NACOSA is part of an interlinked, multisectoral national and global response ecosystem. Our programmes work to reduce the impact of HIV, AIDS, TB, GBV and Covid-19 and contribute to the global strategy to bring about the end of AIDS by 2030. In line with South Africa’s National Strategic Plans, UNAIDS’ 90-90-90 Fast Track targets and the Sustainable Development Goals, NACOSA focuses on women and girls, sex workers, people who inject drugs, those most affected by gender-based violence, children and young people, and other key and vulnerable populations.
Together with our partners, we develop programmes that work on the ground by working closely with local organisations, the global development community, researchers and key and vulnerable population groups. NACOSA’s programmes reach around 200,000 people affected by HIV, AIDS and TB each year.
NACOSA manages a number of large grants: the Global Fund Investing for Impact against Tuberculosis and HIV, the USAID and PEPFAR-funded Community-Based Violence Prevention and Linkages to Response in South Africa grant, the Imagine social impact bond for young women in schools with the South African Medical Research Council and the Preventing HIV/AIDS in Vulnerable Populations focusing on Orphans and Vulnerable Children in the Western Cape and the, also funded by USAID and PEPFAR. Other partnerships with the First for Women Foundation, Frontline AIDS and the International Treatment Preparedness Coalition add to NACOSA’s integrated programming.
Children and young people, particularly adolescent girls and young women, continue to be disproportionately affected by HIV, AIDS, poor sexual and reproductive health and GBV in South Africa. To prevent HIV in children and youth and increase access to testing, care and support we need to make sure they are safe, stable, healthy, and schooled.
NACOSA implements a number of programmes focused on vulnerable children, adolescents and young people. The largest of these is the My Journey Adolescents and Young People Programme, funded by the Global Fund, which aims to aims to increase retention in school, decrease HIV incidence, teenage pregnancy and gender-based violence and increase economic opportunities for young people in South Africa. The programme works to engage, inform and empower adolescents and young people with a package of community- and school-based, peer-led health and social services. This programme reaches over 100,000 adolescents and young people a year.
NACOSA is the lead implementer on an innovative new programme called Imagine, to prevent HIV and unwanted pregnancy in adolescent girls and young women, funded through a social outcomes-based financial instrument managed by the South African Medical Research Council. The Imagine programme aims to help girls and young women in school imagine and bring to life a happy, healthy future for themselves.
NACOSA has run programmes for orphaned and vulnerable children since 2011 and currently implements a programme to prevent HIV, AIDS and GBV in orphans and vulnerable children in the Western Cape, funded by PEPFAR and USAID. The programme supports vulnerable children and their families to prevent and reduce the impact of HIV and violence against children in communities.
South Africa has some of the highest rates of gender-based violence (GBV) in the world which largely impacts on women and children. Aside from the devastating physical, psychological, economic and social impact of violence, it is also one of the main drivers of our HIV epidemic. NACOSA believes that communities have a vital role to play in preventing and responding to violence against women and children.
NACOSA’s flagship GBV intervention is the Community-based Violence Prevention and Response Programme, funded by PEPFAR and USAID, which assesses families for gender-based violence, works to change harmful attitudes and promotes protective family and community norms and parenting practices using evidence-informed interventions. With a focus on girls and young women, the programme is part of DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) and also works to provide survivors of violence with comprehensive post-violence care services in Thuthuzela Care Centres and other post-violence care facilities in communities.
With funding from the Global Fund, NACOSA supports the services of community organisations in integrated post-violence care centres, providing trauma containment, preventing HIV and STIs and increasing access to psychosocial support services for victims of sexual violence. NACOSA has received funding from the 1st for Women Foundation to design and develop the first integrated post-violence care facility in Diepsloot, Gauteng. This project led to NACOSA being able to secure additional funding from the Global Fund to build similar centres at three other sites in Gauteng and the Western Cape.
No Means No is an evidence-based GBV prevention curriculum created by No Means No Worldwide based on the principles of empowerment self-defence – a holistic approach that teaches mental, verbal, and physical skills to prevent and respond to all types of violence. NACOSA is the first organisation to implement No Means No in South Africa and has worked with No Means No Worldwide to adapt the curriculum for the South African context.
To turn the tide on unacceptably high levels of GBV in South Africa, all sectors of society need to work together to prevent violence, but also to make sure that people affected by violence get the care and support they need.
Economic strengthening interventions that empower people to enter the job market or become entrepreneurs are critical to both South Africa’s economic future and its AIDS response. Vulnerable and key populations who are in education or employed and financially stable are much less likely to acquire HIV and be vulnerable to GBV. NACOSA implemented economic strengthening and livelihoods interventions with young women and sex workers, funded by the Global Fund. The interventions include work readiness and financial literacy skills, training and work opportunities, as well as savings and entrepreneurship support. Known as GLO – Grow, Learn, Own – this approach is being extended to other programmes and vulnerable groups.
The AIDS response has taught us that when people come together to tackle public health challenges, they have a stronger voice and are more effective at finding solutions. NACOSA promotes networking and dialogue and helps to build systems that support the community response to HIV, AIDS, TB, GBV and Covid-19. The Community Systems Strengthening approach promotes the development of informed, capable and coordinated communities, organisations, groups, networks and structures so that they can play a meaningful role in the country’s public health responses. NACOSA builds the capacity of community organisations – with capacity assessments, training and mentoring – and manages a small and medium grant scheme for emerging organisations. Funded by the Global Fund, the Community Systems Strengthening programme also works to strengthen planning and co-ordination between implementers and other stakeholders through social mobilisation and strengthening the leadership and governance of Provincial Councils on AIDS.
Community-led monitoring uses the power of people in communities to transform information on health systems into advocacy campaigns that can improve the quality of, and access to, services. NACOSA, in collaboration with the International Treatment Preparedness Coalition (ITPC), implements the Community-Led Monitoring and Advocacy project which deploys trained community-level data collectors to monitor health services in and around facilities to improve access to quality HIV prevention and treatment services for key and vulnerable populations in the West Rand District in Gauteng.
The NACOSA Training Institute has a capacity building methodology and tools developed and refined over 20 years of building the capacity of community-based organisations and structures. NACOSA has developed its own organisational Capacity Assessment Tool (CAT) which assesses organisations against eight focus areas, starting with a self-assessment and followed by a site visit to review and confirm the findings.
Key populations are those who are most affected by HIV, AIDS and STIs. Marginalised, criminalised, stigmatised and discriminated against, they are often prevented from accessing the testing, treatment and care services they desperately need.
People who use drugs are an underserved and often overlooked key population in the South African AIDS response. The People Who Use Drugs Programme aims to prevent new infections of HIV and TB and improve health outcomes and access to drug treatment for people who use drugs. With funding from the Global Fund, NACOSA works to reduce human rights, social and structural barriers to HIV, Hepatitis, STI and TB prevention and care among this population, as well as strengthen the advocacy and national commitment for this kind of programming. The programme deploys peer educators to inform and support other people who use drugs, reducing harm and increasing access to health and other services.
Sex workers face significant and multiple barriers to accessing services. NACOSA has managed a national Sex Work Programme, funded by the Global Fund, since 2013. The programme works to prevent new infections of HIV, STIs and TB amongst sex workers and improve health outcomes for sex workers, their clients and sexual partners. Using outreach and peer education, it also aims to reduce human rights, social and structural barriers to HIV, STIs and TB prevention and care among sex workers.
South Africa’s constitution is rooted in the recognition, protection and promotion of human rights but there are significant gaps when it comes to realising these rights, particularly when it comes to HIV, STIs and TB. NACOSA implements the Global Fund’s Human Rights Programme which includes community mobilisation and advocacy, strengthening the delivery of legal support services, mainstreaming the reduction of harmful gender norms and addressing stigma and discrimination.