The parish of Lukuli and the surrounding catchment of Hope Clinic, includes many people who have not tested for HIV. They are also people with low incomes. To know their status may be understood as something they should test for - but fear of the result and the financial implications for themselves or their children stops them being tested.

Hope Clinic Lukuli is a community NGO, founded by members of an affected population, recognised by the local council and accredited as an ART site by the national Ministry of Health. Despite this and being local and indigenous to the community we serve, we seem invisible to international donors. The management and staff therefore have worked extra hard to reach the programmes that the community needs - not just testing, not just youth-oriented prevention. Our community needs, and so we provide, comprehensive services integrated to general health. We can therefore give our community the assurance that to know their status does not risk them being left alone. We will locate and bring those services they need to Lukuli.

Six PEPFAR, 2 Global Fund and 5 private grants at Hope Clinic Lukuli

The clinic's Director responsible for coordination of our various donors and Government policy implementation is Philip Mitchell. He has led the efforts to open dialogue with the programmes in Uganda and with initiatives that have worked in other countries and which could be re-funded for Uganda. The community has benefited greatly from this work and we now coordinate over a dozen interventions for HIV, reproductive health, child health and malaria prevention and treatment. This coordination is necessary at the community NGO level as whilst national priorities and national strategic policy envisage comprehensive HIV and AIDS services accessible to the population, many programmes involving international contractors are overly focussed on one or two narrow areas of intervention.

Activity	Intervention	Partner
Awareness/ Prevention	‘Stay Alive’ health and lifeskills education program in schools and for out-of-school children	US grant (Until There’s a Cure) and Ugandan implementer (Reach the Children)
Awareness/ Know Your Status	Road show and drama to lower income/ densely populated communities with onsite counselling	Kampala City Council, Makindye Division and Joint Clinical Research Centre (JCRC/TREAT)
Awareness/ mobilisation to test	Distribution of leaflets in English, Luganda and Swahili on 6 topics of HIV including VCT, prevention, stigma and care for those with HIV	Developed by USAID Business PART, printed by Aggreko International (whose staff also received HIV awareness training from Hope Clinic, following the PART curriculum)
Outreach, counselling and testing	Mobilisation to community, reducing stigma and providing pre and post test counselling at the Hope Clinic	Aggreko International paid for 1 year. HCL is a Prime recipient from the US Embassy Small Grants team allowing HCL to keep counselling free. Now in it's third year of award.
Test Kits	The three types of test kit used for HIV at Hope Clinic Lukuli	The kits are supplied through the Uganda Government's National Medical Stores. HIV test kits and PMTCT drugs are funded with donations to UNITAID, managed by CHAI.
Laboratory Services	Improved microscope and centrifuge equipment and safety for lab staff	DFCU Bank financed new equipment and renovation of the laboratory with technical advice from CDC Entebbe.
Basic Care Package (C,S&T)	The boxed kit comprising two LLIN, a water container with purification chemicals and condoms	Funded by PEPFAR through CDC and the PSI contractor. Initially provided to HCL through PREFA project, Muyenga.
Septrin and self-care materials (C,S&T)	Anti-biotic provided at Hope Clinic to all clients confirmed as HIV positive.	Positive Living literature, peer groups and outreach home visits HCL obtained a US grant from Until There’s A Cure (www.utac.org) for first 200 clients. Then self-funded and now provided by JCRC-TREAT partnership. Peer groups funded by PSI.
Testing for opportunistic infections	Positive clients need prompt diagnosis of infections including STI and malaria	Aggreko paid for laboratory staff and reagents for 12 months to allow free to PLHA and free to youth lab testing.
Care, Support and Treatment for OI/ STI	Drugs for treatment of opportunistic infections, including malaria and STI, for PLHA. Mosquito nets to pregnant women and children under 5 years.	Coartem (ACT) from the Global Fund is free to HCL via Kampala City Council. Hope Clinic Lukuli bears the cost of drugs for other OIs. The Safe Injection Project gives syringes.
CD-4 count and ARVs	Monitoring of CD-4 from date of test and access to ARVs when required.	JCRC TREAT partnership involves fortnightly visit of team to HCL and free CD-4 counts. Since March 2009 ARVs are from Government of Uganda and its partners: UNITAID, Clinton Foundation and Global Fund.

If you would like specific examples and statistics, follow the links on the left above or email the Director