COMPASS 2.0
About COMPASS 2.0
Throughout the course of the AIDS response, vibrant advocacy and activism have driven solutions to the pandemic by focusing on accountability, making sure that power, funds and policies work for people living with and at risk for HIV. As the HIV response has matured, data/evidence-informed decision-making has become a primary driver for the programmatic response. Access to and analysis of the data behind these decisions has been limited for civil society activists and advocates; at the same time, in East and Southern African countries, as in other regions, civil society organizations have been enlisted as partners by the very funders and programs they must hold accountable, increasing the risks they face when they speak out as activists.
For the past years, the Coalition to build Momentum, Power, Activism, Strategy and Solidarity (COMPASS) Africa has confronted these realities head on with bold, well-resourced, coalition-based, data-informed advocacy and activism. COMPASS combines country-based coalitions of civil society groups in Malawi, Tanzania and Zimbabwe with seasoned advocacy partners in the global North. Connected through a unique structure of strategic planning, real-time support and coordinated advocacy and activism, COMPASS partners have worked together to gather, analyze and use evidence and data to drive strategic advocacy campaigns and change policy and programs in the coalition focus countries and beyond.
Over the last year, coalition partners continued their bold, impact-driven advocacy and shifted the coalition to African leadership.
Outcomes
- Improved development, adoption, implementation and evaluation of laws and policies
- Increased allocation and/or improved use of HIV-specific human, financial and technical resources.
- Improved country, regional and global pandemic preparedness responses to mitigate the impact on HIV progress.
- Sustained and evolved coalition that sets the standard for transnational coalition-based, Africa-led activism.
Results and Impact
Domestic Resource Mobilisation / National Financing
- Government of Tanzania increased the HIV/AIDS-related vertical budget allocation from 0.2% in 2022/23 to 4.5% in 2023/2024, in line with Sikika’s campaign targets; this includes the domestically financed AIDS Trust Fund (ATF). In 2023/2024, there was an 88% increase in allocation to the ATF directly from the national government's budget. The President of Tanzania also signed the Health Insurance Bill in November 2023, making health insurance mandatory for all citizens, a move that aligns with Sikika's advocacy for strengthened domestic financing mechanisms in health care to achieve UHC. The government committed to use domestic resources to subsidize health insurance for approximately 26% of the population who cannot afford it.
Key Populations
- KVPF and GABINET influenced the establishment of the Crisis Prevention and Response mechanism (also known as Violence Prevention and Response) in Tanzania to enhance the quality of HIV and related health services for KVPs by timely addressing violence facing KVPs and other related structural barriers at their localities to ensure access to services without stigma and discrimination. The mechanism is funded by PEPFAR ($1.2M) and the Global Fund ($500,000) to be implemented in 20 regions (12 PEPFAR supported, and 8 GF supported) with KVP programs.
- TaNPUD’s advocacy to increase availability of harm reduction services in Tanzania, including in prisons, contributed to GFATM’s commitment to scale up harm reduction services during GC7. 10 CSOs in 10 regions will be funded to implement the Needle and Syringe Program (NSP) scale up and 9 CSOs to implement Medical Assisted Therapy (MAT) services. GF approved more than $5M to harm reduction services scale up. Government under Drug Control and Enforcement Agency (DCEA) committed to scale up MAT services including in Prisons settings. Already, the establishment of MAT services in Ruanda prison in Mbeya and construction of MAT facility in Chalinze and Muheza is underway. The construction is expected to be complete during the next GF implementation cycle of 2023 to 2026.
Community Led Monitoring
- NACOPHA through its secretariat role to administer the national Community Led Monitoring program motivated the government to integrate CLM into Tanzania’s five-year Health Sector HIV Strategic Plan V 2021-2026 and the National Multisectoral Strategic Framework V 2021-2026. NACOPHA has facilitated a joint coordination structure and action plan which includes a central repository for national CLM data.
Differentiated Service Delivery
- BHASO advocated for the increased availability and accessibility of DSD models with stakeholders, including local and national governments, PEPFAR implementing partners and civil society. Ministry of Health and Childcare through the Care and Treatment Performance- Strategic Information report (June 2023) has noted an increase in patient DSD coverage from 41% in 2022 to 47% (472,104) in 2023.
SRH/HIV integration, AGYW
- 2FG advocated for increased access to HIV and SRH services for homeless youth and street children among PEPFAR and Global Fund funding priorities. The Global Fund prioritized Children and Youth Living and Working in the Streets (CYLWS) as a priority population in the GC7 national HIV response. PEPFAR also committed to including children living and working on the streets as priority populations targeted through the DREAMS program, while adolescent girls and young women (AGYW) living and working on the streets will be reached through the PEPFAR OVC program.
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My Age advocated for the inclusion of young people with disabilities in HIV, SRH, TB, and COVID-19 guidelines and monitoring frameworks, resulting in disability indicators being included in key national systems:
- Zimbabwe National Family Planning Council Monitoring and Evaluation systems, enabling tracking of progress, gaps, and challenges in Sexual Reproductive Health and Rights for persons with disabilities, including AGYW.
- The Ministry of Health and Child Care, through the Permanent Secretary, committed to include disability-responsive indicators in DHIS2 to strengthen data availability and evidence for policy, resource allocation, and programming decisions.
- The National AIDS Council, through the National Monitoring and Evaluation Director, committed to include disability indicators in the National Core Output Indicator framework for the HIV and AIDS response, targeting AGYW as a priority population.
Human Resources for Health
- Ministry of Health (MoH) deployed Health Workers to six regions through National Health Workforce and Volunteerism Guideline (NHWVG) at Primary Health Care Facilities that was the center piece of BMF’s campaign. GoT released 8,070 Government Human Resource for Health (HRH) Work Permits that contributed to 2% reduction of the overall HRH gap. GoT has mainstream BMF supported Volunteers as full-time employees. 1,318 health volunteers were allocated to regional referral hospitals in 21 regions. Local Government Authorities (LGAs) are allocating budgeting for their Comprehensive Council Health Plans to deploy health care workers through NHWVG. The Government has established the Human Resource for Health Information System (HRHIS) dashboard to track the national progress in a coordinated and structured manner.
People Living with HIV/ Advanced HIV Disease PLHIV/AHD
- Ministry of Health and Childcare in partnership with ZNNP+ capacitated a total of 654 health facilities out of 1706 on Advanced HIV Disease Management. In the process health practitioners and community cadres were trained to screen for AHD. PEPFAR and Global Fund committed resources to facilitate provision of AHD Management services in GF and PEPFAR supported districts.
