This activity also relates to Counseling and Testing (9080), Palliative Care Basic (9075) , HIV/AIDS Treatment/ARV services (9077), Other prevention(9084), Orphans and Vulnerable Children (9081) and Other/Policy analysis and system strengthening (9082). Building on USG existing private sector initiative which ends May 2007, this follow on activity will continue to serve as the USG prime mechanism for leveraging the private sector to increase access to and use of AIDS treatment, prevention and care services through mid and large size employers.

The Uganda HIV Sero Behavioral Survey (UHSBS) secondary data of faithfulness shows that 88% of men are not lifetime faithful, compared to 56% of women, and only 10% of couples are mutually lifetime faithful. The Private Sector Initiative shall implement activities in line with the Uganda National Road Map for Accelerated HIV Prevention that emphasizes the prevention of sexual transmission of HIV as the key priority area. Much as knowledge of HIV/AIDS is relatively high across all recent survey respondents, there is need for more mature BCC interventions provided to the company employees, dependants and surrounding community.

Building on current private sector prevention activities and in keeping with USG's mass media campaign promoting faithfulness and addressing issues related to gender roles and norms, interventions will be implemented at the workplace and surrounding communities through peer educators, community outreaches during CT promotion and through company leadership.

This activity also relates to Counseling and Testing(9080), Palliative Care (9075), Prevention/Abstinence and Being Faithful (9086), HIV/AIDS Treatment/ARV services (9077), Orphans and Vulnerable Children (9081) and Other/Policy analysis and system strengthening (9082). Building on USG private sector initiatives which ends in may 2007, this follow on activity will continue to serve as the USG prime mechanism for leveraging the private sector to increase access to and use of AIDS treatment, prevention and care services through mid and large size employers.

Selected achievements to date: 200,000 individuals reached through HIV/AIDS prevention messages. The numbers are reached through the peer education program currently sponsored by the current private sector initiative. Currently 26 community outreach programs mainly covering plantation-based companies (tea and sugar estates) are being supported to reach approximately 40,000 individuals. The individuals are reached through awareness campaigns and one-on-one peer talks where HIV/AIDS brochures, materials and/or messages are also distributed.

The Private Sector Initiative will emphasize provision of relevant information to both stationed and highly mobile worker populations (migrant workers). For example, sugar cane and tea grower companies that have very high seasonal labor turn over during the harvest season will be supported by peer educators to provide information focusing on risks of having more than one sexual partners, use of condoms consistently, increasing risk of transmitting HIV to several partners (including sexually transmitted diseases), in addition to their regular cohabiting spouse. Private companies will be supported to maintain prevention programs that benefit employees, dependants and the surrounding community. The prevention programs will include focus on problems related to alcohol consumption, substance abuse, promoting responsible behavior that reduces risk of transmission, including couple testing and mutual disclosure within established couples, as well as consistent and correct use of condoms within discordant couples, but also with casual partners. The private sector will leverage other USG and non-USG activities to strengthen the private sector interventions through linking up private companies with testing, STI diagnosis, treatment and prevention, family planning and PMTCT services.

This activity also relates to Counseling and Testing (9080), HIV/AIDS Treatment/ARV Services (9077), Prevention/Abstinence and Being Faithful (9086), Other Prevention (9084), Orphans and Vulnerable Children (9081) and Other/Policy Analysis and System Strengthening (9082). Building on USG private sector initiatives which end in May 2007, this follow on activity will continue to serve as the USG prime mechanism for leveraging the private sector to increase access to and use of AIDS treatment, prevention and care services through mid and large size employers.

Achievements to date: The existing private sector initiative has provided general HIV-related palliative care to about 100 persons, trained 200 providers and expanded services thorugh over 50 employers.

One of the components entails training private sector providers (physicians, clinical officers and nurses) in the provision basic palliative care skills. The Private Sector Initiative will leverage existing HIV/AIDS training programs to train workplace physicians, clinical officers, and senior nurses and peer educators in the provision of basic palliative care. The training includes classroom courses and practicals in which trainees work with a mentor in a palliative care center. The project will monitor and evaluate how trainees are providing palliative care within their workplace clinic settings. The training will cover approximately 200 private providers from predominantly semi - urban and rural industries that have agreed to offer palliative care as part of their AIDS treatment services (including peer educators) either through worksite health units, insurance or referral units where employees and dependants access services.

Within the various companies under the umbrella organizations, the project will ensure that the employees, dependants and surrounding communities receive HIV/AIDS services through worksite health units. The services shall include counseling and testing and HIV/AIDS prevention services as an entry point to care and treatment offered within the company facility or sourced outside the company.

This activity will use the private sector as an entry point to reaching families with prevention, CT and palliative care services. Employees, dependants and surrounding community members who are found to be HIV+ will referred for follow on support to the either the company facilities of company referral clinics that provide confidential services. The family approach will also be able to identify sexual partners (including discordant couples identified and monitored under a referral arrangement) and children that require early referral to care and treatment. When focusing on the surrounding community, the project will work in partnership with various community based structures including PHA networks, religious leaders, faith based organizations and volunteers engaged in delivery of care and referral at community level to provide onward support.

The other component of this activity includes promoting appropriate elements of the basic care package through social marketing. The project will link up with the AFFORD program to broker costs that improve access of socially marketed basic care components to benefit the employees, dependants and surrounding community. Socially marketed products and services will be cost shared between the employee and company where viable or solely bought by the company and placed in the site facilities / referral facilities for those who cannot afford the products. The USG planned palliative care assessment will be used to define standardized approaches and quality indicators that support improved palliative care delivery in the private sector.

This activity also relates to Counseling and Testing (9080), Palliative Care (9075), Prevention/Abstinence and Being Faithful (9086), Other Prevention (9084),Treatment:ARV Services (9077) and Other/Policy Analysis and System Strengthening(9082). Building on USG private sector initiatives which ends in may 2007, this follow on activity will continue to serve as the USG prime mechanism for leveraging the private sector to increase access to and use of AIDS treatment, prevention and care services through mid and large size employers.

Although planned USG OVC program expenditure has increased through PEPFAR, significant resources are still needed to meet the critical needs of 2 million orphans and other vulnerable children. Partnership with national and multinational corporations need to expand support to OVCs in neediest communities is one of our new strategies. The partnership will be built on existing Global Development Alliance (GDA) agreements currently being implemented by TASC II mechanism through Business Preventing AIDS and Accelerating Access to Anti-Retroviral Treatment (Business PART Project). GDA is an agreement where the private sector partner contributes a minimum 50% of the resources to carry out the terms of the GDA. Through the regional USAID ECA program and the O/GAC private sector office, USG/Uganda will explore and facilitate private sector OVC initiatives with local and international banks, fuel companies, hotels, soft drink companies, and telecom companies that are currently supporting or exploring how they can support OVC initiatives. A partnership with the private sector umbrella organization (Private Sector Foundation of Uganda - PSFU) will likely serve as a key partner in developing sustainable programs.

Critical programs that the private sector can support will aim to strengthen capacity of families, mobilize and support community/home-based responses, and ensure access to essential services. Leveraged USG resources through the private sector will enhance and scale up the delivery of key OVC services areas like education support, provision of basic health care, food and nutrition, shelter improvement, and economic strengthening of OVC caregivers.

OGAC Reviews: Activity 9081. Private sector initiative - please clarify this activity - Is this a workplace initiative or an activity for the broader community?

Private sector initiative - This is a community-based initiative and not a work-site activity. This activity will be working with private for profit companies such as local and international banks, fuel companies, hotels, soft drink companies, and telecom companies to strengthen capacity of families, mobilize and support community/home-based responses to enhance and scale up the delivery of key OVC services areas like education support, provision of basic health care, food and nutrition, shelter improvement, and economic strengthening of OVC caregivers.

This activity also relates to HIV/AIDS Treatment/ARV services (9077), Palliative Care (9075), Prevention/Abstinence and Being Faithful (9086), Other prevention (9084), Orphans and Vulnerable Children (9081) and Other/Policy analysis and system strengthening (9082). Building on USG private sector initiatives which ends in may 2007, this follow on activity will continue to serve as the USG prime mechanism for leveraging the private sector to increase access to and use of AIDS treatment, prevention and care services through mid and large size employers.

Selected achievements to date: The current private program has trained service providers from 15 companies that provide VCT services at either company site facilities or private facilities where employees, dependants and surrounding community receive services. The trained service providers have been able to reach 1,600 clients with VCT services. Free VCT outreach services especially during the HIV/AIDS workplace policy launches have been arranged to benefit employees, dependants and the surrounding community reaching over 5,000 individuals. Referrals are made at the time of testing to services for both the HIV+ and HIV- clients.

One of the key areas identified through stakeholder consultations as a major entry point to CT was the workplace. Workers spend most of their time at the workplace place and their behavior is largely influenced in the workplace. However, workplace practices such as human resource policies on accommodation of sick employees, fear of stigmatization and dismissal can hinder workers from accessing CT services to know their HIV status and also seek HIV/AIDS care and treatment services early. This program will build on existing private sector initiative program to work with private sector organizations to develop HIV/AIDS workplace policies and programs aimed at reducing stigma and increasing access and utilization of CT services. The program will work with these organizations to train peer educators and HIV/AIDS champions in the workplace that will break the silence and move the HIV/AIDS discussions from personal-private to the public policy sphere and act as change agents. The peer educators and champions will also provide counseling and encourage their peers to go for counseling and testing. They will also provide follow up post-test counseling to those that agree to test. For those testing HIV+ve, peer educators will facilitate referrals and linkages to care and treatment services.

Through dedicated CT days, at least once every three months, all workers and their dependants will be offered an opportunity to receive counseling and testing at the workplace. Community outreaches for CT will also be provided to cater for satellite posts and the surrounding community. Special emphasis will be placed on encouraging couple counseling for the company employees and surrounding community members. In case the company site is surrounded by a most at risk population such as migrant workers, fishing community and commercial sex workers, greater emphasis will be placed in ensuring periodic mobile CT outreaches with referrals to care and treatment.

This activity also relates to Counseling and Testing (9080), Palliative Care (9075), Prevention/Abstinence and Being Faithful (9086), Other Prevention (9084), Orphans and Vulnerable Children (9081),and Other/Policy Analysis and System Strengthening (9082). Building on USG private sector initiatives which ends in may 2007, this follow on activity will continue to serve as the USG prime mechanism for leveraging the private sector to increase access to and use of AIDS treatment, prevention and care services through mid and large size employers.

Selected achievements to date: Through the existing private initiative, 75 physicians, clinicians and senior nurses from company facilities or private facilities where cheats are referred have been trained in the provision of state-of-the art ART provision to company employees, dependants and surrounding community. The trained personnel have been able to provide ART to over 734 clients with an estimated 1,500 clients expected to receive ART by mid-May next year. The clients receiving ART are from 15 companies/work associations who provide treatment to their employees, dependants and surrounding community either directly at the company clinic or directly through accredited facilities that have a special arrangement with the company. Support has also been provided to 3 largest health insurance companies to include HIV/AIDS treatment as part of the client benefits package. Currently 2 of the 3 insurance are covering all their clients (employees and dependants) with HIV/AIDS treatment reaching approximately 15,000 clients.

This activity has several components. The first is leveraging resources from the existing USAID Global Development Alliance (GDA) initiatives currently being implemented. The existing GDAs cover the flower and coffee sectors. New sectors, (will be explored through the follow on private Sector Initiative) through various umbrella organizations to develop GDAs. The GDA supports members associations to increase access to ART availability through establishing in-house AIDS treatment programs for their employees and dependants. A GDA is an agreement where the private sector partner has to contribute at minimum 50% of the resources to carry out terms of the GDA. If a company within the umbrella organization does not have a clinic on site, the project will develop agreements so that local AIDS treatment providers can offer care to HIV positive employees and dependants from the company. The activity will include training to cover peer educators from predominantly semi - urban and rural industries through printing of various IEC/BCC materials to address ART literacy, palliatives care and CT for employees, dependants and members of the community surrounding the company.

The other component for this activity includes training private sector providers in AIDS treatment. The Private Sector Initiative will build on previous successes by current TASC II program to train physicians, clinical officers and senior nurses in the provision of up-to-date guidelines on AIDS treatment. The training includes both classroom based courses and hands-on "internships in which trainees spend several days working with a mentor in a treatment center, applying skills and knowledge they learned in classroom. The project will monitor and evaluate how trainees are providing HIV/AIDS treatment. The training will cover proximately 100 private providers from predominantly semi - urban and rural industries that have agreed to offer AIDS treatment.

Another component of the project will focus on expansion and monitoring of insurance based work carried out with current funding. This activity will facilitate urban based insurance firms and local rural based health insurers to provide AIDS treatment coverage as part of the standard benefits package to approximately 10,000 beneficiaries. Another component of the project will provide private sector facilities with support in ART accreditation. The project will work closely with the Ministry of Health (MoH) to strengthen the mechanism for certification of private sector provider clinics that have had staff rained to provide ART in line with national standards. Support will also be provided to make sure that the standard guidelines are closely followed the private sector accredited facilities.

This activity also relates to Counseling and Testing (9080), Palliative Care(9075), Prevention/Abstinence and Being Faithful (9086), Other Prevention (9084), Orphans and Vulnerable Children (9081) and HIV/AIDS Treatment/ARV Services (9077). Building on USG private sector initiatives which ends in may 2007, this follow on activity will continue to serve as the USG prime mechanism for leveraging the private sector to increase access to and use of AIDS treatment, prevention and care services through mid and large size employers.

The existing private sector initiative program has supported over 20 private companies to develop and strengthen HIV/AIDS in the workplace programs. In partnership with the Ministry of Gender Labor and Social Development (MoGLSD), this activity will support the roll out of the new HIV/AIDS in the Workplace Policy that is currently before Cabinet for approval.

The private sector initiative will also work closely with the Ministry of Health (MoH) to explore opportunities for providing TA during the formation and implementation of the National Social Health Insurance Scheme (NSHIS). The current format of NSHIS has received very strong opposition from the Federation of Uganda Employers (FUE) claiming that government is rushing the scheme with limited key stakeholder consultation. The NSHIS scheme has also not used scientific methods though a proper actuarial stud to arrive at the suggested contribution of 8% by both the employees and workers. The Private Sector Initiative drawing on its past experience in Uganda within the private sector is in a strong position to provide relevant TA to facilitate private sector buy-in. The biggest challenge foreseen for implementing the NSHIS within the private sector is the competition with the existing health insurance schemes that provide efficient services.

This activity shall build on existing private sector initiative to supporting FUE's extensive HIV/AIDS experience in providing HIV/AIDS training and IEC materials to FUE members (including Uganda manufacturers' Association - UMA and Private Sector Foundation of Uganda - PSFU). The Private Sector Initiative will provide continued support to further develop FUE's ability to make succinct financial or "bottom-line" based arguments to members companies on the financial importance of addressing HIV/AIDS at the workplace. The program will also train supervisors and management to provide support to employees that may want to disclose their sero-status to fellow workers and implement flexible working environment for sick HIV+ve employees. This will greatly encourage other workers to know their HIV status without fear of losing their jobs. Workers and management will be trained on corporate philanthropy to extend the workplace experiences into surrounding communities to the benefit of the general population.

OGAC Reviews: Activity 9082 (Other Policy Analysis): please clarify the status of the legislation - is there potential for passage?

Activity 9082 - In partnership with the Ministry of Gender Labor and Social Development (MoGLSD), this activity will support the roll out of the new HIV/AIDS in the Workplace Policy that is currently before Cabinet for approval. This policy is still in Cabinet, but we do not anticipate any issues preventing approval