The Surgeon General manages the HIV Programme of the Department of Defence (DOD) since 1991 through a multi-disciplinary approach. The structure of the SA Military Health Service makes provision for various levels of management, and the HIV Management Structure mirrors these levels.

• The first level of the HIV Management Structure allows for consultation to the Surgeon General and the rest of the DOD, policy formulation, monitoring and coordination of the HIV Programme. This is achieved through the
  • HIV/AIDS Advisory Committee that is responsible for the provision of strategic direction to the HIV Programme and approval of all policies and decisions with regard to the programme.
  • HIV/AIDS Coordinating Committee that is responsible for the coordination and monitoring of the main components of the programme. These are as follows:
    • Research and Development
    • Training
    • Education and Prevention
    • Care and Support
    • Communication
• The second level of the HIV Management Structure allows for implementation of the HIV programme throughout the DOD by means of
  • “Regional” HIV/AIDS Committees.
  • "Nodal Points" or regional HIV programme managers appointed in the provinces, military hospitals, the Institute of Military Medicine, Aerospace Medicine and the Institute of Maritime Medicine.
  • HIV Workplace Programme Managers, appointed in every unit/workplace in the DOD.
  • HIV Master trainers and other personnel involved in the HIV Training Programme of the DOD.

The HIV/AIDS Advisory Committee acts as the main consultative, decision-making and monitoring body with regard to HIV management in the Department of Defence. The Director of Medicine acts as chairperson of the committee.

The composition of the HIV/AIDS Advisory Committee:

• Chairperson
• HIV Programme Manager
• SAMHS Statutory Directors
• SAMHS Medico-legal Staff Officer
• Chaplaincy
• SAMHS Corporate Communications
• GIPA Representative
• Co-opted members as required

Functions of the HIV/AIDS Advisory Committee:

• Advisory body to Surgeon General and Ministry of Defence wrt HIV/AIDS.
• Environmental assessment wrt HIV management in the following spheres:
  • Political climate
  • Scientific advances
  • International and National public opinion
  • Legislative framework
  • National socio-economic direction
  • National Health policies and programmes
• Update of Surgeon General and Ministry of Defence wrt environmental assessment reading.
• Approval of HIV/AIDS Programme.
• Monitoring of the HIV/AIDS programme.
• Providing guidance to the HIV/AIDS Coordinating Committee on HIV Management issues as directed by the Surgeon General and Staff.

The HIV/AIDS Coordinating Committee is responsible for ensuring implementation and coordination of the HIV programme and monitoring the execution of the HIV programme. As such the committee is output driven with regard to the management of the total HIV Programme. The HIV Programme Manager acts as chairperson of the committee.

The composition of the HIV/AIDS Coordinating Committee:

• HIV Programme Manager
• Development and Research Programme Coordinator
• Training Programme Coordinator
• Tertiary Military Health Formation HIV Coordinator
• Area Military Health Formation HIV Coordinator
• Mobile Military Health Formation HIV Coordinator
• SAMHS Corporate Communications Coordinator

Functions of the HIV/AIDS Coordinating Committee:

• Ensure implementation of the HIV/AIDS Programme and projects within the programme with particular reference to:
  
  • The HIV Training Programme
  • Research and Development
  • Prevention and Education
  • Care and Support
  • Communication
    
• Coordination of goals within and between specific focus areas and projects in the HIV/AIDS Programme.
• Monitoring of specific focus areas and projects.
• Ensure the submission of reports to the HIV/AIDS Advisory Committee on specific focus areas and projects.

The Area and Tertiary HIV/AIDS Committees are responsible for the execution of the HIV Programme as approved. The Area or Tertiary Military Health Unit Officer Commanding acts as chairperson of the committee.

Composition of the Area and Tertiary HIV/AIDS Committees:

• Chairperson
• HIV Nodal Point
• Statutory Staff Officers
• SAMHS Corporate Communications
• Occupational Health Officer
• Chaplaincy
• GIPA Representative
• Co-opted members as required

Functions of the Area and Tertiary HIV/AIDS Committees:

• Implementation of regional HIV/AIDS Programme.
• Planning and manning of regional response.
• Coordination of regional HIV activities.
• Environmental assessment wrt HIV management in the following spheres:
  • Regional political climate
  • Regional public opinion
  • Regional socio-economic direction
  • Regional Health policies and programmes
• Execution of policies wrt HIV Management.

The HIV Programme Manager. The manager of the HIV programme has the role of overall design, coordination and monitoring of the DOD HIV programme. This is done with the support and approval of the HIV Advisory Committee. Amongst others, the following specific responsibilities are assigned:

• HIV/AIDS impact assessment.
• Identification of priority areas to be addressed within the HIV programme.
• Policy development wrt HIV management.
• HIV programme design.
• Coordination, monitoring and management of HIV programme and project implementation.
• Mass Awareness (eg Masibambisane).
• GIPA Consultancy Programme (Greater Involvement of People living with AIDS).
• Handling of ministerial, media and general enquiries wrt HIV management.
• Identification of, and liaison and coordination with sectoral partners, stakeholders and donor organisations.
• Specialist advisor wrt HIV management in the Department of Defence.
• Communication of relevant HIV management issues to senior management.
• Coordination and monitoring of functions of the HIV/AIDS Coordinating Committee.
• Feedback wrt functions of the HIV/AIDS Coordinating Committee to the HIV/AIDS Advisory Committee.
• Coordination between HIV management and other programmes within the Department of Defence.
• External communication of the Department of Defence HIV programme.
• Coordination of advocacy and personal development opportunities of members involved in the HIV Management Structure.

GIPA Representatives. The GIPA Representatives has the role of coordinating and monitoring non-discriminatory HIV/AIDS work-based policies and programmes with specific focus on creating support systems for HIV infected and affected members and personnel. The following responsibilities are assigned:

• Attendance of HIV/AIDS Management meetings.
• Assessment of HIV/AIDS related policy areas that need development.
• Assessment of the HIV/AIDS programme of the Department of Defence, with particular reference to the development of a non-discriminatory environment.
• Addressing employees of the Department of Defence about their personal experience of living with HIV.
• Involvement in HIV/AIDS awareness, education and training activities of the Department.
• Networking with relevant organisations.
• Raising the profile of the DOD HIV/AIDS programme.
• Creating and maintaining support structures for HIV infected and affected members and employees.

The Tertiary, Area and Mobile Military Health Formation HIV Coordinators. These Coordinators have the role of coordinating and monitoring the execution of the total DOD HIV Programme in the DOD. The following specific responsibilities are assigned:

• Providing direction and support to Nodal Points and health care personnel involved in the management of HIV positive individuals.
• Updating Nodal Points and health care personnel on new policy directions and decisions wrt HIV management.
• Ensuring that Nodal Points and other health care personnel are provided with the necessary knowledge, resources and skills to implement effective regional training, prevention and education programmes and to deliver a high standard of health care to HIV infected and affected personnel.
• Establish and update a database with demographical and biographical information of Nodal Points and health care personnel who are specifically involved in HIV training and management.
• Consolidation of feedback from Nodal Points and health care personnel wrt regional HIV/AIDS activities and programmes.
• Inputs to policy development wrt prevention, education and care and support across the complete continuum of care.

The Training Programme Coordinator. The Training Programme Coordinator has the role of coordinating and monitoring all the training on HIV in the DOD. The following specific responsibilities are assigned:

• Providing direction and support to all personnel involved in HIV training.
• Ensuring that personnel involved in HIV training are provided with the necessary knowledge, resources and skills to provide quality training throughout the organisation.
• Administrative support to all aspects of the DOD HIV/AIDS Training Programme.
• Ensuring that training modules on HIV are updated and revised as required.
• Establish and update of a database with demographical and biographical information of members involved in the DOD HIV Training Programme.
• Consolidation of feedback from trainers involved in HIV training.
• Inputs to policy development wrt HIV training.
• Coordination with the Development and Research Coordinator wrt DOD HIV/AIDS Training Programme as required.

The Development and Research Coordinator. The Development and Research Coordinator has the role of bio-psychosocial monitoring and evaluation of HIV programme components, coordination of research wrt HIV and update and development of HIV Training Packages. The following specific responsibilities are assigned:

• Consolidation and evaluation of research performed on military populations, both internal and external to the Department of Defence and making recommendations wrt the current HIV programme.
• Identification and submission of monitoring and research opportunities with regard to HIV.
• Providing direction and support to personnel involved in monitoring and research on HIV.
• Establishment and maintenance of databases to monitor the epidemiological parameters of HIV in the DOD and disease progression in the military population.
• Analysis of data obtained through databases, monitoring and research and making recommendations wrt HIV Programme development and policy formulation.
• Coordinating the development of new HIV training modules and the update of existing training modules.
• Coordination with the Military Health Research Institute and other identified research bodies (internal and external) as required.

HIV Nodal Points. HIV Nodal points have the role of coordinating and monitoring the execution of Tertiary, Area and Mobile Military Health Unit HIV programmes. The following specific responsibilities are assigned:

• Project management of regional HIV programmes.
• Informing Tertiary, Area and Mobile Military Health Unit HIV/AIDS Committees of new policy directions and decisions wrt HIV management.
• Identification of, and liaison and coordination with regional sectoral partners and stakeholders.
• Feedback to relevant Tertiary, Area and Mobile Military Health Formation Coordinators as required.
• Coordinating regional research and monitoring programmes.
• Coordination and control of regional HIV equipment and resources.

HIV Master Trainers. HIV Master Trainers have the role of implementing regional HIV Training Programmes. The following specific responsibilities are assigned:

• Training and mentoring of Educational Officers.
• Providing direction and support to Educational Officers wrt further training.
• Providing specialised information on HIV best practice and management protocols for Tertiary, Area and Mobile Military Health Unit HIV/AIDS Committees.
• Peer education to statutory health personnel.
• Assist in resource determination with specific regard to the health management of HIV.
• Coordinate and direct research priorities and provide general assistance in research wrt HIV.

HIV Educational Officers. HIV Educational Officers are Social Work Officers and Clinical Psychologists and have the role of executing and coordinating regional HIV training and counselling. The following specific responsibilities are assigned:

• Coordination, training and mentoring of Health Care Workers as Pre and Post-test counsellors.
• Coordination, training and mentoring of HIV/AIDS Workplace Programme Managers.
• Monitoring and providing technical support to HIV/AIDS Workplace Programme Managers with regard to implementation of HIV Workplace Programmes.
• Act as referral points for continued counselling of HIV positive members who have disclosed their status to Peer Educators.
• Referral of HIV positive members who have disclosed their status or who have tested HIV positive for multi-professional management of their disease.
• Counsellors for continued counselling following HIV positive diagnosis.
• Feedback to HIV Nodal Points wrt HIV training and counselling.