Policy/Enabling Environment

Improving HIV Service Delivery for Infants, Children and Adolescents: Towards a framework for collective action

In June 2019, UNICEF convened a group of about 40 global experts from 24 organizations and institutions to advance the collective thinking on paediatric HIV service delivery. The aim of this “think tank” consultation was to build consensus on the specific programme interventions that need to be scaled up to improve the quality of HIV treatment services and reach more infants, children and adolescents with these lifesaving medicines.

Participating organizations included:

Aidsfonds
Africaid-Zvandiri
African Network for the Care of Children Affected by HIV/AIDS
(ANECCA)
Baylor College of Medicine
Centers for Disease Control and Prevention (CDC)
Clinton Health Access Initiative (CHAI)
Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)
ELMA Philanthropies
Health Innovations Kenya
FHI 360
ICAP at Columbia University
Joint United Nations Programme on HIV/AIDS (UNAIDS)
Kenya Ministry of Health
Office of the Global AIDS Coordinator (OGAC)
Pact
Pediatric-Adolescent Treatment Africa (PATA)
Positive Action for Children Fund (PACF) / ViiV Healthcare
Réseau Enfants et VIH en Afrique (EVA)
United Nations Children’s Fund (UNICEF)
University of Nairobi
United States Agency for International Development (USAID)
World Health Organization (WHO)
World Council of Churches – Ecumenical Advocacy Alliance (WCC–EAA)
Yale University

Experts addressed the gaps in the continuum of care which are causing children to be missed before they are tested, before they are given their test results and before they are provided with lifelong treatment and care. Read more about the evidence base and the call for action in the brief above.

Integrated Testing for TB and HIV using GenExpert Devices Expands Access to Near-Point-of-Care Testing

This brief summarizes lessons learned from Zimbabwe’s pilot implementation of integrated or multi-disease testing. Partnerships in the country focused on leveraging existing GeneXpert platforms for both TB and HIV testing to improve access to early infant HIV diagnosis and viral load testing. These findings describe the benefits of integrated testing for clients, health providers and the health system and are a resource for other countries scaling up point-of-care integrated testing.

Accelerating Access to Point-of-Care Viral Load Testing for Pregnant and Breastfeeding Women Living With HIV

This brief highlights the current scenario of policies and programmes related to point-of-care viral load testing among pregnant and breastfeeding women living with HIV. In many countries, viral load policies are not differentiated for pregnant and breastfeeding women despite evidence that point-of-care viral load testing is helpful for this population. Same-day results for pregnant and breastfeeding women can help ensure timely initiation of ART, improved rates of viral suppression and retention in care to support efforts of preventing vertical transmission of HIV.

Approaching 2020: Scaling up key interventions for children and adolescents living with HIV

Urgent and ambitious 2020 global targets are on the horizon, yet there has been insufficient progress in paediatric and adolescent HIV to date. Scaling up HIV services for all children and adolescents is needed, in alignment with the UNAIDS super-fast-track framework. It’s time to make sure that nobody is left behind.

This series of 12 policy briefs by the Child Survival Working Group (CSWG) looks at scaling up key interventions for children and adolescents living with HIV. They present evidence, policy and monitoring considerations, implementation guidance and tools necessary to scale up 12 key interventions which have proven successful in identifying, linking and supporting children and adolescents to access and remain in quality care and treatment.

They are designed for program managers in government and civil society programs, particularly at country-level, and provide practical information and direction.

All In in ESA: Catalysing the HIV Response for Adolescents

Building on the collaborative effort that resulted in tremendous progress in scaling up lifesaving anti-retroviral treatment and preventing mother-to-child transmission of HIV in Eastern and Southern Africa region (ESAR), UNAIDS and UNICEF launched a campaign titled All In to End Adolescent AIDS (All In) in 2015 in Nairobi, Kenya.

This report highlights how All In mobilized partners, engaged adolescents and young people and influenced policies and programmes in the 14 high-burden HIV countries in ESAR. The report documents the progress made in a few short years on adolescent HIV, and offers suggestions and recommendations on how to strengthen strategic information, apply evidence-based programming and mobilize resources for adolescents in the HIV response. 

Catalysing Paediatric HIV Early Diagnosis and Treatment within West and Central Africa Country Catch-up Plans: Report of the meeting at ICASA 2017 and Agenda for Action

The West and Central Africa Catch-up Plan provides a framework for political advocacy and accelerated action for countries to adapt and scale up effective approaches and innovations that will reduce inequity in access to HIV treatment. Twelve countries have adapted this regional initiative to their national contexts and developed country catch-up plans, with the support of the World Health Organization (WHO), UNAIDS and UNICEF.

At the 19th International Conference on AIDS and STIs in Africa (ICASA), country representatives and partners took part in a meeting convened by UNICEF and UNAIDS to reflect on the shortfalls within West and Central Africa country catch-up plans and to agree on ways to sharpen acceleration strategies and interventions that will increase access to paediatric ART.

The meeting at ICASA had three high-level strategic objectives:

  1. Call greater attention to the gap in paediatric HIV testing, including EID, and paediatric treatment within the West and Central African country catch-up plans
  2. Define the priority actions for children in country catch-up plans in 2018, with a focus on: (a) expanding access to paediatric HIV testing through improved EID and rapid testing at other entry points; (b) improving immediate linkages to care and treatment; and (c) task-shifting to enable nurses within maternal, neonatal and child health facilities to treat children
  3. Galvanize partnerships in support of country catch-up plans

More information can be found in this meeting report.