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PA00X9W9.Pdf 16 PROJECT SUMMARY Project Name: Ending AIDS in West Africa Project (#EAWA); CA No. AID-624-A-17-00004 Life of Project (start and end dates): September 29, 2017 – September 28, 2022 Total Estimated USAID Amount: $16,500,000 Goal: Achieve HIV epidemic control in West Africa by accelerating progress across the region towards Ending AIDS through prevention, care and treatment, and accelerating of achievement of UNAIDS 90-90-90 targets with a focus on Key Populations and PLHIV Project Objectives: • Improve service delivery at community and health facility level • Strengthen the viral load laboratory system • Strengthen the monitoring and evaluation system Prime Awardee: FHI 360 Project sub-awardees for FY20: – 25 health facilities (20 DSD and 5 TA – SDI sites) in Togo – 17 health facilities (DSD sites) in Burkina Faso Submission of Report Date: October 30, 2020 ii TABLE OF CONTENTS TABLE OF CONTENTS....................................................................................................................... iii LIST OF ACRONYMS.......................................................................................................................... iv Section 1. Summary ............................................................................................................................ 5 Section 2. Description of main results achieved ........................................................................... 10 Description of results achieved under the service delivery component ................................ 10 HIV Prevention achievements .................................................................................................. 10 HIV testing, linkage and ART initiation.................................................................................... 14 Retention on ART and viral load suppression ....................................................................... 28 Full cascade of prevention, care and treatment ..................................................................... 36 Description of results achieved under the KPIF project ........................................................... 38 Implementation of the Environmental Monitoring and Mitigation Plan (EMMP) .................... 41 Protecting Life in Global Health Assistance (PLGHA) .............................................................. 41 Section 3. Discussion of challenges to implementation .............................................................. 42 Monitoring of key assumptions................................................................................................ 43 Section 4. Activities planned for next quarter .............................................................................. 44 Section 5. Financial brief .................................................................................................................. 45 1-Obligated amount ................................................................................................................... 45 2- Expenditures for Q4 FY20 and Cumulative Expenditures ................................................ 45 3- Subgrantees Disbursements (Q4 FY2020) and cumulative ........................................... 45 4- Next Quarter Projections (Q1 FY2021) ............................................................................. 45 5- Next Quarter Subgrantees Planned Disbursement (Q1 FY2021) ..................................... 45 Section 6. Summary of FY20 annual achievements ...................................................................... 46 Annual achievements on core indicators ............................................................................... 46 Trend of key indicators over the four quarters of FY20 ........................................................ 47 iii LIST OF ACRONYMS ART Antiretroviral Therapy CCM Country Coordinating Mechanism COPCT Continuum of Prevention, Care and Treatment CSO Civil Society Organization DIC Drop-in Center EPOA Enhanced Peer Outreach Approach FHI 360 Family Health International FSW Female Sex Worker GBV Gender-Based Violence GFATM Global Fund to Fight AIDS, Tuberculosis and Malaria HIP High Impact Practice HTC HIV Testing and Counseling IPs Implementing Partners KP Key Populations KPIF Key Populations Investment Fund M&E Monitoring and Evaluation MoH Ministry of Health MSM Men Who Have Sex with Men NAC National Commission for the Fight against HIV/AIDS NGO Non-Governmental Organization PE Peer Educator PEPFAR The US President Emergency Plan for AIDS Relief PLHIV People Living with HIV PMP Performance Monitoring Plan PSSLS Programme Sectoriel Santé de Lutte contre le Sida et les IST RHO Regional Health Office RNR Risk Network Referral ROP Regional Operational Plan SBCC Strategic Behavior Change Communication SOP Standard Operating Procedures STI Sexually Transmitted Infections TA Technical Assistance UNAIDS Joint United Nations Program on HIV/AIDS USAID United States Agency for International Development USG United States Government VLS Viral Load Suppression iv Section 1. Summary The Ending Aids in West Africa (#EAWA) project is a five-year cooperative agreement between the United States Agency for International Development West Africa Mission (USAID/WA) and Family Health International (FHI 360). #EAWA was initiated with the goal of accelerating progress across the region towards Ending AIDS in West Africa through prevention, care and treatment, focusing on Key Populations to accelerate the achievement of UNAIDS 90-90-90 targets. From the second year of implementation of the #EAWA project (FY19), the US President Emergency Plan for AIDS Relief (PEPFAR), the main source of funding of #EAWA, undertook a major shift in programming in some West African countries. Because Togo and Burkina Faso have demonstrated the greatest progress nationally on the HIV clinical cascade, the PEPFAR West Africa Regional Operational Plan (ROP) 19, allocated additional funding to accelerate progress towards achieving the UNAIDS 95-95-95 goals. This funding was awarded through the Game Changer Fund to support the intensification of case finding strategies, linkage to care and retention, and viral load suppression (VLS), thus significantly improving their HIV/AIDS clinical cascades in two years (FY20 and FY21). With the Game changer funds, the project will go beyond KP programing and will target also general population. Therefore, the goal of #EAWA has evolved to: “achieve HIV epidemic control in West Africa by accelerating progress across the region towards Ending AIDS through prevention, care and treatment, and accelerating the achievement of UNAIDS 95-95-95 targets with a focus on Key Populations and PLHIV”. In this context, #EAWA oversees three components of the Game Changer strategy: (i) the service delivery component, (ii) the viral load laboratory system strengthening component, and (iii) the monitoring and evaluation component. With the service delivery component of the Game Changer funds, PEPFAR aims to reach nationally the first and second 90 in FY20 in Burkina Faso and Togo, and achieve the third 90 in FY21 through direct service delivery, with a targeted focus on the highest burden sites for PLHIV and KP (Centre, Hauts Bassins, and Centre Ouest Regions in Burkina Faso; Lomé Commune, Maritime, and Plateaux Regions in Togo), and with technical assistance to other sites. The Key Population (KP) program is also supported by the two-year (FY20/FY21) Key Populations Investment Fund (KPIF) via the Meeting Targets and Maintaining Epidemic Control (EpiC) project that is also led by FHI 360. This progress report depicts achievements and activities conducted during the fourth quarter of year 3 - period of July 1 to September 30, 2020 as part of the implementation of the #EAWA project. This report highlights also the achievements of the fourth quarter of implementation of the Game Changer Funds. It also highlights key achievements made over fiscal year 2020 – covering October 2019 to September 2020. Summary of achievements on Key indicators • HIV prevention, testing, ART initiation, retention, and viral load suppression cascade During the fourth quarter of the fiscal year 2020, July 1 to September 30, 2020, a total of 8,221 individual key populations (3,851 MSM and 4,370 FSW) were reached with prevention interventions in both Togo (4,844) and Burkina Faso (3,377). 46,694 individuals (including 6,634 KPs) were tested for HIV and received their test results. Among those who received an HIV test, 5,142 individuals 5 (including 622 KPs) were newly diagnosed HIV positive (11% case finding). Among individuals newly diagnosed HIV positive, 4,957 (including 595 KPS) were newly enrolled on ART in the course of the quarter (96.4% ART linkage rate). The ART linkage rate in the two implementing countries is 96.4% (96.1% in Togo and 97.6% in Burkina Faso). The ART linkage rate is higher among female than male (96.9% vs 94.7% in Togo and 98.2% vs 96.1% in Burkina Faso). The table 1 below provides an overview of the cascade from the HIV testing to the viral load suppression in both countries during this quarter. Table 1: Overview of the cascade of COPCT in Q4/FY20 HTS_TST HTS_TST_POS TX_NEW TX_CURR VL VL suppressed (yield) (%ART linkage) documented (TX_PVLS) Togo 36,439 3,988 (10.9%) 3,831 (96.1%) 32,808 13,531 11,186 (82.7%) Female 20,438 2,487 (12.2%) 2,409 (96.9%) 23,007 9,775 8,163 (83.5%) Male 16,001 1,501 (9.4%) 1,422 (94.7%) 9,801 3,756 3,023 (80.5%) Burkina Faso 10,255 1,154 (11.3%) 1,126 (97.6%) 25,483 2,015 1,562
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