SACBC AIDS Office Report, December 2014

Antiretroviral (ART) Programme

• The ART programme of the SACBC AIDS Office was considerably down-scaled during 2014, and the patients of a number of sites transferred to Department of Health clinics. The Centres for Disease Control (CDC) approved a No Cost Extension to the programme for an additional year to May 2015 for two sites, Nazareth House in Johannesburg and Tapologo in Rustenburg.
• At the request of the National Department of Health, an evaluation of the impact of the services of both facilities, and the satellite clinics in the case of Tapologo, was conducted by Strategic Evaluation, Advisory and Development Consulting (SEAD). The SEAD evaluation also assessed the impact of the work of the Department of Health clinics in the relevant catchment areas. SEAD has recommended that both the Catholic facilities continue beyond the end of PEPFAR funding with Department of Health support. Final decisions in this regard are awaited from the relevant Provincial Departments of Health.
• “Transitions” to Department of Health clinics of SACBC patients elsewhere proceeded relatively smoothly, having been long anticipated and prepared for. Blessed Gerard in Mandini, Diocese of Eshowe, has continued in a public private partnership, with the Provincial Department of Health supporting drugs and laboratory services, and private funding supporting staff and facility costs.
• PEPFAR marked ten years of support to South Africa. Filming was done at a number of the places where its support had been marked. For the SACBC these sites included Nazareth House, Johannesburg, and Newcastle.
• New PEPFAR funding is for technical assistance to the Department of Health, helping it strengthen delivery of services in local clinics, strengthening Supply Chain Management of drugs, and providing for effective monitoring and evaluation systems to track the numbers of patients on treatment across the country. The SACBC AIDS Office is not a recipient of a technical assistance grant.
• The SACBC AIDS Office was invited by AJAN, the African Jesuit AIDS Network, to participate in a study on ART in Africa, part of an advocacy campaign to improve access to ART across the continent.

PEPFAR Orphan and Vulnerable Children’s Programme

•  The OVC programme received a No Cost Extension for an additional year to May 2015, after which there will be no funding from PEPFAR for the 25 projects spread across the various provinces.
• The Department of Family Medicine at the University of Pretoria is conducting an assessment of a number of sites in the programme due to be completed by the end of January 2015. The assessment is examining impact, reach, services rendered, socio- economic environment, and perceptions of how the programmes support the work of the Church to address AIDS.
• Various training workshops for the projects have been conducted regionally, and have included Education for Life, Proposal writing, and Good Governance.
• The Centres for Disease Control (CDC) under which the grant falls is conducting assessments at each of the OVC sites, regarding the particular activities expected and the documentation to be maintained. For a number of sites there is a challenge in this regard.
• Alternative funding for the whole programme is not possible. The SACBC AIDS Office hopes to access some funding to support some of the sites, and some of the sites themselves have been able to source additional funding from other sources to support their work. These funding sources are both South African (for the sites that are registered as Non Profit Organisations), and international (often Church-related).

TB Screening

• The TB screening programme supported by the British government (DFID) and the National Department of Health has done good work in both South Africa and Swaziland. Because of the strong British currency in relation to the South African Rand, the SACBC AIDS Office was able to add in additional sites, above those originally agreed on. The programme screens people for TB, and ensures follow up testing and treatment where recommended. People are also counselled and tested for HIV, with follow up where called for.
• A grant end evaluation of the project is being conducted through the School of Nursing of the University of the Free State, with some of the field work having been conducted by Dr Ruth Stark, formerly Country Director of Catholic Relief Services in South Africa. The final research report is expected by the end of January 2015.
• The DFID programme will not be funded after March 2015.

The Global Fund (GF) Home Based Care and Orphan and Vulnerable Children’sProgramme

• The SACBC AIDS Office is a sub-recipient of funding from the National Association for Social Development (NRASD) of a Global Fund grant, covering work in both home based care, and orphan and vulnerable children’s support.
• Currently an extensive evaluation of the programme by CASE is underway. It is expected that all the SACBC GF sites will be visited, as well as those of all the other sub recipients.
• The SACBC AIDS Office has experienced funding challenges in respect of the Global Fund grant, but it hoped that going forward funding will be received timeously.
• There have been a number of challenges also in respect of Monitoring and Evaluation (M & E), and it is hoped that moving forward these will have all been settled in view of the fact that the sites will be expected in the course of 2015 to have their data captured on the new CBIMS system of the Department of Social Development. This system aims to capture data of all children in the country provided with services.
• The National Association of Child Care Workers (NACCW) is conducting extensive accredited training for selected care workers from GF sites. The training will be concluded in 2015.

Orphan Housing

• Homeplan has been the main funder of two-roomed houses for child-headed and grandmother-headed households in rural areas, with some funding also from the National Lottery, and from a number of private German donors.

• Homeplan donors made two “building trips” to Pomeroy in the Diocese of Dundee to assist in the construction of some of the houses.
• Cycling for Pomeroy was another initiative of the Homeplan donors. A group of cyclists cycled from Pomeroy in KZN to Nairobi, Kenya to raise funding to continue the programme. Johan Viljoen of the SACBC AIDS Office participated in the trip.
• Misereor is supporting the training of orphaned youth and the construction of some houses in Swaziland.

Other Programmes

• A Catholic Relief Services (CRS) programme supported 4 four OVC sites in Swaziland and South Africa. Catholic Relief Services has partnered the SACBC AIDS Office since 2000 though the nature of its support has changed over the years. A small grant will continue in 2015 though CRS will no longer have an office in South Africa.
• A Lotto grant supported OVC sites in four districts of South Africa, providing food, clothing and shelter.
• A legacy received through Christian Aid has supported some Church projects in Gauteng, especially in the Johannesburg area. Some have received a once-off grant for a particular need, others are receiving regular monthly support.

Retreats, Conferences, Training, Publications

• Retreats for staff and caregivers in most of the projects were conducted during the year. These were found to be beneficial for all concerned, those who bear the brunt of responding to situations related to AIDS at grassroots level.
• A number of retreats were supported by funding from Mensen met een Missie which has pledged further support for 2015. An anonymous donor has funded training for spiritual directors and retreat givers who work with caregivers to enhance their pastoral skills, and follow up retreats to mentor the trainees. The programme is underway and will continue in 2015.
• The Symposium of the Episcopal Conferences of Africa and Madagascar (SECAM) was mandated to produce a training manual for the Church in Africa on AIDS and Church responses. The first training, and the beginning of the dissemination of the training manual, was hosted by the SACBC AIDS Office near Johannesburg in November for people representing Anglophone Africa. In 2015 the training will be done for both Francophone and Lusophone countries by SECAM.
• Sr Alison Munro presented a paper at a colloquium held in Nairobi on “The Church we want”, a follow up to the Second African Synod. She participated in a conference organised by Caritas International and UNAIDS in Rome, examining the importance of the Church’s response to AIDS globally, and the need for ongoing efforts to address AIDS. She was also part of the study day on the Church’s response to AIDS of the International Commission for Church Affairs of the German Bishops. Conference, meeting in Cologne, Germany.
• In preparation for the extraordinary Synod on the Family in Rome Sr Alison submitted a paper to INTAMS at the University of Louven on the response of the SACBC region to the preparatory questionnaire on the family. Her paper on the response of grassroots women to AIDS will be included in a new book by the African
  Jesuit AIDS Network (AJAN) on theological and pastoral responses to AIDS in Africa, due in 2015.
• The SACBC AIDS Office book, Catholic Responses to AIDS in Southern Africa,edited by Fr Stuart Bate (of St Joseph’s Theological Institute) and Sr Alison Munro, was launched in Manzini during the plenary session of the SACBC and the during the centenary celebrations of the Church in Swaziland.

APPENDIX 1

TB Program: Johan Viljoen

• Highlights: The program uses community health workers in implementation sites to screen clients for TB, take sputum samples of those suspected of having TB, have the samples tested, enrol those who test positive on TB treatment, monitor those on TB treatment for adherence, counsel and test clients for HIV, enrol those who test positive on ART and monitor them for adherence. The program is currently funded by DFID and the National Department of Health.
• Major Achievements: TB is the major cause of death of HIV positive people in both South Africa and Swaziland. There is anecdotal evidence that the program is resulting in a decrease in morbidity due to TB in its implementation sites. The Priest formerly in Charge at Regina Mundi in Swaziland reports that the number of funerals conducted in the parish decreased to less than a quarter of the number experienced previouslyafter this program was initiated there. He attributes this solely to the fact that people with TB are now accessing treatment in time.
• Geographical Locations: The program is implemented in the Dioceses of Dundee (Madadeni, Pomeroy, Maria Ratschitz), Aliwal North (Joe Qwabi and Sterkspruit), Queenstown (Ntaba Maria Clinic), Port Elizabeth (Caring Ministry and King Williams Town), Kroonstad (Virginia, Viljoenskroon, Maokeng), Durban (Estcourt and Elandskop), Manzini (Piggs Peak and Siteki), Rustenburg (Chaneng), Tzaneen (Mokgolobotha, Mothupa and St Joseph’s Sibasa) and Keimoes/Upington (Bisdom Vigsministerie).
• Statistics: The combined statistics (for all sites and for both funders) for the period January – October 2014 are as follows:Health workers trained in TB and in HIV Counselling and Testing: 200 Clients screened for TB: 161 959
  Clients initiated on TB treatment: 6 789
  Clients counselled for HIV: 65 301Clients tested for HIV: 27 446
  Clients initiated on antiretroviral treatment: 3 360

• NSP: “Accelerated Case Finding of TB” is one of the NSP’s top priorities. In this regard, the SACBC AIDS Office TB program fully supports the NSP.
• Beneficiaries: TB screening and HIV testing is done from house to house. All residents of target communities are beneficiaries. Most communities where the program is implemented are poor, rural communities with high HIV infection rates and high unemployment figures.

APPENDIX 2
ART Program: Theresa Bossert
This is a time of final transition of direct services by church to Government. The transition looks different at different sites, but overall the transition steps are to transfer patients to Department of Health facilities, transfer assets and where possible program staff to be absorbed by either Department of Health or Department of Health partners giving technical support going forward.SACBC AIDS Office has successfully transitioned 4 sites since January 2014 (Siyathokoza in Botshabelo; Kurisanani in Tzaneen Diocese; Blessed Gerard and Newcastle, both in KZN). Two parkhomes (at Newcastle and Siyathokoza) and clinical equipment were transferred for continued use by the Department of Health. No staff has been absorbed at any of the DoH sites.The 2 remaining SACBC ART projects (Tapologo and Nazareth House), are both being considered to become DoH supported sites by North West and Gauteng provinces respectively. This came about after SACBC commissioned SEAD, at the request of the DoH, to evaluate SACBC clinics and surrounding DoH clinics to establish the impact the transition will have on the welfare of the patients.Tapologo has a signed MOA and been receiving their drug supply from DoH since December 2013, and has been using NHLS (National Heath Laboratory Services) for blood tests since 1 September 2014. Nazareth House has signed an MOA with the DoH very recently and is waiting for drugs and lab support to come into place. Nazareth house had meetings with Gauteng DoH and future Department funding looks fairly promising.Our patients all over the country are very grateful to SACBC and PEPFAR for the last 10 years of support and they wish for us to continue; many patients fear a transition to DoH due to a lack of confidence in the Government’s ability to treat them. The love and care that the church clinics give will long still be remembered.

APPENDIX 3
Fleiszer Legacy Program: Theresa Bossert

During 2014 SACBC AIDS Office received finding through Christian Aid from the Fleiszer Legacy to assist orphans and vulnerable children, and the poor, in and around the Johannesburg area.
We were able to assist 10 Sites with once off funding to improve or repair infrastructure, and to procure some needed vehicles, furniture and equipment. Six of the ten organisations also received funding to contribute to their monthly running costs. In September Gui Carvahlo from Christian Aid visited three of the sites, Nazareth house, Missionaries of Charity Yeoville and St Francis, and was pleased that the money was being put to good use.

The sites which benefitted from this year’s Fleiszer funding were from:

• Tshwane District: The Missionaries of Charity in Klipgat: Holy Cross Sisters project called Emmanuel Place of Hope crèche in Plastic View; Sizanani Children’s Home in Bronkhorstspruit and the Good Shepherd sisters with education centres in Madidi, Mmakaunyane and Hebron.
• In Ekhuruleni we supported St Francis Care Centre’s Rainbow cottage in Boksburg; Little Eden in Edenvale and KIDS Community College in Ivory Park.
• Under the City of Johannesburg Metro we have Missionaries of Charity and Nazareth House in Yeoville, and The Love of Christ Ministries in Eikenhof.

The sites are caring on average for the following number of children: