This funding application describes the epidemiological situation and country context with regards to HIV/AIDS in Malawi. Urban HIV prevalence in adults is estimated at 17% while the rural prevalence is 9%. 46,000 HIV-related deaths are estimated to have occurred in 2012. In 2011, with support from the Global Fund, Malawi started implementation of its innovative integrated ART/PMTCT guidelines. An estimated 12,600 new infant infections have been prevented by the integrated programme in Malawi in 2012.
Malawi is one of the best examples for true country ownership of its national HIV Programme. This has been possible through the Global Fund’s firm commitment as the key funder for the preventing mother to child transmission (PMTCT) and antiretroviral therapy (ART) programme. This allowed the MOH to develop and implement one set of national guidelines and one standard national M&E system that is used by all sites in the country.
The Malawi HIV program has recorded successes and growth in several key areas which are further detailed in the full document. Key areas of success include:
• The integrated ART/PMTCT approach and the adoption of a CD4 count threshold of 350 for ART eligibility
• Behaviour change interventions
• TB/HIV integration
The main challenge is with respect to the achievement of the HIV Testing and Counselling targets. There were problems with management of the supply of test kits. Mitigating measures to address the supply chain issues include a directive from the Ministry of Health to all facilities to treat HIV test kits as controlled commodities; improved security of pharmaceutical agents and Laboratory reagents through the 3 key system; the on-going reform of Central Medical Stores Trust and improved logistics and stock monitoring system.
The remainder of the report outlines grant performance ratings; relative financial contributions of the grant; analysis of targets; resource needs and gaps for the implementation period; proposed activities for the implementation period; counterpart financing requirements; partnership details; grant risk management; and financial request justification.