This activity is linked to Palliative care: Basic (8422), TB/HIV (8423), Treatment: ARV Drugs (8428), ARV Services (8425),Counseling and testing (8424),OVC (8427) and Laboratory Support (9455).

The Inter Religious Council of Uganda (IRCU) is a coalition of the five largest religions in Uganda, namely; Roman Catholic Church, the Uganda Muslim Supreme Council, Church of Uganda, Seventh Day Adventist Church and the Uganda Orthodox Church. IRCU also works with other Pentecostal and independent churches. It was formed as a joint initiative to pool efforts of the religious communities in responding to various development challenges including HIV/AIDS. It has been receiving PEPFAR funds since 2004 to support a comprehensive HIV/AIDS prevention, care and treatment program. Using FY06 resources, IRCU has initiated an HIV prevention program using combined approaches including inter-personal communication, peer groups, mass media and community based approaches.

FY07 funds will be utilized to consolidate IRCU's prevention strategies and programs, under the ambit of the renewed government commitment to reposition prevention in its HIV/AIDS response. Key emphasis will be put on addressing sexual behavior, given that high risk sex, particularly multiple and concurrent sexual relationships remain the major drivers of the epidemic in Uganda. IRCU will strengthen its interventions focused on promoting abstinence for young people and mutual fidelity for couples. While the "being faithful" component of the IRCU program initially targeted married couples, emerging evidence shows that there are many individuals engaging in sexual relationship before transitioning into marriage. In addition, as youth mature, they need information and skills to prepare them to safely initiate sexual activity. In this context, IRCU will broaden its AB approach to prevention beyond a focus on abstinence only or until marriage but also to assist youth build appropriate norms and skills around faithfulness, open communication in relationships, mutual trust and healthy decision making. IRCU will also continue to address gender and other cultural norms that increase exposure and vulnerability to HIV infection by promoting activities that engender the independence of women and girls and those that seek to eliminate harmful cultural practices.

Through faith based associations and networks, IRCU will also target the hard to reach/ high risk and vulnerable categories of youths such as taxi drivers, as well as housemaids and barmaids. 800 community members will be equipped with life skills and behavioral change messages. Peer education approach will be implemented to reach out and to effect change in the hard to reach categories of people and this will be supported by provision and dissemination of IEC materials promoting A and B. Mass media such as print, electronic and outdoor approaches including bill boards will be used to relay age appropriate messages on abstinence and mutual fidelity. These will be reinforced by community approaches such as music, dance and drama, many of which are led by PLHA whose groups will be facilitated through training and other logistical needs to be able to conduct HIV/AIDS education in communities. Religious leaders will continue to play pivotal roles in this program, especially in the promotion of mutual fidelity among couples. The religious leaders will be trained in HIV/AIDS prevention and referral skills to enable them to pass on accurate and consistent information. IRCU targets to reach a total of 500,000 youths and 300,000 adults through this program.

This activity links to HIV counseling and testing (8424), HIV prevention (8426), Palliative care: TB/HIV (8423), OVC (8427) and Treatment: ARV Drugs (8428), ARV Services (8425) and Laboratory Support (9455).

The Inter-Religious Council of Uganda (IRCU) is an indigenous, faith-based organization uniting the efforts of five major religious institutions of Uganda including Catholics, Anglican Protestants, Muslims, Orthodox and Seventh Day Adventists to jointly address HIV/AIDS and other development challenges. IRCU also works with other religious organizations including Pentecostal and other independent churches. Through its religious affiliates, IRCU encompasses a nation-wide network of not-for-profit hospitals and clinics as well as faith-based community organizations, providing an array of HIV/AIDS services including prevention, care and support to affected individuals, families. IRCU has received PEPFAR funds since 2004 and has developed a sub-granting program through which resources are channeled to faith-based organizations.

In FY07 IRCU is poised to further roll out palliative care services through two broad approaches, namely; facility and home based care. Home based care services will be delivered largely through the network of religious leaders and volunteers. Using FY06 funds religious leaders, home care givers and community volunteers have been trained in delivery of intermediate care and referral. The Ministry of Health is the final stages of developing a comprehensive Home Based Care Policy, IRCU will assist to roll out this policy and also use it to harmonize interventions among its various faith-based organizations. Similarly capacity is being built at facility level to be able to absorb and offer quality care to the increasing numbers of PLHA being referred from communities. This includes training of providers in AIDS care, strengthening human resources especially critical cadres like counselors and nurses, improvement in commodity procurement and logistics systems as well as building referral networks between communities and static facilities. IRCU will continue to consolidate the existing linkages between palliative care and other HIV/AIDS services including HCT, treatment and PMTCT through referrals within the same facilities and outside.

With FY06 funds, IRCU initiated the process of integrating new elements of care including pain and symptom management and end of life care, as well as context-specific elements of basic care into its existing care and support services. In FY07 IRCU will continue to scale up these care components through training of providers and raising community awareness. A partnership agreement will be developed with Hospice Africa Uganda, to continue building capacity for pain and symptom management and end of life care with IRCU supported Faith Based health units. Also negotiations are underway with the USAID supported AFFORD program to craft a cost-effective mechanism for distributing basic care commodities, especially insecticide treated nets and water purifying solutions. With the support of the new SCMS program, IRCU anticipates improvement in national systems for the procurement and distribution of palliative care commodities especially drugs for treatment and prophylaxis of opportunistic infections.

Double counting of service recipients remains one of the challenges for IRCU in monitoring its palliative care program. In FY 07, IRCU will work with faith-based partners to establish unique client registration files in which all palliative care data for all visits are kept. With the support of the USAID funded programs for AIDS Capacity Enhancement (ACE) and the Monitoring and Evaluation of the Emergency Plan (MEEPP), IRCU will also develop a comprehensive Monitoring and Evaluation system to track outputs and outcomes for its program. During the year, IRCU will a hold special review meeting for its faith-based palliative care providers to share good practices in the delivery of services and address any bottlenecks to the program in unison.

Through this activity, IRCU will expand provide palliative care services to reach 20,000 individuals through twenty faith-based sites. At least 1600 AIDS care providers including counselors, clinicians, nurses, laboratory staff and religious leaders will be trained.

This activity is closely linked to HIV prevention (8426), palliative care: basic (8422), treatment: ARV dugs (8428), ARV Services (8425), OVC (8427) , HIV counseling and testing (8424) and Laboratory Support (9455).

The Inter Religious Council of Uganda (IRCU) is a coalition of the five largest religions in Uganda, namely; Roman Catholic Church, the Uganda Muslim Supreme Council, Church of Uganda, Seventh Day Adventist Church and the Uganda Orthodox Church. IRCU also works with other Pentecostal and independent churches. It was formed as a joint initiative to pool efforts of the religious communities in responding to various development challenges including HIV/AIDS. It has evolved as the official coordinating mechanism for the faith-based HIV/AIDS response in Uganda. Through its constituent faiths, IRCU coordinates the largest network of faith-based health units in Uganda, which together deliver close to 50% of the health care services in Uganda. In this position, IRCU plays a big role in delivery of HIV/AIDS care, prevention and treatment. It has been receiving PEPFAR funds since 2004 and currently offers palliative care to over 23,000 PLHA and their families.

Integration of TB care into routine HIV/AIDS care and other health services is just evolving within IRCU supported health facilities, just like other health care settings in Uganda. Currently TB services TB services in faith-based facilities are delivered in discrete units, usually separated from the general medical wings. In addition, TB screening and diagnosis is not a routine medical practice, and remains limited to those identified to have clinical symptoms. Given that over 50% of PLHA are co-infected with TB and HIV, prevention and treatment of TB is a critical element of comprehensive palliative care and IRCU is well placed to take to scale initiatives in these key areas.

In FY07, IRCU will endeavor to reduce TB mortality, morbidity and transmission within its facilities by increasing focus on HIV/AIDS and TB integrated service delivery. TB screening will be integrated in all HCT sites targeted at all individuals who test HIV positive. Those found to have leading TB symptoms will be referred for clinical examinations using sputum smear microscopy and where necessary x-rays. Those found TB-positive will be treated. Similarly, counseling and testing will be emphasized as a routine procedure within TB wards and wings. Those who test positive for HIV will be referred for appropriate care within the health facility. IRCU will further streamline reporting systems within its health facilities to be able to capture individuals screened and referred from counseling and testing units as well as those tested for HIV within TB wings. With FY06 funds health workers received training in TB screening and management but will continue to receive refresher courses in FY07 to be able to internalize dynamics around HIV/TB integrated service delivery.

Uninterrupted supply of TB drugs is critical to the success of this activity. The resumption of Global Fund activities offers hope for renewed supply of TB drugs and IRCU will continue to liaise with the National TB and Leprosy Program to ensure that all the supported FB sites received a steady supply. Using the network of faith based volunteers IRCU will actively support the government DOTS program in its communities. These volunteers will play key roles in community advocacy on TB and support adherence for those on TB treatment. IRCU will also continue to strengthen its support to networks of PLHA so as to increase their role in referral and adherence monitoring.

IRCU targets to screen 15,000 PLHA for TB in 16 sites and provide TB treatment and prevention services to 700 PLHA. 32 health workers will be trained in TB management, 16 lab technicians will be trained in diagnosis of TB, 48 counselors in TB screening and referral and 1,000 volunteers (religious leaders and PLHA) in treatment, adherence monitoring and referral.

This activity is linked to HIV prevention (8426), palliative care: basic (8422), TB/HIV (8423), treatment: ARV drugs (8428), ARV services (8425), HIV counseling & testing (8424) and Laboratory Support (9455).

The Inter Religious Council of Uganda (IRCU) is a coalition of the five largest religions in Uganda, namely; Roman Catholic Church, the Uganda Muslim Supreme Council, Church of Uganda, Seventh Day Adventist Church and the Uganda Orthodox Church. IRCU also works with other Pentecostal and independent churches. It was formed as a joint initiative to pool efforts of the religious communities in responding to various development challenges including HIV/AIDS. It has evolved as the official coordinating mechanism for the faith-based HIV/AIDS response in Uganda. IRCU plays a big role in delivery of HIV/AIDS care, prevention and treatment. It has been receiving PEPFAR funds since 2004 and currently offers palliative care to over 23,000 PLHA and their families. Support to OVC has been one of the major HIV/AIDS interventions under PEPFAR. Using FY06 resources, IRCU has provided assistance to 9,000 OVC through sub grants to 45 FBOs, with services ranging from support with formal education, skills-based vocational training for children that dropped out of school, advocacy for child rights at community level to support economic strengthening of families caring for orphans. Evaluation of these interventions continues to indicate that they contribute incredibly to restoration of hope and self esteem among OVC and has also greatly relieve care taker families.

During the FY 07, IRCU will further strengthen its OVC services, building upon the achievements realized through its current interventions. IRCU will focus on building capacity of its 45 partner FBOs to strengthen their institutional and technical abilities in key areas such as programming, integrated service delivery, quality assurance as well as monitoring and evaluation. In line with the National Strategic Plan for OVC Interventions, IRCU will adopt a community driven approach to service delivery, with community members at the helm of defining OVC needs and how best these needs can be addressed. At the same time, IRCU will also increase the involvement of local governments, particularly the lower level government structures such as Community Development Officers and District Probation Officers in the delivery, monitoring and provision of technical assistance to the faith-based organizations. Of particular importance, the FBOs will engage technical staff of the sub-counties where they work in the process of selection of OVC, planning and implementation of OVC activities. This is envisaged to enhance coordination and alignment of interventions to the sub-county and ultimately the district plans.

In order to offer more holistic and integrated services to OVC, IRCU will link OVC program with other HIV/AIDS program components like HIV counseling and testing, prevention, palliative care and treatment. This will enable OVC access a wide range of services. Religious leaders and community volunteers will be at the helm of OVC care and protection at the community level. Therefore religious leaders and community volunteers will be equipped with basic skills in counseling, referral, mobilization, home based care so that they are able to direct OVC on how to obtain other services. Further technical support will be sought from ministry of Gender, Labor and Social Development and the USAID supported CORE Initiative to ensure that OVC services meet the quality standards and are in line with National OVC Policy.

In the FY 07, IRCU targets to support 9000 OVC in areas of education, psychosocial support, HIV/AIDS prevention and where necessary, care and treatment. IRCU will also pay special attention to expanding community advocacy for children to ensure that they live in free and protective environments and that their rights are protected. IRCU will also strive to strengthen the capacity of caretaker families to cope with increased orphan burden through training of 3,000 care givers and where necessary initiate activities to enhance their economic security.

To enhance networking, peer support and experience sharing, IRCU will convene quarterly joint meetings for FBO team leaders to review performance and impact of interventions on beneficiaries. These meetings will also be useful for IRCU to receive feedback on the utility of its support to the OVC and their families, FBOs and the challenges encountered.

This activity is closely linked to HIV prevention (8426), Palliative care: basic (8422), OVC (8427), Treatment: ARV drugs (8428), ARV Services (8425) and Laboratory Support (9455).The Inter-Religious Council of Uganda (IRCU) is an indigenous, faith-based organization uniting the efforts of five major religious institutions of Uganda including Catholics, Anglican Protestants, Muslims, Orthodox and Seventh Day Adventists to jointly address HIV/AIDS and other development challenges. IRCU also works with other religious organizations including Pentecostal and other independent churches. Through its religious affiliates, IRCU encompasses a nation-wide network of not-for-profit hospitals and clinics as well as faith-based and community organizations, providing an array of HIV/AIDS services including prevention, care and support to affected individuals, families. IRCU has received PEPFAR funds since 2004 and has developed a sub-granting program through which resources are channeled to faith-based organizations.

In FY07, IRCU plans to expand access to quality HIV counseling and testing (HCT) services through twenty faith-based palliative care and treatment sites. HCT will be provided as an entry point to and will be linked to care and treatment. All individuals testing positive will be linked to care and where necessary, ART through a developed and monitored referral system. Religious leaders will be utilized to play key roles in raising community awareness on HCT, refer individuals for services and provide basic intermediate care for those testing HIV positive. Using FY06 funds, IRCU has trained several community level religious leaders and pastoral agents to integrate HIV/AIDS messages including HCT in their routine work. IRCU will also provide support to Post-Test Clubs composed of individuals who graduate from HCT services and use these groups to further raise advocacy for HCT in communities and also serve as a support system especially for those testing HIV-positive.

In partnership with other USAID-funded partners, including the AIDS Information Center (AIC), AMREF, and the CDC-funded Mbarara/Mulago Joint AIDS Program, IRCU will continue to build the capacity within its supported health facilities to deliver quality HCT. Focus will be put on training laboratory staff in new HCT technologies including rapid testing and the new finger prick approach. Similarly counselors will receive more training on emerging HIV/AIDS challenges, particularly the rising HIV discordance among couples and how to appropriately assist clients in these situations. 85 counselors, 34 laboratory technicians and 1,000 community level religious leaders will be trained in HCT delivery and mobilization. Where need arises, more counseling rooms will be refurbished to enhance confidentiality in service delivery. To ensure quality assurance, health facilities will be required to send samples of specimens and test results from their laboratories for re-testing and comparison with other major HCT providers in Uganda.

IRCU will also support the introduction of provider-initiated counseling and testing, commonly known as Routine Testing and Counseling (RTC)) as part of the routine clinical investigations within the twenty faith-based health units. RTC will primarily be targeted at in-patients, STI clinic attendees, TB wards and antenatal clinics and it is envisaged to enhance access to early comprehensive care for individuals. Currently HIV prevalence among in-patients in Uganda is estimated to be between 40% and 60%. With no access to HCT, HIV remains undiagnosed and hence patients continue to receive inappropriate care. To ensure quality and cost-effectiveness of care, service providers will be trained to emphasize risk assessment especially among those testing HIV-negative with the aim of reducing the need for repeat tests and also crafting appropriate interventions to reduce the risk of HIV infection. Individuals who test negative will be referred for on-going HIV prevention information delivered through networks of religious organizations and institutions.

Stable supply of test kits and other laboratory supplies will be critical to this activity. IRCU will utilize test kits supplied through the national system but will also develop procurement systems which can be used for chronic stock outs in the system. IRCU will also ensure that HCT is provided within the MOH guidelines and that testing protocols are harmonized with the national HCT policy and guidelines.

Through this activity, IRCU targets to access counseling and testing to 58,000 individuals through twenty sites. 85 counselors, 34 laboratory technicians and 1,000 community level religious leaders will be trained.

This activity is linked to HIV prevention (8426), Palliative care: basic (8422), TB/HIV (8423), OVC (8427), Counseling and testing (8424), Treatment: ARV Services (8425), and Laboratory Support (9455). The Inter-Religious Council of Uganda (IRCU) is a coalition of the five largest religions in Uganda, namely; Roman Catholic Church, the Uganda Muslim Supreme Council, Church of Uganda, Seventh Day Adventist Church and the Uganda Orthodox Church. IRCU also works with other Pentecostal and independent churches. It was formed as a joint initiative to pool efforts of the religious communities in responding to various development challenges including HIV/AIDS. It has evolved as the official coordinating mechanism for the faith-based HIV/AIDS response in Uganda. Through its constituent faiths, IRCU coordinates the largest network of faith-based health units in Uganda, which together deliver close to 50% of the health care services in Uganda. In this position, IRCU has been a major player in rolling out ART services in Uganda. Using FY06 funds, IRCU plans to access quality ART to 2,500 individuals by September 2007 in 15 Faith based hospitals.

IRCU, like other stakeholders including Joint Clinical Research Center (JCRC), Ministry of Health, CRS and TASO is committed to contributing to the PEPFAR goal of increasing the number of patients on ART in resource limited countries. IRCU plans to utilize FY07 funds to sustain the 2,500 individuals on therapy through fifteen faith based hospitals and health centers IVs. The number of people on therapy is likely to increase as the cost of drugs continues to fall, especially as more FDA approved generic drugs enter the Ugandan market. Currently there are approximately 90,000 Ugandans country wide that are eligible for treatment with no available source of therapy. The IRCU approach is to integrate the ART services with existing HIV care and overall health services rather than create a parallel program which mounts additional strain on the already overstretched capacity of its implementing partners. In this regard, IRCU plans to continue procuring drugs through the Joint Medical Stores (JMS) a mechanisms currently used by faith-based organizations to buy drugs and other essential health commodities. IRCU has already initiated a partnership with the Supply Chain Management System (SCMS) to procure the required FDA approved drugs, which will be shipped to JMS, where they will stored and later collected by respective implementing partners bimonthly after submitting accurate reports to IRCU. Learning from preceding ART programs, prompt forecasting and ordering will be paramount for the smooth running of the ART program. This will avoid stock out of drugs and any interruptions in the supply chain management. The SCMS will offer technical support and training to the health unit staff in forecasting, supply chain management as well as drug recording and storage.

All the 15 sites are providing generic ARVs through Global Fund and MAP funds at the Ministry of Health. As the procured drugs will be a different brand from the currently supplied ARVs at the sites, units will need to strengthen the counseling services for the patients encouraging them to cope with the use of the new set of drugs as they promote adherence. IRCU will ensure that systems are put in place to facilitate different ordering, forecasting, storage of drugs and log books but joint reporting and auditing mechanisms. IRCU will provide the necessary human resource, data systems and logistics to ensure both IRCU and Global Fund drugs are optimally utilized and accounted for at all sites.

IRCU will work closely with the administration at the implementing sites to reinforce Post Exposure Prophylaxis (PEP) of the health workers at the units. IRCU will ensure that the needed protocols and information about PEP are in place at the units and the administration will provide the necessary antiretroviral drugs needed for prophylaxis. IRCU will continue to target children for ART as a special and vulnerable population and to take a leadership roll in expanding access to pediatric ART beyond the major urban areas. Of the 2,500 PLHA targeted with FY06 funds, 500 will be children.

This activity links to HIV prevention (8426), Treatment: ARV drugs (8428), palliative care: basic (8422), TB/HIV (8423), OVC (8427), Counseling & testing (8424) and Laboratory Support (9455).

The Inter-Religious Council of Uganda (IRCU) is a coalition of the five largest religions in Uganda, namely; Roman Catholic Church, the Uganda Muslim Supreme Council, Church of Uganda, Seventh Day Adventist Church and the Uganda Orthodox Church. It was formed as a joint initiative to pool efforts of the religious communities in responding to various development challenges including HIV/AIDS. Through its constituent faiths, IRCU coordinates the largest network of faith-based health units in Uganda, which together deliver close to 50% of the health care services in Uganda. In this position, IRCU has been a major player in rolling out ART services in Uganda. Using FY06 funds, IRCU plans to access quality ART to 2,500 individuals by September 2007.

In FYO7, IRCU will intensify its efforts in strengthening services that: 1) increase the number of people seeking services, 2) support adherence for those on treatment and 3) further strengthen capacity of provider institutions to offer quality services. In collaboration with other prominent ART providers in Uganda, such as JCRC, Mildmay and the Infectious Diseases Institute (IDI) IRCU will continue upgrading the skills of 100 cadres of staff running the HIV/ART clinics in all its fifteen supported faith-based ART providers. This will entail training them in comprehensive adult and pediatric HIV and ART service provision with key focus on pediatric care, treatment efficacy, drug resistance and drug counter-indications. 300 PHLA receiving treatment will be supported to form adherence teams which will constitute a major part of care at the implementing sites with respect to monitoring adherence at the units, homes and also tracking patients who fail to return for scheduled clinical visits. These teams will be trained on use of standardized methods of monitoring adherence including visual analogue scales and patient self reporting. They will work closely with the nurses, dispensers and will establish good links with the families of patients on ART and the community as they are essential in providing psychosocial support for the patients on ART.

Over 20,000 HIV positive patients enrolled into care will receive routine monthly cotrimoxazole prophylaxis, and context specific components of the basic care. At the minimum each PLHA will receive two Insecticide Treated Nets (ITNs) and messages on positive living. IRCU will work with the Ministry of Health and its supported faith-based health units to streamline provision of free Fluconazole needed for treatment and prophylaxis of Cryptococcal infection in HIV. Supported faith-based health units will be facilitated to store electronic data which will simplify the periodic reporting process and also promote operational research, from which findings will be used to further improve the program. In units lacking sufficient cadres of staff to provide optimal ART care, IRCU will support minimal recruitment of such identified key personnel including Medical Officers, Nurses, Counselors and Dispensers. Provision of quality ART care will be IRCU's hallmark. To enforce this, the teams will be trained on quality assurance processes and they will be required to set up quality control systems which will be monitored periodically. The clinics will be supported to provide health message dissemination in form of Information Education Communication (IEC) materials, visual and audio messages. IRCU in partnership with SCMS will strengthen the logistics systems at the units to enhance accurate ordering and forecasting of the required drugs and other inputs. IRCU will support limited refurbishments of HIV clinics to provide basic working areas and waiting sheds for patients in five of the fifteen units.

Provider initiated routine testing and counseling (RTC) services will be initiated or enhanced at all IRCU supported ART sites. RTC will create the demand for both basic and ART care programs at these sites. Centers like Mulago and Mbarara Hospitals where RTC was initiated have shown that 60-80% of patients presenting to the HIV clinics in the hospitals are referred through the local RTC programs. 40 selected staff will be trained as trainers of trainers (TOTs) in the RTC model. These will then sensitize the rest of the hospital staffs on RTC. Religious leaders will also be vital in mobilizing the community to access prompt care at the units as well as raising treatment literacy at the grass roots. A total of 500 religious leaders will be trained in adherence monitoring and in mobilization skills to encourage the people to seek services The religious leaders together with PHLAs will initiate or maintain Post-Test clubs including new support groups for discordant couples. IRCU will encourage horizontal and vertical networking at all levels. The Ministry

of Health will be the main stakeholder in terms of policy dissemination, quality control and technical advice for IRCU's health facilities. Ministry of Health through Global Fund provides only ARVs to these 15 sites. IRCU will supplement the patients receiving drugs through the ministry by catering for all the monitoring follow-up requirements of these clients. The core IRCU team, will offer periodic support supervision to the units and offer technical input in the running of the ART clinics.

This activity is linked to HIV prevention (8426), Palliative care: basic (8422), TB/HIV (8423), OVC (8427), Counseling & testing (8424), Treatment: ARV drugs (8428) and ARV Services (8425). The Inter-Religious Council of Uganda (IRCU) is a coalition of the five largest religions in Uganda, namely; Roman Catholic Church, the Uganda Muslim Supreme Council, Church of Uganda, Seventh Day Adventist Church and the Uganda Orthodox Church. IRCU also works with other Pentecostal and independent churches. It was formed as a joint initiative to pool efforts of the religious communities in responding to various development challenges including HIV/AIDS. It has evolved as the official coordinating mechanism for the faith-based HIV/AIDS response in Uganda. Through its constituent faiths, IRCU coordinates the largest network of faith-based health units in Uganda, which together deliver close to 50% of the health care services in Uganda. In this position, IRCU has been a major player in rolling out ART services in Uganda. Using FY06 funds, IRCU plans to access quality ART to 2,500 individuals by September 2007.

Efficient laboratory monitoring of individuals on treatment remains at the helm of an effective ART program. Using FY06 funds, IRCU is providing support at 20 sites in various aspects of laboratory improvement including refurbishment of buildings, procurement of equipment for basic diagnostic and monitoring tests related to HIV and ART. All the 20 these labs will carry out the following tests: 58,000 HIV screening tests, 20,000 estimated repeat HIV tests, 5000 TB screening microscopic and radiologic tests, 2000 baseline syphilis screening tests and 260 pregnancy tests. Units with mal-functional equipment vital for HIV care will work with IRCU to repair such equipment and maintenance. All HIV testing will follow the Ministry of Health algorithm for testing. 2 out of the 20 labs have on site CD4 machines. IRCU will enter into a Memorandum of Understanding with Joint Clinical Research Centre (JCRC) to source laboratory services, from its regional centers of excellence, especially the tests that are beyond the capacity of its health units to offer. Under this arrangement, most IRCU supported facilities will continue to collaborate with proximal JCRC centers of excellence in reference to specific tests like CD4 cell counts, PCR and resistance testing. IRCU is also working in partnership with JCRC to offer technical support to 20 laboratory technicians in form of training, continued supervision and quality control to ensure that lab services conform to nationally acceptable standards. 40 health workers will also be trained in lab related logistical issues. 20,000 HIV positive patients will be enrolled into care during the reporting year. All these will have routine baseline CD4 tests, lymphocyte counts and hemoglobin levels. 2500 patients starting ART will have quarterly hemoglobin and lymphocyte estimates and bi-annual CD4 cell counts. IRCU sites will be part of the national infant diagnosis program under Ministry of Health and will ensure infants born of HIV positive mothers have access to DNA-PCR through regional centers of excellence. Treatment of all affected infants will be there after initiated by the units.

In FY07, IRCU will consolidate and where necessary expand its current initiatives in the laboratory component of its programs. In situations where there is shortage of laboratory staff, IRCU will support recruitment of additional people upon negotiations with the host facilities. With the support from SCMS, IRCU will train the laboratory staff in ordering and forecasting of laboratory reagents as well as other logistical inputs to ensure a reliable supply. Routine reliability and quality assurance checks will be undertaken to ensure that lab services conform to nationally acceptable standards. IRCU will supplement the procurement of lab commodities at units as they will mainly access these commodities through the national lab credit line system through Joint Medical Stores (JMS). However, access to laboratory services still remains a challenge, especially to individuals living in rural areas.