Sustaining the Momentum: The March Towards Universal Access to HIV and AIDS Services in Tanzania 1. Background and Summary:    The primary goal of this Program is to reinforce the Government of Tanzania’s response to the HIV/AIDS epidemic by expanding service delivery to the lower tiers of the health system. Attaining this goal requires financing recurring costs, such as Health Products and consumables, as well as supporting activities that maintain and strengthen the system in place, such as refresher training for community health workers, supervision and mentoring. Experience with previous Global Fund grants has highlighted the need for greater coordination among relevant stakeholders.  Accordingly, this grant will support the scale up of HIV/AIDS services by strengthening capacity and coordination among key stakeholders in the public and private sectors, including: Civil Society Organizations (CSOs), Faith-based Organizations (FBOs), People Living with HIV/AIDS (PLHA) groups, as well as the Tanzania Commission for AIDS (TACAIDS), the national coordination body for Tanzania’s multi-sectoral HIV/AIDS programming.  Tanzania faces an urgent need for drugs and commodities for the delivery of HIV/AIDS services. The scale-up of the national anti-retroviral therapy (ART) program has resulted in a seven-fold increase in the number of patients enrolled in treatment, from 23,951 in 2005 to 189,494 in October 2008.  Funding for commodities that are key to the delivery of key services such as HIV testing, Sexually Transmitted Infection (STI) management, Prevention of Mother to Child Transmission (PMTCT), ART, Opportunistic Infection (OI) treatment and prophylaxis, and early infant diagnosis will therefore form an integral part of the Program. The Program will additionally measure the outputs, outcomes and impact of HIV/AIDS interventions addressed by the Program. Specifically, this program’s main objectives are to scale up through expansion of care and treatment services to primary health care facilities, increase coverage of key prevention services all over the country, ensure continuous quality service delivery and strengthen the national-level stakeholders and coordination mechanisms.  Two Principal Recipients will work on attaining the goals of the program, namely the Ministry of Finance and African Medical Research Foundation (AMREF).  2. Goals:   • Secure and sustain Tanzania’s HIV/AIDS prevention, care, treatment and support services; and • Strengthen coordination and implementation capacity of key stakeholders.    3. Target Group/Beneficiaries:  • PLHA who are eligible for care and treatment • PLHA suffering from chronic illness and/or malnourishment • Patients on care and treatment • In- and out-patients at health facilities • Pregnant women and their partners • Infants born to HIV positive mothers • Sexually active population, especially youth • Health care workers and PLHA accessing HIV/AIDS services  • Private sector  and Individuals and groups served by FBOs, PLHA, CSOs • General population of Tanzania   4. Strategies:  • Expand care and treatment services to the lower tiers of the health system;  • Expand health services, including ART, PMTCT, STI treatment and OI treatment and prophylaxis, to underserved populations; • Extend provision of home-based care services to facilities in targeted district; • Provide resources and supportive structures in order to mitigate the adverse effects of chronic illness and opportunistic infections among PLHA; • Provide nutritional supplements to malnourished children; • Expand coverage of Provider Initiated Testing and Counseling (PITC) services to reach all in- and out-patients in targeted  health centres and dispensaries; • Strengthen supportive supervision and mentoring networks and the provision of service delivery tools.   • Build the human resources and organizational capacity of key public sector, private sector, and CSOs, PLHA groups, and FBOs.  5. Planned Activities: • Procure and distribute ARVs, Home-based Care Kits, RUTF (Ready-to Use Therapeutic Food), medicines to treat