This activity is related to HKID activities 9125, 9155, 9148, 8225, 8230, 9213; HBHC activity 9207, and HTXS activity 9167.

The World Food Program (WFP) has worked closely with WHO efforts to develop approaches based on the latest available scientific evidence with respect to identifying the macronutrient and micronutrient needs of HIV-infected peoples, the specific nutritional needs of children infected and affected by HIV/AIDS and the nutritional needs of HIV-infected adults and children receiving ART. It was recognized that HIV infected adults and children in general have greater energy needs, greater presence of micronutrient deficiencies and that growth in children can be severely impaired if infected with HIV or if they do not have access to a properly balanced diet. To achieve the full benefits of ARV and proper growth of a vulnerable child, adequate dietary intake is essential and dietary and nutritional assessment is an essential part of comprehensive care.

With the rapid roll out of ART in the country, the ever increasing number of OVC, and the unreliable food supply in Mozambique due to droughts and floods, the interest in associated food support is growing. Most recently this has been given impetus by a request from the Minister of Health for urgent clarity on the design and implementation approach of appropriate food based interventions in the context of ART both at the clinical setting and within the household. WFP along with USAID is working closely with colleagues in the Ministry of Health, Ministry of Women and Social Action and other stakeholders in the development of a programmatic model for the provision of food in conjunction with clinical and home-based ART services.

The goal of this activity is to improve the health and nutritional status of PLWHA (adults and children) receiving ART at USG-supported sites in order to improve treatment adhenence and reduce any potential negative effects of the drugs. WFP will continue to work closely with PEPFAR partners (World Relief, World Vision, FDC, Save the Children, Project Hope, and Care ) to determine if clients meet WFP guidelines for vulnerability and nutritional need. Guidelines were set with assistance from WHO, SETSAN*, MOH, and other multi-lateral organizations and bi-lateral missions. PEPFAR-funded partners will contract with WFP to provide a specific number of supplemental packages for no longer than 6 months for PLWHA and will distrubute them. This activity will provide PLWHAfood rations equivalent to one meal a day. PEPFAR partners will ensure that PLWHA on food supplements will have available wrap-around services including nutrition information and opportunities to be involved in food sustainability practices (home gardens) or livelihood activities to provide longer term food security. If studies are published that suggest a different combination of supplemental foods, any new guidelines will be incorporated into the food rations. Monitoring of clients that receive food suppliments will be carried out to determine the effectiveness of the supplements and related assistance on ARV treatment reactions and treatment adherence.

With COP07 funding support it is anticipated that WFP, along with treatment partners in Mozambique, will assist all PLWHA initiating treatment and deemed to need nutritional support based on clinical criteria with food and nutritional support. It is estimated that ½ of people starting ART will need food supplements to ensure proper uptake and adherence.

*SETSAN is Mozambique's Technical Secretariat for Food and Nutrition Security. The multisectoral Vulnerability Analysis Group (GAV) monitors food security and vulnerability within the country. Indicators used include: i) availability - agriculture production, livestock, seeds, food aid and rainfall; ii) access - prices, markets terms of trade, income sources; iii) utilization - nutrition, health, water, sanitation and consumption; and iv) social protection and survival strategies.

Reprogramming October 2007 - $500,000 decrease

This activity is related to HBHC 9138 and HXTS 9167.

The World Food Program has worked closely with WHO efforts to develop approaches, based on the latest available scientific evidence, to identify the macronutrient and micronutrient needs of HIV-infected peoples, the specific nutritional needs of children infected and affected by HIV/AIDS and the nutritional needs of HIV-infected adults and children receiving ART. It is recognized that HIV infected adults and children in general have greater energy needs, greater presence of micronutrient deficiencies and that growth in children can be severely impaired if infected with HIV or if they do not have access to a properly balanced diet. To achieve the full benefits of ARV and proper growth of a vulnerable child, adequate food intake is important and dietary and nutritional assessments are essential parts of comprehensive care.

The interest in associated food support is growing due to the rapid roll-out of ART in the country, the ever increasing number of OVC, and the unreliable food supply in Mozambique due to droughts and floods. Most recently, the Ministry of Health has convened several meetings to gain better clarity on program designs and implementation approaches for clinics and households for food interventions in the context of ART. WFP, along with USAID, is working closely with colleagues in the Ministry of Health, Ministry of Women and Social Action and other stakeholders in the development of a programmatic model for the provision of food in conjunction with clinical and home-based ART services.

The goal of this activity is to improve the health and nutritional status of the neediest OVC and their caregivers at USG-supported service sites. WFP will continue to work closely with PEPFAR partners (World Relief, World Vision, ADPP, FDC, Africare, Save the Children, Project Hope, Care, HACI and any other new OVC partners) to determine if clients meet WFP guidelines for vulnerability and nutritional need. Guidelines were set in collaboration with MOH, SETSAN* (Mozambique's Technical Secretariat for Food and Nutrition Security), WHO, and other multi-lateral organizations.

The USG will fund WFP to provide logistical support to PEPFAR-funded partners to receive a specific number of supplemental food packages for no longer than 6 months for OVC and their caregivers. The cost of these food packages have been leveraged by the WFP through private-sector funds. The supplementary food ration will then be distributed to OVC living in vulnerable, food-insecure households, distributed through the PEPFAR implementing partners. This activity will provide OVC and caregivers with food rations equivalent to one meal a day. PEPFAR partners will ensure that OVC and their caregivers on food supplements will have available wrap-around services including nutrition information and opportunities to be involved in food sustainability practices (home gardens) or livelihood activities to provide longer term food security.

It is anticipated that over 15,000 OVC will be reached with emergency individual food rations and 1,000 individuals will be trained for this wrap-around activity with COP07 funding.

*SETSAN is Mozambique's Technical Secretariat for Food and Nutrition Security. The multi-secotor Vulnerability Analysis Group (GAV) monitors food security and vulnerability with the country. Indicators used include: i) availability - agriculture production, livestock, seeds, food aid and rainfall; ii) access - prices, markets terms of trade, income sources; iii) utilization - nutrition, health, water, sanitation and consumption; and iv) social protection and survival strategies.

This is a follow-on to the FY06 activity and is related to HKID 9124 and HBHC 9138. This activity duplicates other activities because food subsities will be provided to currents clients of OVC and ART services. Therefore, no separate targets are provided.

With the rapid roll out of ART in the country, the ever increasing number of OVC, and the unreliable food supply in Mozambique due to droughts and floods, the interest in associated food support is growing. Most recently this has been given impetus by a request from the Minister of Health for urgent clarity on the design and implementation approach of appropriate food based interventions in the context of ART both at the clinical setting and within the household. WFP along with USAID is working closely with colleagues in the Ministry of Health, Ministry of Women and Social Action and other stakeholders in the development of a programmatic model for the provision of food in conjunction with clinical and home-based ART services.

The goal of this activity is to improve the health and nutritional status of PLWHA receiving ART at USG-supported sites in order to improve treatment adherence and reduce any potentially negative effects of the drugs. WFP will continue to work closely with PEPFAR partners (HAI, Columbia University and EGPAF and any other new treatment partners) to determine if clients meet WFP guidelines for vulnerability and nutritional need. Guidelines were set with assistance from WHO, SETSAN*, MOH, and other multi-lateral organizations and bi-lateral missions. PEPFAR-funded NGO partners will contract with WFP to provide a specific number of supplemental packages for no longer than 6 months for PLWHA on ART and their families. Patients will be assessed clinically on a regular basis and taken off the supplemental foods earlier than 6 months if warranted. WFP will provide a supplementary food ration to PLWHA on ART living in vulnerable, food-insecure households, distributed through the PEPFAR-supported Day Hospitals where patients go for initial assessment, CD4 counts and ART follow-up. This activity will provide PLWHA receiving ART and their families (an average family size of 5) with family food rations consisting of 1200g cereals, 200g pulses, 100ml Vitamin A-enriched oil, and 600g corn-soya blend per person daily for one meal per day. PEPFAR partners will ensure that clients on food supplements will have available wrap-around services including nutrition information (which is part of the curriculum for home-based care providers) and opportunities to be involved in food sustainability practices (home gardens) or livelihood activities to provide longer term food security. If studies are published that suggest a different combination of supplemental foods, any new guidelines will be incorporated into the food rations. Monitoring of clients that receive food supplements will be carried out by WFP to determine the effectiveness of the supplements and related assistance on ARV treatment reactions and treatment adherence.

With COP07 funding support it is anticipated that WFP, along with treatment partners in Mozambique, will assist all PLWHA initiating treatment and deemed to need nutritional support based on clinical criteria with food and nutritional support. It is estimated that ½ of people starting ART will need food supplements to ensure proper uptake and adherence.

*SETSAN is Mozambique's Technical Secretariat for Food and Nutrition Security. The multisectoral Vulnerability Analysis Group (GAV) monitors food security and vulnerability within the country. Indicators used include: i) availability - agriculture production, livestock, seeds, food aid and rainfall; ii) access - prices, markets terms of trade, income sources; iii) utilization - nutrition, health, water, sanitation and consumption; and iv) social protection and survival strategies.

Reprogramming October 2007 - decrease in funding level to $800,000 from $1.6M but no changes to the narratives.