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Rationale

The Deparntren'' o, Healtli tooi; thc- i-raci ii-. e:rat*lisiiir-ig the l.-atirna, liiiS Preve::iic:: aq:, Ccnrrci Prcgrari: ir: i99E in respo:-'r'r to tl)* efterging hree"t of rho gici:a, AIDS panienic. ::1994. )OFI integrated its STI prograin v.,i:i, ti:t-- NAFC. r,'hic'; lrac b*er, l:noru: as i',*ionr.

AIDS STI Prevention and Control Proglarr O* aSIrCPi. NASPCP is under the Infectious Disease Ctf,ct of tire Nationai Centei fbr Disease Prevention and Conkol (NCDPC)" A Program Manager is riesignated, supeii iseC b1, iire Directors of IDC (Director III) ald NCDPC (Director I\/).

Presently the NASPCP has its distinct roie of technical lea<iership in the STIIFII\,'/AIDS ,"ipo*r. in the health sector, u.'herein it provides poiicl, guidance, tecir:ical assistance. capacitv Suiliing and other resource augmentation as well as monitoring and evaiuation r.r,ithin the ambit of the health care system.

NASPCP has coordinative roie in other healtir proâ&#x201A;Źrams of the DCI{ (AO on RI{i anC ilitiatiyes. such as maternai and child health" famii5'pianning. adoiescent RF{, blood safetl' snd uni'ersal STi/TIW/AIDS.

In 1995- DOI{ tkough the Hospital Management Office anci the NASPCp enacted the poiic3,. guidelines on the creation of HIV AIDS Core Team as the focal point for aii FIIV related s..ric"s in hospital setting, which is currently the platform for HIV counseling and testing, treatment of opporfunistic infection, universal precaution and infection conkol, psychosocial support to people living with HW and AIDS and clinical management of AIDS Urrl"gi, pro'ision-of anti retro-viral drugs.

The Philippines has identified HIV and AIDS as one of the priority public health programs in cognizant of the country's commitment to the Millennium Development Goais ty zbrO"grrroCl and the United National General Assembly Special Session on IIIVand AiDS (L[.IGASS).

TE ITASCP supports and contributes to the attainment of goals and objectives of the Fifth AIDS Medium Term Plan 2011-2016 (AMTP5), objectives and rir"t.gi" ;hr;;;.-

ro;.

STI/i{IV/AIDS in the heatth sector, which is also refiected in the Philippine healtl sector plan * National Objectives for Heaith 20ll-2016.

Sce

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ler,'e.. Overali crrerali nat nationai a-*rii'- il\j erir':raic in the oouiill\- i.i categorizec a*q iorn' leve,. (oi spec:;ici'-5' ; popuiation (..:i9,i) generai the among prer.alence leriains &t ress titar. one

The

i{Iv

b.OlStor'.; in 2007. Flowever. receni passive reports of lil\r infection q,ithin the icientifiec ll:os'. at -risk popuiation showed arr expanrirng and steadil5'i.ncrsasing trencis particuiarif it t*e iasl five years. In December 2011, th.ere 'werc 268 new HIY posiuve individuals confiiireci and reporred to the HW and AIDS Registn'. Tnis was 54a/t higber compared to the same perici 'ast year (n:174 in 2010). This increasei tire total number of cases to 2,349 for 2011. h4os" cithe cases (94Ya) were males. The median age was 27 years (age range: 16-59 years). The 20-29 t,eur (62%) age-group had the most number of cases. Forty-eight percent (128) of the reported oases were from the Nationai Capitd, R-egion (I.JCR) (NEC AIDS Registry December 2?lr.

The steep increase in cases reported results can be conhibuted in the combination of yarious fbctors including acceptability and avaiiability of HW counseiing and testing selices, irnproved surveillance system, enabling environmenr, intensified health promotion campaigns, and persistence of risk-taking behaviors of most-at-risk populations. However, STI including i{tV are highly stigmatized health conditions, majority of the infected remain undiagnosed, underheateC and unconsciously transmitting the infections to their sexual parhrers.

HI.

Vt/hat are the Interventions/Strategies emplol,ed DOH

otr

implemented by

Anchored on the Philippine AIDS Prevention and Control Act of 1998 (RA 8504), the Phiiippine National AIDS Council (PNAC) as the primary policy-making and coordinating body will launches the 5th AIDS Medium Term Plan (AMTP-V) 201 I - zArc. The plan aims for further reduction of new infections among most-at -risk population and the rnrlnerable popuiation and provicle comprehensive prevention, treatment and care services to infected and affected individuals The Department of Health as part of the PNAC contributes to the PNAC goals and based on the best available evidence, NASPCP have adapted the global (WHO) strategic d,irections and priority interventions and recommendations applicable to the context of epidemic in the country:

1.

.

Expanding HIV counseling and testing Enabling peopie to know their HIV status especially those who are exposed to gnsafe behaviors that have HIV risks is the key to expanding access to HiV prevention, treatrnent and care.

To attain this interventions/strategies implemented by IDO-NASPCP are: o fuaplementation of Voluntary, HIV Counselin-s and Testing (HCT)

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o

Implementation of Iiospirar Ssltings

c FII\i pr*fitieee'

trainings

ard Testing ai

for rce{iicai rc;hnologists rn:iuding

ta:-,

STI/Fii\

counseling *

Mrsc i *,ti z i rz g pr ev e.Ni i o tt the progrim airns to i::rplement prevention w a *irde range ilf a*tivitieE furvo:-*ring health proph,vlactic an* otUer secto$, compiimerited-witli ihe availai:iliq'and access to essrntiai to Chfld mother preveni to clean needies, and ART :;nrmodities like "o*do*r, transmission of i{fii. HIV prevention should not oniY cover the un-infected but also those cuffentty iiving with i{rv. pLHtrV should be empowered to avaid unintended, inadvertent HIV transmission to their significant others. Thus, tire program hopes to attain tirru tire following interventions.,' stiategies : o $a% Conoom use Program (cuP) for Fligtr Risl: Grou:rs - a strateg), composeri of iocal legislation on 1A09o ai'aiiabilif' in ali entenainmeirt estabiishments, organizatioti of snls6ainment estabiisirment o\4'nels anc

c

rvorkers. communiX,' empo\remlent. monitoring Partnersiripslprofessionai support u'ith NGCs

o o o o

Comrnunication fbr Most-Ar-Risk-Popuiation . Behavior Change Comrnunication . HIV Counseling anci Testing " STi Management r Peer Sciucation 'r" "'Condom anri.self-protection measures (c/o NGO) STI D*g augrnentation for Sociai i{;,giene Ciinics Comprehensive STI Case fuIanagement (S.vndromic management of STI,I Prevention of Mother-to-Child Transmission of HfV Post-exposure Prophl'laxis for Heaith Care Workers

on Behar{or

Chanse

3. Scaling-up

treatment, care and support For infarrts, children or adults living u,i1[ I{IV. a comprehensive package of prevention, treatment and care interventions should be made available. Early referral aftel ifIV diagnosis is essential including especially pregnant wornen to prevent IviTCT.

To attain this program interventions/ strategies implemented are: o Provision of GOP/Global Fund procured Anti-Retrovirals (First-line and selected second-line regimen drugs) and Drugs f6l Opporlunisiic Infections o implementation of lnteprated h4anagement of Pediatric HIV incluCing provision of ARV

4.

Inttesting in Strategic Information

Tire foliowing are ke1, informaticur that guides health policy, pianning. allor,:,-ition, programme ma.il?.gemen1., service delivery and accountability: ..t" Surveillance of HI\r and scp.rally 1121i56itted infections;

resolllcc)

dd

lt4cni:nring and evaliraticn (inclu<jing patier|- monitrdn;,. preventiol anc assesrrlefi of HIV drug resistance, ano phartnaccvigiianoe); Cperntions anC Formative Researches

5.

ffealtr; Iitsrem S:rengthintng-

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cieilnes a healtir s5'stem as "the sum total of aii the orga::izations, pecpie a:rd actions ra.hose primary intent is to promote. resiore or maietain health." A countr--'s health systern embraces those who try to influence the determinants of health, as weli as th ,-e who deliver heaith-improving services. So <iefined, a health system is more than the pyramid of facilities owned by government, private business and NGCs, and of the health workers and support personnel who staff those faciiities. It inciudes a mother caring for an HfV-infected child at home; peer eduoators u,&o deliver behavior change conununications; organizations run b,v and for sex workers that, distribute preventive literature and condoms; health insurance providers; legislators who adopt health and safety and antidiscrimination laws; those who enforce the laws; and so on.

.

o o

ry.

' Advocacy for Institutionalization of Local AIDS Counciis Training of Regional Assistance Team (CHD, DILG and DSWD Regional Focal Persons) to provide assistance of LGU in setting/sustaining Local AIDS Councils

Status ofimplementation/accomplishment .HCT in place in major DOH and selected LGU hospitals 'HCT in 50 Social Hygiene Clinics (specialized. clinics

for

STi services in highly urbanized cities ' Trained MT on HIV proficiency from 50 Social Hygiene Clinics and seiected hospitals nationwide o100Yo CUP in Angeles City, and other LGUs "Institutionalized Extemal Assurance Quality System for STI HIV testing centers by

].TRL-SACCL in pregnancy and syphilis screening to selected LGUs sHC oDissemination and Publication of STI Management during pregnancy o

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.Developed lnformai network of sex worker Supported Operations Research for MSM on STI and HW 'Trained 27 Master Trainers on HIV counseling and resting r HiV-TB collaboration currently implemented Cnrrently there are 1,992 People Living with HIV on free ARV (anti-retrovirais) as of December 2011 oFunctional referraunetrvorking system of treatment hubs with o

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United $lester gi52vas inc.. Crossbreeds. Cebu Ptus, {ida ani Mindanao" Advo caie'.. c Bahal' Lingap - Iialf-r,*a;r' home for PLI{\r ir-. San Lazato Hospitz'l c Extended Chfrd Care - Da1, g*. center for ciriidren of patients ra,:ih ciircnic debiiitating disorders (TB, AIDS) hospitalized at San Lazarc Hospitai *Liveiihood Programs of DLHI\/ (SLH and DS\\D) cPrevention of AR\r Drug Resistance thlough AR\i Adherence Monitoring r Palliative Care in the Facilitr'.Levei * Arrailment of Philltrea"trtir Cui-Fatient EII v- and AIDS Tieatment Package *Provision of ART in 16 Treatment Hubs for I{IV i. San Lazaro Hospitai 2. Research lnstitute of T:opical Medicine 3. Philippine General Hospital; 4. Ilocos Training and Regional Medical Center 5. Vicente Sotto Memorial ivledical Center 6. Southern Philippines Medicai Center 7. Baguio Generai Hospital and Medical Center 8. Bicol Regional Training and Teaching Hospital 9. Western Visayas Medicai Center 10. Corazon Locsin Montelibano N4emoriai Regional Hospital 11. Zamboanga City Medicai Center 12. Jose B. Lingad Medical Center 13. Cagayan Valle"v Medical Center

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.

Care anc S*ppcn

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-:1 4. -The,Medical-Cit5r 15. Makati Medical Center

16. Gov. Celestino Gallares Memorial Hospital Provision of augmentation OI and STI drugs thru CHDs

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Plan/Action

NOH for HIV/STVAIDS Strategic Plan Tatrle Overall Goal: Reduce new STI and TfIV infections by 50% among the most-at-risk and vulnerable & population by 2016 Strategic Indicator Data Source Latest traseline Target Obiective

Maintain HIV Prevalence of IHBSS prevalence of HIV among SW NEC

less than

1%

2OO9

0.57%

2OO9

TBD

<1.AYo

and MSM

amons MARP

Contain i{fv Prevalence among PWID

HI\T PWID

of IHBSS

among

NEC

Maintain HIV prevalence

among PWID from baseline

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f.\. ;,h1* ,

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l:loidence gcnococcai

oi

SSESS 2OO

lL.!:Lta

5C%

r:ouctic:-

SSESS 2OO9

1.2.6'

:',0-vc

le

infectioa .among risk males Ineidencebf NGi among at risi: at

.

l. ir-

females

Prevert Congenitai Syphilis

%

preguan:

women

Progran: Daia TB}

9}aia

2009

diagnosed with Syphilis receiving Penicillin treatrnent

Improve quaiify 3-year survival ProgSam Data 82% of life of PLHI\/ rate of PLHIV on 20a9 ART Reduce Pediakic Infection Rate of Program Data infants born to 2049 HW Strengthen

% priority LGU

community systems for STI

impiementing 1OO% CUP

Prograrn Data 2047

Prepared by:

JOSE GERARD B. BELIMAC, MD, MPH NAPSCP Program Manager

At least

807c

TBD

Reduced by 8A%

t0%

80%

;