Our programming works to reduce the impact of HIV, AIDS, TB and other socio-economic conditions and contribute to the global strategy to bring about the end of AIDS by 2030. In line with the National Strategic Plan and the 90-90-90 Fast Track targets, NACOSA focuses on young women and girls, sex workers, those most affected by gender-based violence, children and youth, and other vulnerable and key populations.
We work with our partners to manage two main grants: the $43 million Global Fund Investing for Impact against Tuberculosis and HIV and the $10 million USAID and PEPFAR-funded OVC Community Systems Strengthening Programme. Other partnerships with FHI360, the Elma Foundation and the Departments of Social Development and Health add to NACOSA’s integrated programming.
Strengthening systems is our core business – it underpins everything we do. Communities have unique knowledge and experience of the issues they face. Coordinated, capacitated and resilient communities therefore play a vital role in the national response and help improve access to services for key at-risk groups. The Community Systems Strengthening programme, funded by the Global Fund, supports the coordination of the national AIDS response and builds the capacity of community organisations and structures across the country. NACOSA works with the AIDS Foundation of South Africa to implement this programme nationwide.
The programme aims to create functional, effective community systems and to enable community based and emerging NPOs to fulfil their role in the national response through:
The most important key population for the HIV epidemic in South Africa is young women and girls. Adolescent girls have an HIV prevalence which is 8 times higher than their male counterparts and almost 2,000 young South African women are newly infected every week.
In July 2016, the Presidency launched a national campaign, She Conquers, focusing on empowering girls and young women aged 15-29. As part of this national initiative, our Young Women and Girls Programme, funded by the Global Fund, offers a comprehensive package of health, education and support services for young women and adolescent girls. The package includes:
NACOSA implements the programme in four districts in Mpumalanga, KwaZulu-Natal and Limpopo and aims to reach almost 20,000 young women and girls each quarter.
South Africa’s national Sex Work Programme is based on the principle of community empowerment and is implemented by sex workers working as peer educators and site coordinators. The programme mobilises sex workers (male, female and transgender) to address HIV and AIDS, while championing their health, human rights and wellbeing.
Built on the Red Umbrella programme under the previous Global Fund grant, the current programme offers a comprehensive package of services that are peer-led, clinical and holistic according to sex worker needs. Community empowerment and engagement is an integral part of the programme, with sensitisation of stakeholders in and around the areas where it is implemented. As well as HIV testing, condom distribution, STI and TB screening and risk reduction workshops, the programme supports the Sisonke Sex Worker movement and a 24-hour helpline for sex workers. Over 260 full-time peer educators and 32 site coordinators deliver the programme in Gauteng, the Eastern Cape, Western Cape, North West and Free State.
NACOSA’s Sex Work programme is also involved in the ground-breaking roll-out of Pre-Exposure Prophylaxis (PrEP) for sex workers through a Global Fund grant, in line with the with the South African National Sex Worker HIV Plan (2016 – 2019).
Sexual and intimate partner violence is a major driver of South Africa’s HIV epidemic. Addressing gender based violence is therefore a priority, as is the prevention of violence against women. NACOSA’s Gender Based Violence Programme, funded by the Global Fund, acknowledges the importance of both prevention and response, as well as the strategic and geographic intersections between the national Gender Based Violence, Young Women and Girls and Sex Work Programmes.
The Programme includes:
NACOSA works with 9 implementing organisations in four districts in Gauteng, the Eastern Cape, Northern Cape, Western Cape and Free State and aims to reach around 30,000 people a year with prevention and around 20,000 a year with HIV testing services.
Last year, NACOSA started work as a project partner of the Gender, Health and Justice Research Unit on the Improving Case Outcomes for Gender-Based Violence Pilot Project (ICOP), funded by USAID, to develop and pilot practical and achievable strategies and best practices to improve case outcomes and services to survivors of sexual violence through South Africa’s reinstated sexual offences courts.
The NACOSA Orphans and Vulnerable Children Community Systems Strengthening Programme, funded by USAID and PEPFAR, provides direct support to over 30,000 children, facilitation of community dialogues and circles of care and support to create awareness, action and change for children, their caregivers, the community and organisations. The programme also offers sexual and reproductive health information to adolescents through the Vutshilo intervention; a caregiver and adolescent communication programme called Let’s Talk; and HIV testing services (HTS) and adherence support.
NACOSA works with over 44 implementing organisations, providing capacity assessments, technical assistance, mentoring and organisational capacity building training and support. The programme is built on the learning from the Children’s HIV and AIDS Network (CHAiN) and the Global Fund OVC programme and includes gender and key population sensitization, programmatic and skills training for organisations, community care workers, child care forum members and an accredited full qualification in Child and Youth Care Work.
The programme has grown significantly with the inclusion of the DREAMS and ASPIRES projects, at the request of PEPFAR and USAID. NACOSA implements these projects n 2 districts in KwaZulu-Natal, providing communication, sexual and reproductive health workshops and a combination of economic strengthening and prevention activities for adolescents, including savings clubs for vulnerable young people. ASPIRES aims at improving the economic security of highly vulnerable individuals, families and children.
“Orphaned children are at high risk for HIV both from vertical and horizontal HIV transmission.” – Department of Health
Last year, NACOSA became a partner in a project which targets the same districts receiving PEPFAR and Global Fund investment for HIV prevention, to help ensure linkage to care and treatment services for HIV-positive children and adolescents, specifically adolescent girls. The ELMA Foundation is matching U.S. Government funding to NACOSA to provide project support to improve paediatric and adolescent HIV and TB case finding, linkage to treatment and quality of HIV treatment services in four districts in KwaZulu-Natal.
NACOSA has recently been contracted by FHI 360 to implement the ReACH project in KwaZulu-Natal. The project aims to improve the wellbeing of vulnerable children and youth by mitigating the impact of HIV and AIDS, reducing their risk and vulnerability and increasing their resilience and likelihood of growing up to be healthy, educated and socially well-adjusted adults. The project combines a comprehensive package of prevention interventions, strengthening caregiver capacity, improving access to and retention in services, with capacity building and technical assistance to implementing community based organisations.
NACOSA is part of the TB in the Mining Sector in Southern Africa (TIMS) project, funded by the Global Fund via ACHAP. Miners in Southern Africa have some of the highest rates of TB in the world but access to health services for miners and ex-miners is often limited, or non-existent. For their spouses and families, accessing care can be even more difficult. Human rights and gender-related barriers are key factors which limit access to information and health services.
NACOSA is implementing the TIMS project in the mining area of the John Taolo Gaetsewe district around Kuruman in the Northern Cape. HIV is the number one cause of mortality in the Northern Cape, with 8.7% of reported deaths attributed to HIV. TB is the number two cause of mortality, attributing 7.7% of reported deaths.