Program Expansion Supplement for Planning, Implementation and Evaluation of Comprehensive HIV Prevention Programs in South Africa under PEPFAR

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RSA is home to the world's largest HIV epidemic with an estimated 6.4 million adults and children living with HIV in 2012. The country also ranks third among countries with the highest burden of TB in the world, after the more populous India and China, with increasing incidence of multidrug-resistant (MDR-TB) and extensively drug-resistant TB. To address the HIV epidemic, RSA has scaled up HIV clinical services to over 3,500 public health facilities providing antiretroviral therapy (ART) to over 2.7 million adults and children by the end of 2014. With the largest HIV epidemic globally, RSA is at a pivotal stage in addressing its epidemic. While a massive scale-up has been achieved to date, there remain continued service delivery and systems strengthening needs as the programs expand to reach increasing numbers of patients with quality prevention, care, and treatment services to ultimately achieve epidemic control. According to a large-scale review of the national TB and HIV programs conducted in 2013, while great progress has been made to date, key challenges remain in the health system's capacities and quality service delivery. This SEJ is for the purpose of providing additional funding and time to enable the University of Stellenbosch (GH000320) to continue implementing the HPTN 071 (HIV Prevention Trials Network) Population Effects of Antiretroviral Therapy to Reduce HIV Transmission (PopART) project. The PopArt project seeks to determine the impact of two community-level combination prevention packages on population-level HIV incidence. The necessity for this additional funding arose as a result of a change in the South African labor law. The implementation of the South African Labor Relations Amendment Act of 2014 in March 2015 resulted in an increase in minimum wage payments. On the PopART project, the salaries of the Community HIV Care Providers (CHiPs) workerswere then raised significantly and this increase also had a knock-on effect on the salaries of those that supervised the CHiPs workers.

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