South Africa Sustainable Response to HIV/AIDS (SA SURE) Plus

This SA SURE Plus project was preceded by the five-year SA SURE project, running from October 2011 to September 2016, with a sixth year extension to September 2017. The SA SURE project description, with its accompanying reports, can be found in the Archived Projects section of this website.

Project description

The SA SURE Plus project strengthens and supports local capacity to provide sustainable HIV and TB-related care and treatment service delivery in South Africa through training, mentoring, coaching and direct service delivery. Currently, the project deploys over 300 staff members to support seven districts (including over 600 facilities) spread over three provinces (Eastern Cape, Free State and KwaZulu-Natal).

The “South Africa Sustainable Response to HIV, AIDS, TB and maternal and child health” (SA SURE) project focuses primarily on health systems strengthening in the areas of Ideal Clinic Realisation and maintenance, change management within the 90-90-90 initiative, expanding the rollout of alternative access to chronic medication (CCMDD) and supporting Universal Test and Treat (UTT) initiatives in the supported districts, including two hosting the DREAMS project. The approach is focused on sustainable capacity development at the lowest level within the district health system that will not only integrate national health priority actions such as 90-90-90, Primary Health Care Re-Engineering, National Health Insurance, the National Core Standards and the Ideal Clinics initiative but at the same time focus on strengthening systems to improve the quality of care.

The focus of the project is both above and below site level. The activities are accompanied by a monitoring and evaluation framework to track changes in service delivery and monitor and evaluate the impact of the project interventions. This approach allows the project to adapt, improve and innovate, so that we can support the health system through a commitment to sustainability and local ownership, to strengthen health systems, achieve quality service delivery and improved health outcomes and improved linkage to care.

Project outputs

Above site level:

  • Support for Ideal Clinic Realisation and Maintenance (ICRM)
  • Support for the Office of Health Standards and Compliance (OHSC)
  • Strengthening the competencies of District Management Teams through development of job profiles
  • Improving the management of Viral Loads through capacity building using a change management approach
  • Capacity Strengthening and Learning Programme for Ward AIDS Councils and Hospital Boards
  • Supporting ICRM through the development of an e-learning model and approach using the Change Management Approach
  • Improving access to chronic medication
  • Strengthening linkage to care for HIV and TB patients
  • Support for on-going development of the Integrated TIER.Net software
  • Strengthening care and treatment practice through development of combined mentorship and supervision model
  • Technical support for Policy and Planning

Site level activities:

The project continues to support the district, sub-district and facility levels with technical assistance in health system strengthening in the areas of:

  • DIP planning, implementation, monitoring of tracer indicators/cascades, and reporting
  • Data quality, routine health information systems, use of information for management
  • Lab/clinic interface – baseline assessment, QIP development, RTQII training, sample and results management system strengthening
  • Ideal Clinic Realisation and Maintenance, PC 101 training and mentorship
  • Training and mentorship in clinical guidelines
  • Support for the district’s micro-plan for decanting
  • Supporting facilities to identify stable clients for decanting
  • Contracting CBOs to run adherence clubs
  • Identification and marketing of CCMDD pick-up points
  • Support for the implementation of Universal Test and Treat


PEPFAR, through the US Centers for Disease Control and Prevention (CDC), Atlanta


  • Africare
  • South African Catholic Bishops Conference
  • Unversity of Cape Town – CIDER Unit

Project team members

Principal Investigator: Ronel Visser

Programme Manager: Jackie Smith

Monitoring and Evaluation Manager: Stiaan Byleveld

National Co-ordinator: Sibongile Shezi

Provincial Co-ordinator: Eastern Cape – Simphiwe Sandlana

Provincial Co-ordinator: Free State – Mokete Maselo

Provincial Co-ordinator: KwaZulu-Natal – Vukile Mavundla


Current: October 2016 to September 2021

For further information, contact the Programme Manager, Jackie Smith, at

Updated: November 2016