Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4882
Country/Region: Mozambique
Year: 2007
Main Partner: U.S. Department of Defense
Main Partner Program: NA
Organizational Type: Other USG Agency
Funding Agency: USDOD
Total Funding: $593,000

Funding for Treatment: Adult Treatment (HTXS): $100,000

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.

Funding for Strategic Information (HVSI): $300,000

This activity is linked to the policy development (activity 4894) and the prevalence and behavioral studies(activities # and # - COP 05 & 06) and specific prevention activities planned to target this population of recruits (activity #). Starting in 2007, the military will double the recruits' annual intake from 2000 to 4000 people being trained in two training centers (Manhiça and Montepuez). Aware of this change in numbers, DOD will provide funds to be used for HIV testing. Unlike most militaries, including the US, at the present time there is no HIV testing of recruits. These new recruits will be tested for HIV for the first time in the Mozambican military. However, this test will not be used to stop them from being enlisted if one is found to be HIV positive. The data will only be used for the military to have a clear vision of the number of HIV infected people recruited each year. This surveillance will provide substantial data which, combined with the ongoing prevalence and behavioral study data, will be used as a firm basis in developing a new military HIV/AIDS policy (including recruitment) for the Mozambican Armed Forces (FADM). Unlinked anonymous testing will be used to collect HIV prevalence data. All recruits will be offered VCT.

DOD will also support HIV mandatory testing for the Mozambican peace keeping force. The new approach will be to offer then HIV counseling and testing prior to deployment and when they finish their mission and return home. At the present time this is not being done. Without knowing their HIV status, some may return home HIV infected and will thus infect their partners increasing the epidemic.

Funding for Strategic Information (HVSI): $75,000

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.

Funding for Management and Operations (HVMS): $118,000

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).

Table 3.3.15: