Twelve years Eleven million people
TCE
“Only the people can liberate themselves from the AIDS epidemic�
Total Control of the Epidemic
y r o t S E C T e
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Humana People to People
People Turning the Tide Together Reports from around the globe indicate that the tide is beginning to turn in the battle against HIV/AIDS. Governments, corporations, and donor agencies have supported concerted efforts to increase awareness and expand prevention services and access to treatment. While all contributors deserve credit for the gains that have been made, ultimately the people themselves are responsible for these achievements. Though battles have been won, there is still much work to do. Humana People to People’s Total Control of the Epidemic (TCE) program has been organizing individuals and communities in the fight against HIV/ AIDS. TCE is based on the principle that individual action — in addition to the work of governments and civic organizations — is key to stopping the epidemic.
It is a principle that penetrates every action and which is reflected in the corresponding TCE tenet that only the people can liberate themselves from the AIDS epidemic. In the Total Control of the Epidemic, Humana People to People has outlined its TCE program, in which the central theme is the necessary mobilization of the people’s own forces, and in which the central effort rests with the people themselves as the fighting power against the invisible foe. During the last decade, a global community has grown strong, and forces within it have developed around fighting HIV/AIDS. It has been and continues to be a privilege of Humana People to People to be an active participant in this collective effort.
A Systematic Approach TCE educates and mobilizes individuals en masse with a door-to-door campaign that encourages lifestyle changes and preventative behavior. It systematically reaches every individual and household within a prescribed area over a three-year period. TCE subdivides a region into “TCE Areas,� which are circumscribed population units of 100,000 individuals each. TCE Areas are further subdivided into fields of 2,000 individuals. Each field is assigned to a TCE Field Officer, whose job is to inform and counsel every individual in their field. The officers also visit schools, workplaces, and community centers.
TCE rallies empower individuals and reduce stigma.
The Field Officers are the backbone of the TCE program. They are carefully recruited and undergo intensive training that teaches them how to engage individuals in open discussions about HIV/AIDS and sexual behaviors. Field Officers also become skilled counselors, assisting individuals in developing personal risk reduction plans and in guiding them to obtain testing or treatment. The Field Officers are trained in performing HIV testing and become certified by the ministries of health of their respective country.
Passionate Action to Fight the Epidemic
TCE provides in-home testing in areas where access is limited.
Local village volunteers, known as Passionates, are key actors in the TCE effort. These are highly motivated individuals who work to establish support groups, assist communities in creating vegetable gardens for the benefit of HIV affected families, and other activities. Passionates join TCE because they want to do something positive for their own community. Many of the Passionates continue fighting the epidemic in their communities after the TCE program has been completed, bolstering sustainability of the program. The success of the TCE model to fight HIV/AIDS is being extended to other contexts, for example, to improve maternal child health and combat malaria. National governments in Africa have started to recognize the TCE model as a tool to strengthen and scale up their community health worker (CHW) programs, yielding positive results in referrals to care and treatment for hard-to-reach and at-risk populations. TCE has grown into a movement to put an end to AIDS.
TCE unites people in pursuing the fundamental goal of supporting one another and changing behavior to stop the AIDS epidemic.
What About Impact? The TCE Program has demonstrated significant impact, especially with regard to testing and increasing other service uptake. As of this writing, an extensive evaluation of the impact of TCE in a rural district in Zambia is planned to begin later this year under the leadership of the Centers for Disease Control and Prevention (CDC). CDC and its partners (Columbia University in New York and the Center for Infectious Disease Research in Zambia) will measure HIV prevalence and incidence and assess health-seeking behaviors for HIV prevention, care and treatment. Earlier evaluations of the TCE program include a 2010 cross-sectional survey by Human Sciences Research Council of 1,200 TCE beneficiaries in South Africa. An overwhelming 92% of respondents indicated that TCE had made a lasting change in their lives. Moreover, 91% who were HIV negative felt empowered to avoid infection.
Similarly, in 2010 in the Guruve District of Zimbabwe, extensive TCE mobilization led to large increases in demand for expanded voluntary counseling and testing (VCT) services. Before the Guruve program launch, only one local hospital had been providing HIV testing. By the end of the 3-year campaign, 18 local clinics offered testing in response to invigorated demand. Moreover, TCE Field Officers had referred 25,000 people to a clinic, hospital, or to mobile-based HIV counseling and testing (HCT) services. In the same area, TCE increased anti-retroviral therapy (ART) use from 300 to 2,000 individuals by the end of three years. In Malawi, data collected from 11 local clinics in the Zomba Rural District showed that the TCE program helped improve uptake to PMTCT services nearly fourfold. The rate had increased from an initial 370 pregnant mothers attending PMTCT in 2007 (at program start) to nearly 1,500 at the end of three years.
Results from 11 Health Clinics in Malawi Showing the Impact of TCE in 2007-2009
A Growing TCE MOVEMENT SPREADing ACROSS CONTINENTS • 11.3 million people reached with HIV/AIDS information and counseling. • 2 million people referred for HIV testing. • More than 500,000 women educated and mobilized for PMTCT services. • More than 600,000 activists trained and engaged in community mobilization efforts. Public – Private Partnerships TCE is implemented by local member associations of Humana People to People in partnership with government ministries of health and national AIDS councils of the respective countries. The program has been been able to expand its reach thanks to the support of a broad group of businesses, foundations, national governments, UN agencies, and foreign aid agencies. TCE partners include: Johnson & Johnson; the Centers for Disease Control and Prevention; USAID; the World Bank; The Global Fund to Fight AIDS, TB, and Malaria; the U.S. Department of Agriculture; UNICEF; Jhpiego; FHI360; and a range of other partners. Among the many longstanding and enthusiastic The First Lady of Mosupporters of TCE is zambique, who is a strong the Johnson & Johnson proponent of TCE, attends the launch ceremony of Company. Beginning in the Johnson & Johnson 2002, Johnson & Johnson supported TCE Project in Maputo. has supported the expansion of TCE in South Africa and later in Mozambique. In South Africa alone, the company enabled TCE to reach 500,000 individuals in the provinces of Gauteng and Limpopo. The Mozambican TCE initiative is focused on the town of Matola in Maputo Province. Approximately 23,000 individuals now know their HIV status, more than
77,000 individuals have developed a personal HIV risk reduction plan, and more than 3.8 million condoms have been distributed. The program is also being supported by Instituto Criança Nosso Futuro, an institute that assists Mozambican youth and whose chair is the First Lady of Mozambique, Maria da Luz Guebuza.
Former U.S. Secretary of Health and Human Services, Michael O. Leavitt visits the TCE program in Mozambique, which received support under the U.S. President’s Emergency Plan for AIDS Relief.
TCE Coverage China India
Guinea Bissau
Angola 650,000 Botswana 900,000 DRC 300,000 Guinea Bissau 70,000 Malawi 1,000,000 Mozambique 3,230,000 Namibia 1,423,000 South Africa 3,954,000 Zambia 400,000 Zimbabwe 900,000 India China
610,000 350,000
TOTAL
13,787,000
Malawi Mozambique
For more information see www.humana.org or contact: dcinfo@planetaid.org
Humana People to People is a federation that comprises 32 local associations working in 43 countries. Through 470 projects, members of the federation benefit 12 million people annually. From the Zimbabwe global headquarters, Humana People to People provides technical support, supervision, and a wide range of other services, focusing on the development sectors of health, agriculture, education and community development.