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Our programmes work to reduce the impact of HIV, AIDS and TB and contribute to the global strategy to bring about the end of AIDS by 2030. In line with South Africa’s National Strategic Plan and UNAIDS’ 90-90-90 Fast Track targets, NACOSA focuses on young women and girls, sex workers, people who inject drugs, those most affected by gender-based violence, children and youth, and other vulnerable and key populations.

Together with our partners, we develop programmes that work on the ground by working closely with local organisations and including key and vulnerable populations in the design of interventions. NACOSA’s programmes will reach around 270,000 people affected by HIV, AIDS and TB.

NACOSA manages three main grants: the $82 million Global Fund Investing for Impact against Tuberculosis and HIV, the $5 million USAID and PEPFAR-funded Preventing HIV/AIDS in Vulnerable Populations focusing on Orphans and Vulnerable Children in the Western Cape (known as Isibindi Impilo) and the $19.5 million Community-Based Violence Prevention and Linkages to Response in South Africa grant, also funded by USAID and PEPFAR. Other partnerships with the First for Women Foundation, the National Lottery and Synergos add to NACOSA’s integrated programming.

Appointed for the third time as a principal recipient for the Global Fund, NACOSA will implement programmes that address key and vulnerable populations across South Africa, including:


As one of our populations most vulnerable to HIV, the Adolescent Girls and Young Women programme aims to increase retention in school, decrease HIV incidence, teenage pregnancy and gender based violence, and increase economic opportunities for young women and girls. NACOSA will work with 62,425 adolescent girls and young women over three years in Tshwane, Rustenburg and the City of Cape Town, helping them on a journey from vulnerability to safety, health and wellbeing.


Sex workers face significant and multiple barriers to accessing health and other services. The Sex Work Programme aims to prevent new infections of HIV, STIs and TB amongst sex workers and improve health outcomes for sex workers, their clients and sexual partners through combination prevention approaches. Using outreach and peer education, the programme also aims to reduce human rights, social and structural barriers to HIV, STI and TB prevention, care and impact among sex workers. NACOSA will work with over 36,416 female, male and transgender sex workers a year in close alignment with the National Sex Worker Plan. The programme will be implemented by NACOSA in high-transmission districts in Gauteng, Limpopo, the North West, KwaZulu-Natal, the Free State and the Eastern Cape.


People who inject drugs (PWID) are an underserved and often overlooked key population in the South African AIDS response. The People Who Inject Drugs Programme aims to prevent new infections of HIV and TB and improve health outcomes and access to drug treatment for PWID to support HIV prevention and improve quality. Working with 8,112 PWID a year, NACOSA also aims to reduce human rights, social and structural barriers to HIV, Hepatitis, STI and TB prevention, care and impact among PWID; as well as strengthen the advocacy and national commitment for PWID programming. The PWID programme will be implemented in selected urban districts in Gauteng, KwaZulu-Natal, the Eastern and Western Cape.


Community Responses and Systems (CRS) is an approach that promotes the development of informed, capable and coordinated communities, community-based organizations, groups, networks and structures to play a critical role in the AIDS response. The Community Response and Systems Programme aims to strengthen planning and co-ordination between implementers and other stakeholders through social mobilization; strengthen leadership and governance of Provincial Councils on AIDS (PCAs); and build the capacity of community organisations supporting key populations. NACOSA will build the capacity of over 35 organisations a year, as well as manage a small grant scheme for organisations focusing on human rights and key populations. The programme will compliment other Global Fund programming in the Western Cape, Gauteng and the North West.


Sexual violence puts people – particularly young people – at a higher risk of HIV. The Thuthuzela Care Centre (TCC) Programme will support the services of community organisations in integrated sexual violence centres and aims to provide trauma containment, prevent HIV and STIs and increase access to adequate and appropriate psychosocial support services for victims of sexual violence. NACOSA will provide a package of support to over 40,000 victims of sexual violence in 14 Thuthuzela Care Centres and Designated Health Facilities in the Western and Eastern Cape, Gauteng and the North West.

"In my community, children are under a lot of stress, especially the girls.”


Many children and youth in South Africa are vulnerable and live in extremely difficult socio-economic and family circumstances. New HIV infections are concentrated in older adolescents and young people, particularly adolescent girls and young women. HIV and AIDS has left many families and children economically vulnerable, stigmatised and struggling to cope. Child abuse and gender based violence have reached epidemic proportions and disproportionately affect children and youth, further increasing their risk of acquiring HIV.

NACOSA has been an implementing partner for USAID and PEPFAR since 2012, running the NACOSA OVC Community Systems Strengthening programme which led to further children and youth-focused programming such as DREAMS, ASPIRES, the Unfinished Business of Paediatric and Adolescent HIV project (match-funded by the ELMA Foundation) and FHI360’s ReACH programme. NACOSA has once again been appointed as an implementing partner for PEPFAR and USAID, including the following programmes:

Isibindi Impilo

Isibindi Impilo means courage in health. It is a program to prevent HIV and AIDS in vulnerable populations in Khayelitsha and Mitchell’s Plain in the Western Cape run by NACOSA with partner organisation NACCW. The program uses child and youth care workers to reach and support 20,000 vulnerable children and youth and their families to ensure that children are:

  • Safe by improving child protection and prevention of gender-based violence
  • Stable by improving household economic security and social protection
  • Healthy by increasing access to health and HIV services
  • Schooled by improving school retention and progression

A comprehensive basket of services is tailored to address the vulnerabilities and needs of each child and include individual and group interventions.

Community-based Violence Prevention and Linkages to Response   

Linked to USAID’s OVC programming, the Community-based Violence Prevention and Linkages to Response programme will ramp up community-based efforts to prevent and respond to sexual violence among children, teens and young people, particularly adolescent girls and young women. By September 2019, the programme will have reached 24,500 vulnerable children and youth and their families in districts most affected by HIV and AIDS in Gauteng, KwaZulu-Natal, Mpumalanga and the Western Cape. From October 2019, this number will increase to 42,713.

NACOSA has teamed up with technical assistance partner Childline South Africa, as well as seven experienced district-based implementing partners.

The programme assesses families for gender based violence, works to change harmful attitudes and promotes protective family and community norms and parenting practices. Placing a particular focus on responding to violence, the programme ensures that survivors of violence have access to comprehensive, acute post-violence care services. Survivors are also provided with short- and longer-term therapeutic support.

“I was so proud of myself for saving money on my own. I lifted the weight on my mother’s shoulders for buying the blazer that I wanted to have for so long, since Primary [school].”

Circles of Support

We are also excited to continue and expand our Circles of Support Project with funding from Synergos to provide safe spaces where vulnerable caregivers can come together in a mutually supportive space, helping to increase social connectedness and improve support for children and young people living with HIV. The project will be rolled-out in collaboration with Yabonga in the Western Cape and KwaZulu-Natal.