Program Expansion Supplement: Scaling up comprehensive HIV/AIDS services including Provider Initiated Testing and Counseling (PITC), TB/HIV, OVC, Care, and ART in the Uganda under PEPFAR

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The purpose of this program is support the Government of Uganda to provide comprehensive HIV/AIDS services to patients within clinical settings in the districts of the Western region including implementation of the Saving Mothers Giving Life Initiative whose goal is to reduce by 50% maternal death in the implementation districts by September 2017.These services will include Provider Initiated Testing and Counseling (PITC), basic HIV care and support, orphans and vulnerable children (OVC) services, TB/HIV care, PMTCT services and ART for both adults and children. These services will be expanded as appropriate to address complementary activities including Gender Based Violence (GBV), Prevention with Positives (PWP), Child Survival, Reproductive Health and other neglected tropical diseases.This announcement proposes direct service provision of emergency obstetric and neonatal care service at 112 l health facilities supported to implement Saving Mothers giving life (SMGL) in the districts of Kyenjojo, Kabarole, Kamwenge and Kibaale. This support is aimed at ensuring coordinated and cost efficient comprehensive service provision in support of the national health system. Successful applicants should utilize existing health facility staff and where applicable, and with consultation of the health units, support the recruitment of additional staff.Uganda has made significant progress towards providing care and support and ART to People Living with HIV/AIDS (PLHA). By March 31, 2009 PEPFAR funded HIV care and support for more than 350,000 people and provided ART to over 160,000 individuals ART (87% of all people receiving ART nationally). However, the number of people in need of ART is approximately 358,000 (UNAIDS estimate using the CD4<200 cut off), implying an unmet need of more than 50%.In addition, whereas the number of accredited ART sites with capacity to provide pediatric care and treatment has increased from 30 in 2006 to 209 in 2008, only 9% of all persons on PEPFAR supported ART are children. The number of children in need of ART will increase with the recently revised national guidelines that recommend ART for all confirmed HIV-positive infants under 12 months. Based on the new guidelines, an additional infants may require ART in the absence of better PMTCT interventions.

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