FY21 Annual Report: October 1, 2020 TO September 30, 2021

The country also has one of the world's highest incidence rates of tuberculosis (TB), at 615 per 100,000 population in 2019. In addition, South Africa has the highest number of confirmed coronavirus disease 2019 (COVID-19) cases and deaths on the African continent. In collaboration with the Government of South Africa (GoSA) and with funding from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID) Mission in South Africa supports national, provincial, district, and community-based programs, focusing on the 27 highest HIV-burdened districts, which collectively represent more than 85 percent of South Africa's PLHIV. USAID/South Africa is scaling up interventions and increasing resources to help the GoSA achieve its goal of 81 percent of PLHIV on treatment and 73 percent with viral load suppression by 2022. The Technical Support Services (TSS) Activity assists USAID/South Africa and the Regional Health Office (RHO) to address technical priorities and develop creative, innovative solutions to strategically allocate resources, strengthen connections with implementing partners, and replicate best practices and effective program models. Through TSS, Panagora provides technical advisors for strategic work with government stakeholders, implementing partners, or other entities, as requested. The TSS contract is structured as three tasks: 1) Technical support services, 2) Capacity building, and 3) Program and operations support services. These tasks support USAID/South Africa's Country Development Cooperation Strategy Development Objective 1: "Health outcomes for South Africans improved," and its three Intermediate Results (IRs): IR1.1: HIV and TB infections reduced, IR1.2: Sustainability of effective HIV and TB response systems increased, and IR1.3: Care and treatment of vulnerable populations improved. In mid-2020, through a sizeable increase in time and effort in the TSS contract, coupled with a geographic expansion to RHO-supported countries, TSS expanded its support to USAID across the three TSS task areas. TSS is guided by the following principles: serve USAID Health Office and RHO needs strategically, flexibly, and cost-effectively; maximize the use of experts with hybrid expertise in both health and monitoring and evaluation/strategic information; build capacity using pragmatic, highly participatory approaches; manage knowledge to ensure its accessibility and use; and manage nimbly with open access to decision makers. The USAID/South Africa Health Office manages one of the largest PEPFAR programs in the world, which requires a significant number of skilled professionals to effectively engage with a complex, multi-sectoral HIV response. Technical competence is critical – as is strong capacity in strategic information. USAID's HIV program relies on implementing partners (IPs) to provide critical services at the facility and community levels, with these local organizations at times required to rapidly scale their technical and organizational systems. The COVID-19 pandemic and the latest developments in the HIV and TB response have presented significant challenges for the TSS Activity, requiring a flexible and responsive approach to support USAID/South Africa's efforts to address these issues. The TSS Activity has made significant contributions to USAID/South Africa's efforts to address the HIV and TB epidemics, including providing technical support to the Health Office and RHO, building capacity among implementing partners, and managing knowledge to ensure its accessibility and use. Through its work, the TSS Activity has helped to strengthen the HIV and TB response in South Africa, improve health outcomes for South Africans, and support the achievement of PEPFAR goals. The TSS Activity will continue to play a critical role in supporting USAID/South Africa's efforts to address the HIV and TB epidemics, and to achieve the Country Development Cooperation Strategy Development Objective 1: "Health outcomes for South Africans improved."