PROGRAM REPORT FORM General: A report describing progress made in implementing the activity should be prepared at the mid- point of the activity on this form. The report should contain the information as requested in Parts I through IV in this form. PART I. COVER SHEET This cover sheet is self-explanatory as it contains much of the same information found in the Proposal form and must be signed by the responsible officer. Implementing Area 14 Provinces for MSM-TG, (Province): 4 Provinces for MSW, 1 Province for FSW, 7 Provinces for MW, and 12 Provinces for PWID Program Title: Stop TB and AIDS through RTTR (STAR) Grant Number: THA-C-RTF Disease: TB/HIV principle-recipient: Raks Thai Foundation Grant Funds: Grant Signed Amount Up to the amount of US$22,278,214 (Twenty-Two Million Two Hundred Seventy-Eight Thousand Two Hundred and Fourteen US Dollar) or its equivalent in other currencies. Report Period From: 1 April 2017 Report Period To: 31 December 2017 Date Report 5 April 2018 Submitted: Signature of Responsible officer / person for the program: Signature: …………………………………………… Name: Mr. Promboon Panitchpakdi Title: Executive Director Address: 185 Soi Pradipat 6, Pradipat Rd., Samsennai, Phayathai, Bangkok 10400, Thailand Tel.: +66 (0) 2265 6888 Ext. 30 Fax: +66) (0) 2271 4467 E-mail: [email protected] Signature of Chief Financial officer / Person Signature: ………………………………………… Name: Ms. Supaluk Chumkrom Title: Director of Finance and Administration Address: 185 Soi Pradipat 6, Pradipat Rd., Samsennai, Phayathai, Bangkok 10400, Thailand Tel.: +66 (0) 2265 6888 Ext. 20 Fax: +66) (0) 2271 4467 E-mail: [email protected] EN Version 1 20 July 2015 Page 1 Raks Thai Foundation PART II. PROGRAM SUMMARY: [The summary should not exceed two pages in length and should be treated as a self-contained document that can stand alone, without having to refer to any other document. It should include briefly program background, objectives, and planned-activities, accomplishments as of this reporting date, and summary table of target coverage in this report date.] A. Program Background The HIV epidemic in Thailand has peaked and has been rapidly declining since 1992. AIDS related deaths have declined sharply since 2006, as a result of the scale up of ART. IBBS results and AEM trends in new infections have indicated that HIV prevalence is maintained at a low rate (2%) among venue-based female sex workers with decreasing numbers of new infection; still high (7-12%) among MSM/MSW with increasing numbers of infections; and stable but high (25%) among PWID with stable number of new infections. By the end of 2013, an estimated 451,258 people live with HIV in Thailand and 245,306 people have received ART. High prevalence is shown among PWID (over 20%) and MSM (8-25%) during the last five years. 90% of new adult HIV infections were transmitted through unsafe sex and 10% resulted from unsafe injecting drug use practice. For TB, there has been a further decline in associated mortality, prevalence and incidence over the last five years. A prevalence survey was conducted in 2012-2013, but the final results are still not available. An external program review in 2013 identified several issues including: 1) low case notification among at- risk groups; 2) inefficient reporting and surveillance systems; 3) inadequate treatment outcomes; 4) lack of suitable care for migrants in need. Under the Stop TB and AIDS through RTTR (STAR) program, there are two Principal Recipients (PRs) with a dual track financing scheme- the Department of Disease Control (DDC) as the government PR and the Raks Thai Foundation (RTF) as the civil society PR. PR DDC is primarily responsible for managing program implemented by government agencies and Sub Recipient World Vision Foundation Thailand (SR WVFT). Hence, PR DDC is accountable for the health system and for all activities on TB as well as activities for the migrant populations in Bangkok and Kanchanaburi. PR RTF focused on activities provided by civil society and direct implementation with Key Affected Populations (KAP) under the HIV component and on intensified case finding (ICF) for migrants. A.1 Program Goal and Objectives Program Goal The program goal is to end AIDS in Thailand by 2030 (reducing annual new infections to below 1,000 cases (from the current 8,134 estimated new infections annually)) and to reduce the prevalence of TB from 159 per 100,000 to 120 per 100,000 between 2015 and 2019. Program Objectives 1. To prevent the transmission of HIV and TB by sustaining intensive behaviour change activities, appropriate use of prophylaxis and the strategic use of anti-retroviral drugs. 2. Actively find HIV and TB cases in the community and health care settings by recruiting ‘at risk’ and ‘vulnerable populations’ into HIV testing and TB screening. 3. To ensure early and accurate diagnosis of both diseases by improving diagnostic capability, and reducing turn-around time (by using rapid HIV testing and molecular diagnostic techniques for TB) 4. To provide early treatment and ensure retention in care for all those diagnosed with HIV and/or TB. 5. To foster collaborative activities across HIV and TB programs at national and sub-national levels, and ensure sustainability by strengthening linkages between community and health systems. 6. To normalize HIV/TB and reduce stigma and discrimination. EN Version 1 20 July 2015 Page 2 Raks Thai Foundation A.2 Program Implementation Area The STAR program is based on the national RRTTR (Reach- Recruit-Test- Treat- Retain) approach, aimed at optimizing network approaches and delivery models for increasing the uptake of services. STAR focused on the 38 highest HIV and TB disease burden provinces in Thailand. PR RTF provided strong community-based prevention and outreach, especially for HIV and TB prevention in 25 provinces. The PR RTF actively supported community system strengthening as an attempt to maintain sustainability of service provide to KAPs. Additionally, the PR RTF supported building mechanisms that reduce stigma and discrimination at all levels from KAPs to health service providers and policy makers. Under PR RTF the services were provided to five target groups of Key Affected Populations (KAPs) as: 1. Men who have Sex with Men (MSM) and Transgender (TG), 2. Male Sex Worker (MSW), 3. Female Sex Worker (FSW), 4. People Who Injected Drugs (PWID), and 5. Migrant Workers (MW) Table A.2.1: STAR Program Implementation Area No. Province Region SR MSM/TG MSW FSW PWID MW-HIV MW-TB 1 Bangkok (BK) C RSAT SWING SWING OZONE WVFT under PR DDC RTF 2 Nonthaburi (NB) C RSAT 3 Pathum Thani (PA) C RSAT WVFT under PR DDC 4 Samut Prakarn (SP) C RSAT RTF RTF 5 Chonburi (CB) E RSAT SWING FAR 6 Trat (TT) E RTF 7 Rayong (RY) E FAR Kanchanaburi (KB) C PTR under PR DDC 8 Samut Sakhon (SA) C RTF 9 Nakhon Ratchasima (NA) NE B-FRIEND 10 Khon Kaen (KK) NE M-Reach 11 Udon Thani (UD) NE M-Friend 12 Ubon Ratchathani (UB) NE RSAT 13 Tak (TK) N OZONE WVFT under PR DDC 14 Chiang Rai (CR) N OZONE 15 Chiang Mai (CM) N M-PLUS M-PLUS TDN MAP CAREMAT CAREMAT OZONE 15 Chiang Mai (CM) N MPLUS MPLUS extended to Lampoon CAREMAT CAREMAT 16 Nakhon Si Thammarat S M-MOON (NS) 17 Phuket (PK) S RAPG RAPG WVFT under PR DDC Ranong (RN) S WVFT under PR DDC 18 Surat Thani (SR) S RTF 19 Trang (TR) S TDN 20 Narathiwat (NW) S OZONE 21 Pattani (PT) S OZONE 22 Phatthalung (PL) S TDN 23 Yala (YL) S OZONE 24 Satun (ST) S TDN 25 Songkhla (SK) S RSAT OZONE STM Total Provinces 14 4 1 12 13 7 provinces under PR RTF 6 provinces under PR DDC Remarks: N=North, NE = Northeast, C = Central, E = East, S = South EN Version 1 20 July 2015 Page 3 Raks Thai Foundation The implementing agencies shown in Table 1 include the following organizations: Sub-recipients 1) Rainbow Sky Association of Thailand (RSAT) 2) Boyfriend Korat Group (BFK/B-FRIEND) through Nakhon Ratchasima Provincial Health Office (NA PHO) 3) M-Reach Group (MR/M-REACH) 4) M- Friend Group (MFU/M-FRIEND) 5) MPLUS Foundation (MPLUS/M-PLUS) 6) CAREMAT 7) M-Moon Network (MMN/M-MOON), terminated on 20 December 2017 8) Rung Andaman Phuket Group (RAPG), terminated on 31 October 2017 9) Service Workers in Group Foundation (SWING) 10) O-Zone Foundation (OZONE) 11) Thai Drug Users’ Network (TDN) 12) Foundation for AIDS Rights (FAR) 13) MAP Foundation for the Health and Knowledge of Ethnic Labour (MAP) 14) Stella Maris Seafarers Center Songkhla (STM) Technical Assistant (TA) 1) Thai National AIDS Foundation (TNAF) A.3 Key activities of Principle recipient and Sub-recipients In this report, PR RTF separates program results into the following three reporting periods: ñ Six months from 1 April 2016 to 30 September 2016, ñ Twelve months from 1 October 2016 to 30 September 2017, ñ Three months from 1 October 2017 to 31 December 2017 STAR program achieved the key activities listed as follows: 1) Outreach activities and VCCT uptake for KAPs: ñ HIV outreach activities and testing for Key Affected Populations (KAPs) in the 25 provinces and TB performance in 7 provinces under PR RTF are shown in the table below. PR RTF’s performance is demonstrated in table A.3.1aFor reach and test of KPs in the six-month period of 1 April 2017 to 30 September 2017, PR RTF shares around 40% of total test target under the STAR program. These are the number of tested persons who received VCCT at a mobile clinic or HIV Testing Centre (HTC).