Part III: Measuring Progress Towards Targets

COMPONENT 1. Policy Advocacy and Legal Framework

Obstacles

• Lack of political will of most LGU leaders/officials and/or understanding of HIV/AIDS as a development issue - In a de-centralized system of government, policy decisions including resource allocation and provision of services including health are made by local government executives. HIV/AIDS, therefore, competes with a myriad of issues at the local level and in a low prevalence country where very few cases of HIV and AIDS are recorded and faced with resource-challenged settings, this is a major problem.

• Mobilizing HIV/AIDS support from various agencies and sectors which have not been sustained at the local, sub-national and national levels.

• Private sector support to HIV/AIDS remains very minimal.

• Faith based/religious sector support has yet to be tapped more specifically in terms of HIV/AIDS care and support services.

Actions Taken

• With advocacy efforts, putting a human face to HIV /AIDS behind the statistics have helped raised the consciousness of Filipino people to discuss HIV/AIDS. However, sustaining a critical mass of PLWHAs who have "come out" proved to be challenging.

• Some government agencies, especially PNAC member, have adopted and institutionalized HIV/AIDS-related programs within their own agency. Aside from the DOH, DepEd has allocated a separate amount of PHP2.0 million for HIV/AIDS in their annual budget, intended for training module development and reproduction, and training. The Occupational Safety and Health Center (OHSC) has estimated about PHP250,000.00 to finance programs on HIV/AIDS for 2000-2001. Other agencies have given their contributions through the dedication of focal persons and in financing their own transport and travel expenses in attending the various activities of PNAC.

• NGO stakeholders observed that the government agencies tasked to implement their mandates on HIV/AIDS should not depend on PNAC Secretariat funds but must generate from their very own respective agencies budget.⁸

• Conduct of media training/orientation among media practitioners were also done for more sensitive and responsible approach in reporting of HIV/AIDS cases and related issues. Such initiatives have been episodic and it would be more meaningful if engagements have been sustained and not solely dependent on a project/program term.

Roadmap to reach Policy Advocacy and Legal Framework targets by 2010

1)

Increase in the number of identified risk zones having functional LAC

Category/ Baseline Data	2006	2007	2008	2009	2010
Functional LACs 5 - ASEP 6 - GFTAM 1 - Bohol 1- Agusan	13 sustained LACs 5 new LACs established	18 sustained LACs 13 new LACs established Revision of Local AIDS ordinance to include treatment, care and support	31 sustained LACs 10 new Local ordinances -integrated treatment, care and support	31 sustained LACs 9 new LACs established	40 sites with functional and sustainable LACs
Review RA 8504 and IRR - Public hearings conducted	Public hearings and consultations conducted Popularize RA 8504 (old)	Public hearings and consultations conducted Initial draft of revised RA 8504 and IRR	Revised RA 8504 and IRR Popularization of revised RA 8504 and IRR		Revised RA 8504 and IRR

Opportunities for Policy Advocacy and Legal Framework to scale up

• The ongoing review of the Philippine AIDS Law provides an opportunity to include the establishment of a functional mechanism to enhance collaboration and/or establish linkages between PNAC and LACs.

• GFTAM 3 (2004-2009) and GFTAM 5 (2007-2012) - The thrust of GFATM Rounds 3 and 5 is to support and empower LGUs to carry on HIV/AIDS Programs. Although there are only few cities/ sites for intervention, this is an opportunity to demonstrate good practices and learning. Whilst resources are available, it is a very timely opportunity to set up the mechanisms and systems for collaboration between national and local stakeholders on HIV/AIDS program interventions. Towards the end of the support, the LGU will take its counterpart share and continue to sustain the initiatives that have been started.

• Strengthen advocacy efforts among LGUs on HIV/AIDS - Ensure mechanism to recognize the achievements of outstanding LGUs on HIV/AIDS by PNAC and other distinguished award giving bodies (e.g., Office of the President, Galing Pook Award of the Department of Interior and Local Government).

COMPONENT 2. Strategic Planning, Alignment and Harmonization

Obstacles

• The Philippines has just developed its AIDS Medium Term Plan (AMTP) IV for the period 2005-2010 but its operational and investment plans have yet to be developed.

• A functional national M&E system for annual reviews and evaluation is still being established

• A feedback mechanism on AMTP IV among key stakeholders has to be institutionalized.

Actions taken so far to address obstacles

• Newly assigned PNAC Secretariat head in place and committed to deliver operational and investment plan by the second quarter of 2006.

• Establishment of an M&E unit at the PNAC Secretariat is currently under discussion.

• Efforts to fully operationalize the national M&E system on HIV/AIDS response is ongoing.

Roadmap to reach Strategic Planning Alignment and Harmonization targets by 2010

Category/ Baseline Data	2006	2007	2008	2009	2010
National AIDS M&E system still on its development stage	Finalization of National M&E system Pilot test of national M&E system	Final testing of the national M&E system Full implementation	Ongoing M&E system Process review/ assessment of National M&E system	Ongoing M&E system	Functional M&E system in place Process review/ assessment of National M&E system
AMTP IV	Development of operational and investment plan	Annual review and implementation of operational and investment plan	Midterm evaluation of AMTP IV	Annual review and implementation of operational and investment plan	Assessment of AMTP IV and development of AMTP V
Research Agenda plan	Review and revise research agenda	Dissemination of research agenda Conduct of special survey on street children under GFTAM 5	Review research agenda	Review research agenda	Special surveys/ studies are conducted to improve HIV programs
Drug resistance study on ARV among PLWHAs	Ongoing study on Drug resistance study on ARV among PLWHAs (new)	Dissemination of the study			Drug resistance study

COMPONENT 3: Sustainable Financing

Obstacles

• Inadequate mechanism for long-term funding and reserve mechanism

• Need to refine the initially identified funding needs for AMTP IV.

• No national financial system for the National AIDS account to track HIV/AIDS related program disbursements

• No resource mobilization plan for AMTP IV

• Lack of capacity of PNAC on resource tracking

• Inadequate funding for treatment, care and support services. Funding for these have been limited to laboratory tests, prophylaxis for Opportunistic Infections (OIs) and treatment of OIs. Cost of ARV is usually borne by the AIDS patient, although there is now a growing movement to provide it for free. Overall, the country's total HIV/AIDS spending over the last five years (2000-2004) showed an erratic trend, peaking in 2001 (PHP 493,918 or USD 9,687), and declining in the years that followed (2004 PHP 158,313 or USD 2825).

Actions taken so far to address obstacles

• Newly assigned PNAC Secretariat head with dedication and commitment to endorse NASA system.

• Efforts are ongoing to make ARVs accessible and affordable. Under the GFATM Round 3 project, ARVS are provided for free.

Roadmap to reach Sustainable Financing target for 2010

1)

Develop resource tracking system HIV/AIDS

Category/ Baseline Data	2006	2007	2008	2009	2010
No resource tracking system for HIV/AIDS National AIDS Spending Assessment (NASA) report conducted by NEDA	Organize a PNAC Finance committee Develop resource tracking system NASA report reviewed and recommended to PNAC for adoption	Identify issues/ gaps in running resource tracking system NASA report updated	Midterm review of resource tracking system as part of Midterm evaluation of AMTP IV NASA report updated	Identify issues/ gaps in running resource tracking system NASA report updated	Final analysis of resource tracking as part of Final evaluation of AMTP IV NASA report updated
AMTP IV	Develop investment plan	Annual review and implementation of investment plan	Midterm evaluation of AMTP IV	Annual review and implementation of investment plan	Assessment of AMTP IV and development of AMTP V

Opportunities for Sustainable Financing to scale up

• Gender and Development (GAD) funds, Countrywide Development Funds (CDF) and Internal Revenue Allotment (IRA) of the local government units. - These are potential fund sources for HIV/AIDS programs that have not been optimized. For LGUs, there is an annual 5% GAD allocation as approved by law to be used for gender responsive programmes. Unfortunately, most of the LGU have limited knowledge on how these funds can be fully utilized. A lot of advocacy work on HIV/AIDS on how to use GAD budget has to be done. Approximately PHP 50 million in CDF are allocated to each legislator for their priority projects. These are funds that can also be tapped for AIDS programs at the local level.

• External donor support for condom - Increased Contraceptive Self reliance (CSR) is a strategy currently being explored wherein LGUs will have to set up their own procurement/supply chain mechanism. This mechanism can be optimized to ensure adequate support for condoms as well as ARV commodities.

COMPONENT 4: Human Resources

Obstacles

• "Brain drain" of health professionals (medical doctors, nurses, midwives) who go abroad either as permanent residents or migrant workers resulted to the need to constantly train STI and AIDS health service providers. This not only increases programme cost in capacity building, it has also kept inadequate the quality of services.

Actions taken so far to address obstacles

• Although different options have been explored in various national fora (e.g., levy asked from receiving counties, bilateral agreements between the Philippines and receiving countries), no concrete action has been taken to date.

Roadmap to reach Human Resources target for 2010

• Since HIV/AIDS is a specialized field, continuous capacity building among skilled health professionals should be institutionalized. It is important to invest in capacity building initiatives to ensure the best quality medical and psychosocial services for PLWHAs.

• Broadening the human resource base also entails building the capacity of community workers and families of PLWHAs. Since the Philippines is experiencing "brain drain" among health professionals, other alternatives to increase human resources for HIV/AIDS services should be explored.

COMPONENT 5: Organization and Systems

Obstacles

• The PNAC is central in lobbying, assisting and coordinating the integration of HIV/AIDS prevention and control programmes within among government agencies. However:

  • PNAC secretariat remains to be mainly driven by health/medical staff, thus further losing the advantage of a multi-disciplinary, multisectoral body that a national HIV/AIDS response requires. Some agencies (e.g., DILG, PIA, DOLE, NEDA, DSWD) have assigned staff to work on HIV/AIDS initiatives within their own agencies and have participated in PNAC-sponsored activities, but this does not address the staffing needs of the PNAC Secretariat.¹⁴

  • PNAC has been strong in policy formulation but low in results delivery and accountability. There is confusion on its mandate, roles and responsibility (e.g., coordination versus implementation, PNAC Secretariat activities versus DOH programmes).¹⁵

  • Feedback mechanism within PNAC and between PNAC and NGOs, LGUs and other stakeholders is weak. Submission of accomplishment reports by member agencies on HIV/AIDS is not a regular practice. Moreover, submission of PNAC annual report to the President of the Philippines, as provided for in the AIDS Law, have been absent for the past 8 years. (Last report was in 1998)

• Inefficient use of resources earmarked and released to support PNAC Secretariat functioning

Actions taken so far to address obstacles

• PNAC needs to discuss AMTP IV operational and investment plan by the 2nd quarter of 2006 and this will be timely to revisit existing PNAC structure and mechanisms.

Roadmap to reach Organization and systems target for 2010

• Since HIV/AIDS is a specialized field, continuous capacity building among skilled health professionals should be institutionalized. It is important to invest in capacity building initiatives to ensure the best quality medical and psychosocial services for PLWHAs.

• Broadening the human resource base also entails building the capacity of community workers and families of PLWHAs. Since the Philippines is experiencing "brain drain" among health professionals, other alternatives to increase human resources for HIV/AIDS services should be explored.

Category/ Baseline Data	2006	2007	2008	2009	2010
PNAC structure and organization	Different committees reorganized PNAC and its secretariat strengthened Advocacy, operational and investment plans developed LACs established	Sustain capacity building efforts for PNAC and its secretariat   Review of Advocacy and operational investment plan	Review of PNAC structure organization and functionality of the system	Enhanced PNAC structure organization and improved systems	Strengthened PNAC structure organization
10 HIV Surveillance system in place 11 sites under GFTAM 3 undertook IHBSS in 2005 for baseline purposes (next will be 2009 at the end of the project)	HIV surveillance system in place - 10 sites	Sustained 10 sites GFTAM 5 : Additional 15 sites for IHBSS for baseline purposes (next will be 2011 at the end of the project)	Sustained 10 sites HIV surveillance system in place - 36 sites Budget line item under GAA (DOH) established for surveillance activities.	Sustained 10 sites	Sustained HIV surveillance system in 10 sites Adhoc surveys using rapid methodology conducted among risk groups (Note: to expand sites and be conducted yearly among IDU, MSM and other emerging vulnerable populations) ** LGU supporting HIV surveillance (with corresponding fund/resource allocation)

COMPONENT 6: Infrastructure

Obstacles

• Some LGUs still lack logistic capability to deliver decentralized functions to improve health service delivery, including HIV/AIDS.

• Actual provision of pre and post test counseling as required by law has not been fully complied with since this is seen as an added burden as it requires time and trained staff. Protocols for testing are not widely disseminated, resulting in violation of rights related to confidentiality.

Action being taken

• Available facilities are currently being upgraded to support HIV/AIDS programs. Currently there are about 500 accredited laboratories capable of providing HIV testing services; 75% of these laboratories are privately run serving the majority of OFWs undergoing HIV testing as a requirement for employment, as well as blood banks around the country. The remaining 25% are located at public hospitals and social hygiene clinics in 10 priority sites (formerly the ASEP sites).

• There are 11 functional LACs and all of them have budget allocations from their LGUs for operations. Almost all cities in the Philippines have social hygiene clinics where STIs can be detected and treated. Public regional, provincial and city hospitals take care of treatment while municipal health centers serves as primary health care stations.

• Currently, two hospitals - Research Institute for Tropical Medicine and San Lazaro Hospital -- are the major referral hospitals for HIV/AIDS treatment including viral load and CD4 counts. The STD/AIDS Cooperative Central laboratory (SACCL) is the national reference center for HIV testing. Fifty six (56) retained government hospitals already have HACT. Under the GFATM Round 3 Project, 6 treatment hubs have been upgraded and supported to deliver care and support services nationwide. PNAC has developed standard operating procedures which include clinical guidelines on the management of HIV/ AIDS in hospitals.

Roadmap to reach Infrastructure target for 2010

Category/ Baseline Data	2006	2007	2008	2009	2010
Limited functional VCT	Baseline assessment and VCT capacity building in 11 sites (GFTAM) Accreditation of SHC laboratories as VCT facilities	11 VCT proficient SHCs/ treatment hubs	Sustained SHC VCT sites/ treatment hubs	Sustained SHC VCT sites/ treatment hubs	# of Efficient and operational SHC VCT centers are available and accessible
Existing policy and regulatory mechanism for STI facilities and services	Review of policy and regulatory mechanism for STI facilities and services	Enhance regulatory mechanism for STI facilities and services	Implement policy and regulatory mechanism for STI facilities and services	Implement policy and regulatory mechanism for STI facilities and services	Institutionaliza-tion of policy and regulatory mechanism for STI services # of Improved operations of SHCs in the Philippines
6 identified treatment, care and support hubs in the Philippines	6 (GFTAM 3)	7 (GFTAM 5)	Maintained at 7	Maintained at 7	7 treatment care and support hubs that is efficient and operational
2 clinics/ laboratories with CD4 count machine		Additional 1 clinic/lab with CD4 count machine		Additional 1 clinic/lab with CD4 count machine	Increase in the number of clinics/ laboratories with CD4 count machine

COMPONENT 7: Partnerships

Obstacles

• Engagement of religious sector, the private sector/ business and media remains weak.

• In a de-centralized set-up, there is a pressing need to support the strengthening of local mechanisms and facilities to accelerate the local response on AIDS.

Actions being taken

• Several initiatives were undertaken to establish local partnerships for HIV/AIDS, among which are: PNAC with DILG provide technical assistance to selected LGUs (PNAC 'risk zones"). NGOs have laid down partnership with the LGUs to localize HIV/AIDS responses (ASEP project sites).

• Government agencies like OSHC-DOLE and a few NGOs have engaged with the private sector to develop AIDS in the workplace programmes.

• Faith-based organization like Caritas Manila, Daughters of Charity, Precious Jewels Ministry (PJM), Salvation Army (SA), Order of Malta and others, are currently focusing on care and support programmes. An Interfaith AIDS Network was recently created, through the AIDS Society of the Philippines.

Roadmap to reach Partnership targets for 2010

Category/ Baseline Data	2006	2007	2008	2009	2010
Partnerships with faith based organization (FBOs) Interfaith AIDS network in place Catholic Bishops Conference of the Philippines (CBCP) issued pastoral letter for World AIDS Day	Partnership of FBOs with PNAC. Capacity building of Catholic institutions in HIV/AIDS programs Caritas Manila AIDS desk strengthened. CBCP issuance of pastoral letters during Candlelight Memorial and WAD	Catholic institutions implementing HIV/AIDS programs Caritas Manila AIDS desk strengthened. CBCP issuance pastoral letters during Candlelight Memorial and WAD	CBCP issuance pastoral letters during Candlelight Memorial and WAD	Possible membership of FBO to PNAC.     CBCP issuance pastoral letters during Candlelight Memorial and WAD	Number as Faith Based Organizations (FBOs) partners in HIV/AIDS prevention Stronger partnerships with FBOs   CBCP issuance pastoral letters during Candlelight Memorial and WAD
Partnerships with the business sector "Business and the MDGs" CEO Champions identified	CEO forum conducted Partnership of business sector with PNAC.	Strengthen partnerships with the business sector	Strengthen partnerships with the business sector	Possible membership of private sector to PNAC	Number of companies implementing AIDS in the workplace program Business establishments supporting HIV/AIDS programs as part of Corporate Social Responsibility (CSR)
Partnerships with positive communities	Increase involvement of PLWHAs/family members in national AIDS response	Increase involvement of PLWHAs/family members in national AIDS response	Increase involvement of PLWHAs/family members in national AIDS response	Increase involvement of PLWHAs/family members in national AIDS response	Number of positives (client/ families) as partners in HIV/AIDS program

COMPONENT 8: Prevention

Obstacles

• The implementation of the STI prevention and control program has been intensified. Various milestones in HIV/AIDS prevention education were undertaken. Through the DOH-supported ASEP (1993-2003), various outreach programs utilizing the BCC approach spearheaded by NGOs proved to be very effective in reaching most at risk groups. Although current responses have been adequate in scope, they remain inadequate in terms of coverage (i.e., numerous prevention programs are undertaken nationwide but limited in reach). Some are still in pilot/developmental stages, others are delayed, and issues on sustainability remain to be a colossal challenge. Thus, prevention initiatives are lagging behind.

• None or inadequate baseline data of populations at risk to base realistic targets; inadequate information on religious and cultural barriers to prevention

• No available institutional mechanisms for wide-scale and sustained information dissemination

• No policy and program on harm reduction targeting injecting drug users (IDUs)

Actions taken so far to address obstacles

• Training/capacity building efforts have been further strengthened to accelerate prevention efforts: service providers such as HACT trained on comprehensive and syndromic STI management; labor sector trained through OSHC on HIV/AIDS appreciation courses; basic AIDS and STI orientation for men and women in uniform; training of DepEd Subject Area Supervisors at the district and division (provincial or city) levels; social workers handling communities and families trained on HIV prevention counseling as well as care and support; mainstreaming HIV/AIDS into counseling and pre-departure services are conducted among OFWs.

• A training module has been developed on migration, mobility and HIV/AIDS for the Foreign Service Institute (FSI) personnel deployed abroad, and representatives from Overseas Workers Welfare Administration (OWWA), the Philippine Overseas Employment Administration (POEA), DSWD and DOH.

Prevention target for 2010

Prevention Targets by 2010: 1.1 Correct and consistent condom use: PIPs - 60%; MSMs - 60%; IDUs - 40%; VPs - 60% 1.2 30% increase in the proportion of IDUs with safe injecting practices 1.3 50% decrease in STI prevalence among MARP and VPs 1.4 Maintain at 18 years old the median age of first penetrative sexual intercourse among 15-24 yrs. old 1.5 MARP who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV: IDUs - 80%; OSYs - 80%; Others - 100% 1.6 % of general population with accepting attitudes towards PLWHAs: employers - 60%; general public - 50%

Roadmap to reach Prevention targets for 2010

Category/ Baseline Data	2006	2007	2008	2009	2010
HIV/AIDS Behavior Change Communication (BCC) program Capacity building of LGUs on BCC	HIV/AIDS BCC communications plan drafted BCC program implemented and expanded to other sites Strengthen capacity building of LGUs on BCC	Strengthen capacity building of LGUs on BCC	Midterm review of HIV/AIDS BCC communications plan   Strengthen capacity building of LGUs on BCC	Annual review of HIV/AIDS BCC communications plan   Strengthen capacity building of LGUs on BCC	HIV/AIDS BCC program in place
Targeted intervention for MARPs	Sustain targeted intervention for IDUs - Cebu, Zamboanga and Gen Santos National Policy on Harm Reduction developed Targeted intervention for MSM, PIPs in identified risk sites	Expansion sites identified (as needed)   Expansion sites identified (as needed)	Harm Reduction program sustained   Sustained program targeting MARP	Harm Reduction program sustained   Sustained program targeting MARP	Enabling and supportive environment for IDUs   Enabling and supportive environment for MSMs, PIPs
Institutionalize DepEd integration of HIV/AIDS in curriculum	TOT of teachers on the HIV/AIDS curriculum. Lobby for the inclusion of HIV/AIDS and related issues as a major subject in the Teacher Education curriculum - to be reflected in the revised RA 8504.	Review DepEd HIV/AIDS curriculum Lobby for the Inclusion of HIV/AIDS and related issues as a major subject in the Teacher Education curriculum	TOT of teachers on the revised HIV/AIDS curriculum.		Full integration of HIV/AIDS in curriculum of DepEd Inclusion of HIV/AIDS and related issues as major subject in the Teacher Education curriculum.
Institutionalize integration of HIV/AIDS and related issues as a major subject in CHED -- College of Education, medical schools and maritime schools	TOT of teachers/ guidance counselors on the HIV/AIDS curriculum Lobby for the inclusion of HIV/AIDS and related issues in the Teacher Education curriculum, medical and maritime school curriculum	Review CHED HIV/AIDS curriculum Lobby for the Inclusion of HIV/AIDS and related issues in the Teacher Education curriculum, medical and maritime school curriculum	TOT of teachers/ guidance counselors on the revised HIV/AIDS curriculum.		Full integration of HIV/AIDS in curriculum of DepEd, College of Medicine, and maritime schools Inclusion of HIV/AIDS and related issues in the Teacher Education curriculum, Medical and Maritime school curriculum

COMPONENT 9: Care, Support and Treatment

Obstacles

• There is a need to popularize the availability of low cost ARVs in the country. Through the GFATM Round 3 project, the country was able to secure first-line ARV regimen.

• There is also a need to procure second-line regimen.

• There are no available pediatric ARVs.

• No baseline data on children needing ARV.

• Limited laboratory/diagnostic service facilities that offer viral load and CD4 count to support monitoring of people under ARV treatment.

• PLWHAs still fear seeking services because of stigma and discrimination

• The capability of private hospitals to manage PLWHAs (ARV and OI management) is also inadequate since HIV/AIDS training has mainly targeted public hospital medical staff.

• No baseline data on families of PLWHAs as caregivers.

Actions taken so far to address obstacles

• Currently there are 6 hubs for treatment, care and support services nationwide. Monitoring of outputs and impact can be carried out.

• Ongoing capacity building initiatives are conducted among health care professionals. HACT have been organized in regional and government-retained hospitals but most are not functioning either due to fast turnover of staff (especially those going abroad) or because the patients themselves prefer to go to another areas where they are not identified.

• NGO partners for care and support provide additional technical assistance through the conduct of home-based care trainings among community workers/volunteers and affected family members.

• Incorporation of ARV drugs in the National Drug Formulary, development of care and support manuals as well as capacity building for social workers on care and support.

Roadmap to reach Care, Support and Treatment targets for 2010

1)

Proportion of PLWHAs seeking medical treatment among adults and children (or % coverage of PLWHAs needing ARV are on ARV)

Category/ Baseline Data	2006	2007	2008	2009	2010
140 adult PLWHAs on ARV (67 are on 1st line regimen) Note: coverage is dependent on of number PLWHAs needing ARV	160 (cumulative) 100% coverage of PLWHA needing ARV	180 (cumulative) 100% coverage of PLWHA needing ARV	200 (cumulative) 100% coverage of PLWHA needing ARV	220 (cumulative) 100% coverage of PLWHA needing ARV	240 (cumulative) 100% coverage of PLWHA needing ARV
Availability of Pediatric ARV formulation for children needing ARV	100% coverage	100% coverage	100% coverage	100% coverage	100% coverage

Note: Additional 20 PLWHAs needing ARV are added every year until it reaches 240 PLWHAs. Children needing ARV should be 100% covered.

2)

% increase of families caring for PLWHA members/relatives

Category/ Baseline Data	2006	2007	2008	2009	2010
Baseline on # of families providing care and support	5% of families providing care and support to PLWHA relative	10% of families providing care and support to PLWHA relative	20% of families providing care and support to PLWHA relative	30% of families providing care and support to PLWHA relative	40% of families providing care and support to PLWHA relative

3)

Decrease in the incidence of OIs among PLWHA taking ARVs

Category/ Baseline Data	2006	2007	2008	2009	2010
Monitor OIs among PLWHAs taking ARVs	Baseline research conducted among PLWHAs with OIs taking ARVs	10% decrease from baseline	10% decrease from previous year Review Guidelines on ARV management protocols	10% decrease from previous year	X % decrease from the baseline of PLWHAs with OIs taking ARVs
Treatment of OIs among PLWHAs (eg. TB)	Baseline research conducted among PLWHAs having OIs	10% decrease from baseline	10% decrease from previous year Review Guidelines on OI management protocols	10% decrease from previous year	X % decrease in the incidence of OIs among PLWHAs from the baseline

4)

Enhanced capability of affected families of PLWHAs to provide home- based care

Category/ Baseline Data	2006	2007	2008	2009	2010
Limited Capacity of families providing home based care (HBC) Home Based Care (HBC) training among families Manual developed on HBC	Capacity building among families on HBC	Capacity building among families on HBC in expanded sites	Assess impact of training provided among families	Integrate inputs from the review obtained from HBC	Established networks of families trained on HBC

Opportunities for Treatment, Care and Support to scale up

• In addition to the GFATM Round 3 project which provides ARVs for free, another mechanism to look into is the DOH through Pharma 50 initiative, where drugs are sold at affordable prices. Through this initiative, second-line regimen can be sourced.

• The DOH has allocated PhP 20 million for the procurement of ARVs in 2005. There is a need to lobby for the continued allocation for ARV procurement by the DOH.

• The DSWD and Lunduyan Foundation (NGO) are developing livelihood schemes for PLWHAs.

• Need to look at how the Philippine Health Insurance (Phil Health) can include HIV/AIDS in its health coverage.

• Opportunity for networking and strengthening referral of cases to enhance care and support.

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