2006 Budget for care activities in Cote d'Ivoire: $8,652,490

The Emergency Plan will improve the quality and expand the geographic coverage of HIV counseling and testing (CT) services as well as care and support for orphans and vulnerable children (OVC) and persons living with or affected by HIV/AIDS (PLWHA). Current CT services in Cote d’Ivoire include innovative models but have poor geographic coverage, leaving 98% of the population sero-ignorant. The USG will help the MOH to expand quality CT services to reach more than 125,000 people before March 2007 through two complementary strategies: expansion of integrated CT at public and other health services (including TB, STI and family-planning services and hospitals) and, with matching resources from local government and/or other bodies, support for at least 25 sustainable youth- and couple-friendly CT services in community settings (with expanded access for rural and underserved populations, sex workers and the uniformed services facilitated by mobile and targeted services).

The first strategy will promote the identification of people with advanced HIV disease in urgent need of treatment (including 47% of 18,000 TB cases and more than 50% of 37,000 University Hospital in-patients). The second will build on existing models in Cote d’Ivoire for leveraging of funds to promote sustainability and local ownership. Improved quality will also be a focus, with improved training and supervision tools incorporating couple counseling and expanding human capacity. Coverage of OVC and home-based and palliative care services in the community will be expanded through community follow-up of all HIV-positive individuals identified through CT and care services. New sub-grants schemes coupled with technical and management assistance targeting faith- and community-based organizations will promote expanded service delivery. The USG will explicitly target underserved rural and crisis-afflicted areas. Implementation of national policy and guidelines for palliative care, community care and OVC care will also assist scale-up of quality standardized services. OVC, PLWHA and other beneficiaries will be supported to become effective advocates for required legal and policy reform. The EP will support a pilot regional project to promote and evaluate a network of linked social and health services and community-based services to inform the national roll-out model. The EP will complement HIV and TB funds from the GFATM and assist the MOH to integrate HIV and TB services with the expansion of CT and comprehensive HIV services at all TB sites (to reach 18,000 TB patients annually) and incorporation of TB screening and referral at all CT services.