analysis, linkages between point of testing and pre-ART care, the robustness of referral systems and establishing the presence of a unique patient identifier. This analysis will support PHC re-engineering and improve HIV management at district level. There will be close collaboration with the NDOH and other partners and will gradually relegate the responsibility of operating pre-ART surveillance to the NDOH to ensure sustainability of the program. Performance evaluation will be carried out at mid-term and end of program life and performance will be measured against the baseline values and targets in the M&E plan and protocol.

The goals of this project are to develop and strengthen the pre-ART surveillance system in South Africa and to improve access to care and treatment for patients who test positive. It will monitor disease progression, reduce morbidity through a package of preventive interventions, prepare patients for ART, and assist clinicians identify patients who are eligible for ART timely. This project supports the partnership framework goal that seeks to prevent new HIV infections through linking persons who test HIV positive to treatment, care, and prevention services early. It also seeks to strengthen and increase effectiveness of the HIV /TB response by supporting/strengthening surveillance and the use of quality epidemiological data to inform policy, planning, and decision making. There will be partnership with SANAC and SHSPH at University of Pretoria will focus on a GAPS analysis that will assess: the existence of policies for pre-ART care surveillance, data collection tools , scope of data collection on pre-ART care by facility type, the competence of data collectors, existing data flow structures, type of information system, data management and analysis, linkages between point of testing and pre-ART care, and the robustness of referral systems and establish the presence of a unique identifier for each patient who is tested positive to allow follow-up for the current system with the aim to guide the establishment of an improved system within the structures of the NDOH. Information will be collected on persons diagnosed with HIV who are not enrolled in ART care and treatment program and in partnership with other stakeholders, the system will be revamped and strengthened, and recommendations of the gap analysis will be implemented . Pre-ART register will be updated to ensure it captures the minimum data required for monitoring pre-ART care. Data capturers at various facilities will be trained on how to fill out the pre-ART register to strengthen data collection and reporting from service sites. Data transmission systems will be strengthened to allow timely reporting of data from facilities upward to the national M&E unit and enable timely feedback on data quality and performance of targets.