THE NATIONAL HIV AND AIDS STRATEGIC PLAN 2020/21/2024/25
THE REPUBLIC OF UGANDATHE NATIONAL HIV AND AIDSSTRATEGIC PLAN2020/21/2024/25“Ending the HIV and AIDS epidemic: Communities at the forefront”UGANDA AIDS COMMISSIONAbridged VersionApril 27, 2020
The development and publication of this National HIV and AIDSStrategic Plan (NSP) 2020/21-2024/25 was made possible withfinancial support from the Government of Uganda, Embassy of Irelandand UNAIDS. UN Women supported the Gender and Human Rightssection while the Global Fund supported printing and disseminationof this document.Published by:Uganda AIDS CommissionOwnership :Reproduction of this publication for educationalor other non-commercial purposes is authorizedwithout permission from the publishers, provided thesource is fully acknowledged. Reproduction of thispublication for sale or other commercial purposes isprohibited without the prior written permission of thepublishers.Preferred Citation: National HIV and AIDS Priority Action Plan2020/2021- 2022/2023: Ending the HIV and AIDSepidemic: Communities at the forefront: Kampala:Uganda AIDS Commission; 2020.Available from:UGANDANS AND AMERICANSIN PARTNERSHIP TO FIGHT HIV AIDSUganda AIDS Commission SecretariatPlot 1-3 Salim Bay Road,Ntinda - Nakawa Division;P.O.Box 10779, Kampala- UgandaTel: 256-414-699502Email: uac@uac.go.ugWebsite: http://www.uac.go.ugUnited NationsUGANDAThe National HIV and AIDS Strategic Plan2020/21 – 2024/25i
ACKNOWLEDGEMENTSUganda AIDS Commission would like to take this opportunity to expressits deep appreciation and sincere thanks to all who participated in thedevelopment of the National Strategic Plan. Thanks to Government ofUganda, Embassy of Ireland and UNAIDS for financial support to UACfor undertaking the exercise to prepare NSP 2020/21 – 2024/25.The process of developing this National Strategic Plan was highlyparticipatory involving key stakeholders and interest groups includingcommunities of PLHIV at national and sub-national levels. Theprocess was mainly supported through the programmatic TechnicalWorking Groups (TWG) that met regularly with respective thematicconsultants in working sessions and workshops to provide their inputsand technical advice. The TWGs were composed of representativesfrom all groups of stakeholders involved in the national HIV response:Ministry of Health and government entities (Ministries, Departmentsand Agencies), Civil Society Organizations (including PLHIV), privatesector partners, decentralized units of government, developmentpartners (UNAIDS, UNFPA, UN Women, WHO, US Government andthe Global Fund).Uganda AIDS Commission was the lead agency in coordinating theNational Strategic Plan development process, but all partners andstakeholders participated actively in all the steps of NSP developmentensuring comprehensive consultation and fully inclusive consensus onthe final document. The facilitation by the consultants from SocioEconomic Data Centre (SEDC) Limited under the leadership of Prof.Narathius Asingwire is appreciated. The conveners at the UgandaAIDS Commission and all the staff played a critical role.I wish to congratulate all partners for their active participation in thedevelopment of the new National Strategic Plan, and above all fortheir invaluable and continuous contribution to the fight against HIVand AIDS.Dr. Nelson MusobaDIRECTOR GENERALiiThe National HIV and AIDS Strategic Plan2020/21 – 2024/25
ACRONYMS AND escent Boys and Young MenAIDS Control ProgrammeAdolescent Girls and Young WomenAIDS Indicatory SurveyIndicatory SurveyAntenatal CareAntiretroviral TherapyAntiretroviral MedicinesCivil Society OrganizationsDistrict HIV/AIDS CommitteesDetermined, Resilient, Empowered, AIDS Free,Mentored and Safe InitiativeDolutegravirEqual Opportunities CommissionEarly Infant DiagnosisElimination of Mother-to-Child TransmissionFaith-Based OrganizationFiscal YearGender-Based ViolenceUnited States of America Government’sGlobal Health InitiativeHealth Care WasteHealth Management Information SystemHuman PapillomavirusInter-Governmental Authority on DevelopmentInter-Religious Council of UgandaJoint Annual ReviewKey PopulationsLogistics Management Information SystemsLot Quality Assurance SamplingMonitoring and EvaluationMost at Risk Populations InitiativeMinistries, Departments and AgenciesManagement Information SystemMaternal, Newborn and Child Health and NutritionMinistry of Education and SportsMinistry of Finance, Planning and EconomicDevelopmentMinistry of Health–AIDS Control ProgrammeThe National HIV and AIDS Strategic Plan2020/21 – 2024/25iii
MTRNADICNAFOPHANUNAISNASANBFNDP IIINPAPNSPNUSAFOVCOWCPCRP UDHSUNYPAUPHIAUWEPVHTsVMMCYAPsYLPZCUivMid-Term ReviewNational AIDS Documentation and InformationCentreNational Forum of People Living With HIV/AIDSNetworks in UgandaNational AIDS Indicatory SurveyNational AIDS Spending AssessmentNational Budget FrameworkNational Development Plan III 2020/21– 2024/25National HIV and AIDS Priority Action PlanNational Strategic PlanThird Northern Uganda Social Action FundOrphans and Vulnerable ChildrenOperation Wealth CreationPolymerase Chain ReactionPost-Exposure ProphylaxisUnited States President’s Emergency Plan forAIDS ReliefPersons with A DisabilityReady-To-Use Therapeutic FoodsSocial Assistance Grants for EmploymentSocial and Behaviour Change CommunicationSelf-Coordinating EntitiesSustainable Development GoalsSexual and Gender-Based ViolenceSexual and Reproductive HealthSexually Transmitted InfectionSexual Violence Against ChildrenTechnical Working GroupsUganda Aids CommissionUganda Demographic and Health SurveyUganda Network of Young People Living with HIV &AIDSUganda Population-Based HIV Impact AssessmentUganda Women Entrepreneur ProgrammeVillage Health TeamsVoluntary Medical Male CircumcisionYouth and Adolescent Peer SupportYouth Livelihood ProgrammeZonal Control UnitsThe National HIV and AIDS Strategic Plan2020/21 – 2024/25
TABLE OF CONTENTSACKNOWLEDGEMENTS .iiACRONYMS .iii1.0 INTRODUCTION AND BACKGROUND.12.0 HIV AND AIDS SITUATION ANALYSIS.23.0 STRATEGIC DIRECTION OF NSP 2020/21-2024/25-. 63.1 Evidence-Based Response and Scenario adopted .63.2 Theory of change for attaining outcomes and goal of NSP . 73.3 Major Strategic Shifts under NSP 2020/2021—2024/2025 . 94.0 THE NATIONAL HIV AND AIDS STRATEGIC PLAN 2020/2021-2024/2025 .124.1 Vision .124.2 Overall Goal .124.3. Objectives of NSP 2020/2021—2024/2025 . 135.0 NSP 2020/2021-2024/2025 STRATEGIC OBJECTIVES AND ACTIONS .155.1 Prevention . 155.2 Care and Treatment . 195.3 Social Support and Protection. 255.4 Systems Strengthening . 305.5 Monitoring, Evaluation and Research. 336.0 NSP 2020/2021-2024/2025 CO-ORDINATION AND IMPLEMENTATION .376.1 Institutional Arrangements for Coordinating the Response . 376.2 Implementation Arrangements for the NSP. 407.0 COST ESTIMATES AND ACCOUNTABILITY .42The National HIV and AIDS Strategic Plan2020/21 – 2024/25v
viThe National HIV and AIDS Strategic Plan2020/21 – 2024/25
1.0 INTRODUCTION AND BACKGROUNDUganda prioritizes control of HIV and AIDS within the country’s 3rdNational Development Plan (NDP) 2020/21- 2024/25 and othernational and international commitments such as the SustainableDevelopment Goals (SDGs). The country is implementing thePresidential Fast Track Initiative (PFTI) on Ending the AIDSEpidemic by 2030, launched by H.E Y.K. Museveni in June 2017.This National Strategic Plan for HIV and AIDS (NSP) 2020/20212024/2025) lays out strategies and actions to implement highimpact evidence-based interventions and innovations, withprogram optimization. The Plan builds on significant progressachieved during the past five years and responds to gaps identifiedas laid out in the Mid-Term Review (MTR) and Joint Annual Reviews(JARs) of previous plans.The process of developing this Plan extensively involved keystakeholders and interest groups including communities ofpeople living with HIV (PLHIV) at national and sub-nationallevels. Technical Working Groups (TWGs) constituted from a widespectrum of development partners, AIDS service organizations,government ministries, departments and agencies (MDAs) offeredtechnical input in each thematic area of the NSP. For purposes ofalignment with inset sectoral and other national plans, this NSPbuilds on the Health Sector HIV and AIDS Strategic Plan 2018/19 –2022/23; National Plan for Achieving Equity in Access to HIV, TBand Malaria Services in Uganda 2020-2024; Acceleration of HIVPrevention Roadmap, Towards Zero New HIV Infections by 2030;and Presidential Fast-Track Initiative on Ending AIDS in Uganda201The NSP 2020/2021 – 2024/2025 builds on the significantprogress achieved to- date and responds to the gaps identifiedfrom the past five years. The ultimate aim is to trigger catalyticaction to end AIDS as a public health threat in the country. Acomprehensive Mid-Term ReviewThe National HIV and AIDS Strategic Plan2020/21 – 2024/251
MTR) of the NSP 2014/15 – 2019/201 and Joint Annual Review(JAR) during the 4th year of its implementation2 revealed specificnoticeable progress in the implementation of the NSP, but alsobrought to the fore a number of glaring gaps and challenges thatrequire fresh planning. These include among others, decline in socio-behavioral change communication (SBCC) interventions coupled bymisinformation of the general public by uncensored messages; limitedcondom supplies characterized by stock-outs for both male and femalecondoms in some districts; inadequate programming for key populations(KPs); limited integration of sexual and gender based violence (SGBV)prevention and human rights with HIV prevention programming;limited adolescent SRH/HIV information and services; inadequateskills in provision of adolescent friendly SRH among health workersand discriminatory provisions in the HIV control law. Noticeable also isthe decline in linkage to care; low uptake of HIV testing services amongmen; and low early infant diagnosis (EID) coverage and retention.2.0 HIV AND AIDS SITUATION ANALYSISThe National HIV estimates show that in 2019, people living withHIV were 1,461,370; HIV incidence per 1,000 uninfected among allages was 1.4, but substantially higher in specific sub-populationsand locations. The national estimates put HIV prevalence at 7.1% forwomen and 4.3% for men; 2.8% among young women and 1.1% amongyoung men, and also indicate that 53,000 people were newly infectedwith HIV (5,700 children 0-14yrs; 48,000 adults 15 yrs, among them28,000 were women 15 yrs). Amongst older adolescents and youngpeople, prevalence is almost four times higher among females thanmales. Whereas all data sources indicate declining HIV prevalence andincidence for more than a decade, there are wide variations by regionand district; most parts of Central, West and South-western of thecountry report higher rates. Same with urban and rural variations. Notall data are current or comprehensive for certain population groups,particularly key populations (KPs); still, HIV prevalence has been foundto be significantly higher among these categories, ranging from 13.7%to as high as 37%.1 UAC (2018). Mid-term Review of the National HIV and AIDS Strategic Plan (NSP) 2015/2016-2019/2020, Uganda AIDSCommission, Republic of Uganda.2 UAC (2019). 12th Annual Joint AIDS Review (JAR) Final Report July 2019-June 2019, Empowering Young people toChampion the End of New HIV Infections, Sept. 2019. Uganda AIDS Commission, Republic of Uganda.2The National HIV and AIDS Strategic Plan2020/21 – 2024/25
Proportion of people living with HIV (all ages) in Uganda per districtThe HIV burden in Uganda is heterogeneously distributed bypopulation, socio-economic, socio-demographic characteristics,and geographical areas (See Figure 1). There are wide variationsby region and district; most parts of central, west and southwestern of the country report higher prevalence rates; districtswith least prevalence are mainly in far east, north-east, and WestNile regions. A national, population- based survey (UPHIA 2017)shows that HIV prevalence not only varies across the ten regions,ranging from 3.1% in West Nile to 8.0% in Central 1 region, but isalso higher in those residing in urban areas (7.5%) compared tothose living in rural areas.Although AIDS-related deaths have declined over the past decade,males, on account of their lower antiretroviral therapy (ART) coverageand health seeking behaviour are more disproportionately affected inmortality statistics (61%). Regarding 90-90-90 target by 2020, countryperformance data indicate that, as at March 2020, 89% of all adults(93% of the women; 86% of the men) living with HIV knew their HIVstatus, 84% (91% of the women; 77% of the men) were on treatment,The National HIV and AIDS Strategic Plan2020/21 – 2024/253
among them 75% (83% of the women; 68% of the men) with viralload suppression (VLS). Rates were 65-65-48 among children. About 93%of pregnant women living with HIV were on ART.The second 90 targeted that 90% of those who know their status are on treatment translating into 81% of all PLHIV. This target was surpassed in 2019with 84% of all estimated PLHIV being on ART. The third 90 targeted that90% of the people on treatment are virally suppressed translating into 73%of all PLHIV. This also was surpassed with 75% of estimated PLHIV beingvirally suppressed.Uganda has also witnessed a general reduction in stigma and discriminationagainst PLHIV and other vulnerable groups: Proportion of individuals aged15-49 with accepting attitudes towards PLHIV increased from 34% in 2011to about 66.8% by 20173. Progress has also been registered in other specificmeasuresof discrimination.The NationalHIV and AIDS Strategic Plan 2020/21 – 2024/25Trendsandinternalstigmatowardspeopleliving livingwith eoplewith HIVTrends in stigma60504020244.51.3201320190External stigmaInternal stigmaA reductionexternal formsas exclusiongatherings redin 2013 tointernal formsas feeling guipositive reduc2013 to 24% inNAFOPHANU Second National Stigma Index Study (August 2019)Areduction in some of the external forms of stigma, such as exclusionfromsocialgatheringsreducedfrom 4.5% in in2013to 1.3%in 2019;However,whilethere havebeen improvementsaccessto servicesin health gHIVwhere there are specialized service delivery points such as at thepositiveMARPI4 clinic, stkey populationspersists.Thein general has continued to engereducedfrom 50%in 2013to legal24% environmentin ssuch asthe PenalCode Act SectiNAFOPHANU Second National Stigma Index Study(August2019)which criminalize sex work and same sex acts respectively.However,whilefactorsthere havebeenaccessto servicessocioin culturaThere are manydrivingtheimprovementsHIV epidemic inthatare behavioral,NAFOPHANUconcurrentSecond National StigmaIndex Study(August 2019) conductedwith 1,398 respondentswith HIV, in 21includingsexualpartnerships,discordanceand livingnon‐disclosure,transdistricts and 9 in sub regions of Uganda,work, low and inconsistent condom use, low male circumcision, alcohol and drug asocio‐cultural and economic aspects include poverty,genderThe NationalHIV andinequalities,AIDS Strategic Plan as well2020/21– 2024/25 low maleto 4prevention, care and treatment services5. Outstanding factorsincludeHIV programming, limited reach and adaptability of health services for key3
health settings particularly where there are specialized service deliverypoints such as at the MARPI4 clinic, stigma directed at key populationspersists. The legal environment in general has continued to engenderstigma and discrimination based on other existing legislations such asthe Penal Code Act Sections 139 and 145 which criminalize sex workand same sex acts respectively.There are many factors driving the HIV epidemic that are behavioral,socio cultural and biomedical including concurrent sexual partnerships,discordance and non-disclosure, transactional and sex work, lowand inconsistent condom use, low male circumcision, alcohol anddrug abuse. Structural, socio-cultural and economic aspects includepoverty, gender inequalities, as well as gaps in access to prevention,care and treatment services5. Outstandingactors include low maleparticipation in HIV programming, limited reach and adaptability ofhealth services for key and vulnerable populations and high levels ofstigma, discrimination and violence against key populations.Behavior change efforts (such as age-appropriate sex education,community-based behavioral prevention, and condom use andprevention programs among populations at greater risk of HIVexposure) also have not been sufficiently implemented to scale toresult in sustainable declines in new HIV infections.The National HIV and AIDS Strategic Plan2020/21 – 2024/255
3.0 STRATEGIC DIRECTION OF NSP 2020/21-2024/253.1 Evidence-Based Response and Scenario adoptedThis NSP has adopted a Prioritized Scale-Up Scenario which envisionsrapid scale-up to maximum feasible coverage of a comprehensiveset of interventions. The critical interventions which have proveneffectiveness for impact are HIV testing services (HTS), antiretroviraltreatment, condoms especially male condoms, safe male circumcision(SMC), Elimination of Mother-to-Child HIV Transmission (EMTCT),Early Infant Diagnosis (EID) and programs for key populations (KPs).Other programs such as Socio-Behavioural Change Communication(SBCC), stigma and violence prevention, and interventions targetingadolescent girls and young women (AGYW) are social enablers thatare expected to influence uptake of key services and provide non-HIVbenefits as well.With Prioritized Scale-Up, new HIV infections are projected todecline by 71% between 2019 and 2025 reaching 15,000 in 2025,averting 72,000 new HIV infections during this period, about 43% ofthe infections that would have otherwise occurred. For AGYW, newinfections decline by almost 85% from 2019 to 2025 to about 2,000per year. The proportion of people living with HIV under age 25 dropfrom 19% in 2019 to 12% by 2025. AIDS-related deaths also declineby 71% averting 42,000 deaths during this period. Overall, HIVincidence rates (15-49yrs) are projected to decline from 0.4% to 0.2%,annual HIV related deaths from 21,000 to 10,800, HIV mor
The National HIV and AIDS Strategic Plan 2020/21 – 2024/25 iii ACRONYMS AND ABBREVIATIONS ABYM Adolescent Boys and Young Men ACP AIDS Control Programme AGYW Adolescent Girls and Young Women AIS AIDS Indicatory Survey AIDS Indicatory Survey ANC Antenatal Care ART Antiretroviral Therapy ARV Antiretroviral Medicines CSO Civil Society Organizations DAC District HIV/AIDS Committees
Silat is a combative art of self-defense and survival rooted from Matay archipelago. It was traced at thé early of Langkasuka Kingdom (2nd century CE) till thé reign of Melaka (Malaysia) Sultanate era (13th century). Silat has now evolved to become part of social culture and tradition with thé appearance of a fine physical and spiritual .
May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)
NATIONAL HIV/AIDS STRATEGY 2011 ‐ 2016 9 CHAPTER I: INTRODUCTION AND SITUATION ANALYSIS INTRODUCTION National HIV/AIDS Strategy, 2011‐2016 The National HIV/AIDS Strategy is a national guiding document for all sectors, institutions and partners involved in the response to HIV and AIDS in Nepal.
̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions
Dr. Sunita Bharatwal** Dr. Pawan Garga*** Abstract Customer satisfaction is derived from thè functionalities and values, a product or Service can provide. The current study aims to segregate thè dimensions of ordine Service quality and gather insights on its impact on web shopping. The trends of purchases have
On an exceptional basis, Member States may request UNESCO to provide thé candidates with access to thé platform so they can complète thé form by themselves. Thèse requests must be addressed to esd rize unesco. or by 15 A ril 2021 UNESCO will provide thé nomineewith accessto thé platform via their émail address.
Resource pack on gender and HIV/AIDS. (Operational guide; fact sheets; WHO: integrating gender into HIV/AIDS programme, a review paper). UNAIDS Interagency Task Team on Gender and HIV/AIDS. Amsterdam, The Netherlands. 2005. Pack of 2 reports; 16 fact sheets. KEYWORDS: gender; HIV/AIDS manuals. Location: WHO. 0004 - UNAIDS HIV/AIDS: its your .
I am pleased to present this study report on Socio-economic impact of HIV/AIDS on people living with HIV/AIDS and their families' . This study is significant as it was carried out by networks of People Living with HIV/AIDS (PLWHA) in four Indian states. I would like to compliment the PLWHA networks, particularly their members,
