The Treatment and Research AIDS Center (TRAC) was created to conduct national HIV/AIDS surveillance and provide technical assistance to the public and private sectors in the prevention, testing and clinical treatment of HIV/AIDS in Rwanda . 

•   Provide technical support and information for the reduction of HIV/AIDS

• Monitor, coordinate and evaluate national HIV/AIDS programs performance

• Enhance surveillance activities and their use

•  Gain recognition as a regional leader in the field of HIV/AIDS

•   Publish technical reports and scientific articles

• Develop resources to ensure the success, growth and sustainability of TRAC and its programs

History of TRAC

TRAC has its origin in the NACP (National AIDS Control Program), which was the national body primarily responsible for AIDS-related programs and activities from 1987 to 2000. The NACP played a traditional role with respect to AIDS control, focusing on coordination and management (including M&E) rather than provision of treatment for PLWHAs. Its mandate evolved over time. From 1987 to 1997, NACP programs and activities spanned administrative, laboratory, VCT/IEC, epidemiological and STI domains. In 1997, the laboratory and VCT center were separated from the NACP, leaving the NACP primarily responsible for 1) coordination, supervision and evaluation of activities related to the prevention of HIV/AIDS/STI; 2) epidemiological and behavioral HIV/AIDS/STI surveillance; and 3) advocacy and resource mobilization

In 2000, the NACP underwent major restructuring as per the decision of the Government Council. Its functions were essentially divided between two new agencies: the National AIDS Control Commission (NACC), created in March 2001, and the Treatment and Research AIDS Center (TRAC), created in April 2001. The NACC was assigned the mission of developing a national policy and program framework for AIDS control, coordinating interventions among the different affected sectors and mobilizing resources nationally and internationally in the fight against HIV/AIDS. The creation of the NACC has been followed by the creation of PACCs at the provincial level (although in some cases a PACC was present before the NACC) and DACCs at the district level, as part of the movement towards decentralization.

Creation of TRAC

The second agency deriving from the restructuring of the PNLS, the Treatment and Research AIDS Center (TRAC) was created shortly after the CNLS and regroups the services provided in the past by PNLS[1][2], the Rwandan AIDS Info Center (CRIS), and the Reference Lab for Retroviral Infections. It functions under the auspices of the Ministry of Health, whose priorities are: improved care for PLWHAs, decentralization of VCT, PMTCT and STI services, and maintenance of epidemiological surveillance and research. The mission of TRAC is to promote treatment and research for HIV/AIDS by providing technical assistance to the public and private sectors in the prevention and clinical treatment of HIV/AIDS.

TRAC is the primary agency responsible for national planning and performance evaluation, policy development, training of trainers and curriculum developmentfor clinical aspects of HIV/AIDS. It executes and manages clinical HIV/AIDS interventions, including voluntary counseling and testing (VCT), prevention of mother-to-child transmission (PMTCT), care and treatment of STI, epidemiological surveillance and applied/operations research Responsibility for management of the Rwandan Center for AIDS Information (CRIS) and the National Reference Laboratory (NRL), which had become autonomous units during the restructuring of the PNLS in 1997, was also conferred on TRAC at its inception. CRIS, a national VCT center located in Kigali, seeks to contribute to the reduction of HIV/AIDS transmission by providing information, counseling and anonymous, voluntary testing to the general public; promoting integrated counseling and testing; developing pre- and post-testing counseling activities for clients; leading information and education sessions for clients (in collaboration with partners, where possible); and training health and social service personnel in counseling techniques. The National Reference Laboratory is the main body responsible for quality control of drugs and HIV testing, and oversees lab-related HIV/AIDS research (e.g. research into drug resistance).

Separation of NRL from TRAC 

In November 2003, the NRL was separated from TRAC by decision of a Government Council. It now has its own director and budget and is managed independently from TRAC. As the main lab-related research entity in Rwanda , the NRL now carries out research activities separately from TRAC. The research mandate of TRAC therefore no longer extends to lab-related issues, except in the case that the NRL and TRAC wish to collaborate to carry out a study

TRAC’s Mandate and Responsibilities 

At present, TRAC is responsible for the coordination and monitoring of its own programs, as well as the performance evaluation of national programs and activities. The mission of TRAC is to promote treatment and research for HIV/AIDS by providing technical assistance to the public and private sectors in the prevention and clinical treatment of HIV/AIDS. TRAC is the primary agency responsible for national planning and performance evaluation, policy development, training of trainers and curriculum development for clinical aspects of HIV/AIDS. It executes and manages clinical HIV/AIDS interventions, including voluntary counseling and testing (VCT), prevention of mother-to-child transmission (PMTCT), care and treatment of STI, epidemiological surveillance and applied/operations research.

Structure of the Organization

TRAC has two intervention units: the first being care and treatment, the second being PMTCT/VCT. PMTCT and VCT are combined because the current national strategy is to integrate these two services to the greatest extent possible. The care and treatment unit combines ARV with STI and OI treatment as per generally accepted protocols in ART. There are two information units: HIV/AIDS (epidemiological) surveillance and Applied Statistics/ICT. These information units provide support to TRAC's intervention units and other national institutions. The fifth unit is a finance and administration unit, which is required in all institutions

The intervention and information units consist of desks which are organized thematically. The desk structure for these units is the following:
 

Relation to other National Institutions

1. Ministry of Health: The titular ministry of TRAC. TRAC depends administratively on the Ministry of Health, and especially on the Minister of State for HIV/AIDS and Related Diseases.

2. CNLS : The coordinating body for national HIV/AIDS strategies and AIDS control institutions, including TRAC.

3. Office of Health Care, Ministry of Health (DSS): The office responsible for coordinating health districts and health centers providing VCT/PMTCT services and care for persons living with HIV/AIDS.

4. National Reference Laboratory: The body responsible for biological monitoring of ARV patients as well as quality control for test samples among VCT and PMTCT services.

5. CAMERWA : The national agency charged with assuring the provision of HIV/AIDS test kits and drugs -- including ARV -- to national health facilities.