U.S. Department of Health and Human Services Grant: Strengthening HIV/AIDS Interventions in Namibia

Under the leadership of the U.S. Global AIDS Coordinator, as part of the President’s
Emergency Plan, the U.S. Department of Health and Human Services’ Centers for
Disease Control and Prevention (HHS/CDC) works with host countries and other key
partners to assess the needs of each country and design a customized program of
assistance that fits within the host nation’s strategic plan.

HHS/CDC focuses on two or three major program areas in each country. Goals and
priorities include the following:

• Achieving primary prevention of HIV infection through activities such as
expanding confidential counseling and testing programs and building programs to
reduce mother-to-child transmission;
• Improving the care and treatment of HIV/AIDS, sexually transmitted infections
(STIs) and related opportunistic infections by improving STI management;
enhancing the care and treatment of opportunistic infections, including
tuberculosis (TB); and initiating programs to provide anti-retroviral therapy
(ART); and
• Strengthening the capacity of countries to collect and use surveillance data and
manage national HIV/AIDS programs by expanding HIV/STI/TB surveillance
programs and strengthening laboratory support for surveillance, diagnosis,
treatment, disease monitoring and HIV screening for blood safety.

Under the leadership of the U.S. Global AIDS Coordinator, as part of the President’s
Emergency Plan, the U.S. Department of Health and Human Services (HHS) works with
host countries and other key partners to assess the needs of each country and design a
customized program of assistance that fits within the host nation’s strategic plan.

The President’s Emergency Plan is seeking a partner to implement rural and limited
urban (in informal settlements of Windhoek), confidential HIV counseling, testing and
related interventions in six regions of Namibia. These six regions are required in the first
year of the project; should funding permit, the project would be expanded to additional
regions during the five-year project period. Grantee activities include providing
confidential HIV counseling, testing and related interventions, including routine testing in
medical and health-care settings and house-to-house and community testing, to
individuals and linking individuals to already-existing HIV care in the area.
The regions in question, Omusati, Oshana, Oshikoto, Ohangwena, Kavango, Caprivi, and
Khomas have the highest rates of HIV in Namibia, as high as 39.4 percent among women
who attend prenatal care in the district of Caprivi, according to the 2006 sentinel
surveillance survey. With the exception of the Khomas Region which includes the
capital city of Windhoek, the remaining regions are in the north, where the majority of
the population of Namibia resides. The northern regions include one of the main routes
for overland transportation traffic in Africa. Additionally, many northern Namibians,
particularly men, migrate from the north to the south each year to work in the service
sector in Windhoek or to mining and agricultural areas in the south. These features make
the people of Khomas Region and the northern regions especially vulnerable to HIV
infections and in need of full prevention, care and treatment.

The grantee will provide confidential HIV testing, counseling and related interventions to
households in the defined target area. The emphasis will be on personalizing the
interventions delivered to each individual in a household, and working systematically
with all households within the defined community area, to provide confidential, routine
counseling and testing (CT) at the home; HIV knowledge and information to promote
behavior-change; referrals to anti-retroviral therapy (ART); counseling on ART
adherence; and referrals for the prevention of mother-to-child transmission (PMTCT).
The program will place a special emphasis on offering confidential, voluntary counseling
and testing to families in their homes. The partner must work in close collaboration with
the Ministry of Health Social Services’ Counseling and Testing Unit, Regional Health
Authorities, the Regional and Constituency AIDS Coordinating Committees (RACOCs
and CACOCS), and other key stakeholders in the regions where the work is to take place.
Addtionally, through special intiative funding, the grantee will scale-up HIV/AIDS
treatment services in prioity regions in Namibia with high HIV disease burden.
Measurable outcomes of the program will be in alignment with the following
performance goal(s) for the Emergency Plan:
PEPFAR Indicators:
1. Number of individuals reached through community outreach that promotes
HIV/AIDS prevention through abstinence and/or being faithful;
2. Number of individuals trained to promote HIV/AIDS prevention through
abstinence and/or being faithful;
3. Number of individuals reached through community outreach that promotes
HIV/AIDS prevention through other behavior change other than abstinence and/or
being faithful;
4. Number of individuals trained to promote HIV/AIDS prevention through other
change beyond abstinence and/or being faithful;
5. Number of targeted condom service outlets;
6. Number of individuals who received CT for HIV and received their test results;
and
7. Number of individuals trained in counseling and testing according to national and
international standards.
Additional Indicators:
1. Number of HIV-positive individuals provided with Prevention with Positives
(PwP) counseling; and
2. Number and type (OVC, care, TB, STI, alcohol) of referrals made.
This announcement is intended for non-research activities supported by the Centers for
Disease Control and Prevention within HHS (HHS/CDC). If an applicant proposes
research activities, HHS/CDC will not review the application. For the definition of
“research,” please see the HHS/CDC Web site at the following Internet address:
http://www.cdc.gov/od/science/regs/hrpp/researchdefinition.htm