Eastern and Southern Africa

This synthesis report reflects a comprehensive review of the body of research undertaken through the Evidence-to-Action partnership.

With support from the Joint UN 2gether 4SRHR programme, a research partnership with the University of Oxford and University of Cape Town was established with the aim to improve HIV, SRH, and the overall well-being of adolescents by providing sustainable and scalable services. The partnership, which was ongoing from 2018 to 2023, investigated drivers of HIV and SRH risk in adolescents, and was committed to generating and using the latest evidence to propose practical solutions, shape programmes and guide decision-making for adolescents.

The results of the partnership are being used in integrating evidence into programming for adolescents throughout the region. They are summarized in a synthesis report, along with the six evidence-to-action briefs featured here.

In 2022 an estimated 930,000 children (aged 0-14 years) were living with HIV in Eastern and Southern Africa. Nearly one-third of these children were not receiving lifesaving treatment. Children with HIV need both antiretroviral treatment and viral load suppression if they are to lead long and healthy lives.

UNICEF, in collaboration with governments and partners, supported an updated analysis of laboratory information management systems (LIMS) data in Malawi, Uganda and Zimbabwe from 2017-2020 to better understand viral suppression among children, especially in the context of WHO recommendations for newer, more efficacious drug regimens and the COVID-19 pandemic.

A previous analysis of 2016-2018 LIMS data found that one in every three children was not virally suppressed. The updated study found a steady increase since then in viral load testing, the use of more efficacious and palatable antiretroviral regimen options, and improved viral load suppression. However, children are still falling short of global targets to end AIDS by 2030. The full report describes the methodology, key findings, limitations, and proposes further prioritization and accelerated action to improve treatment outcomes for children with HIV.

The AU Summit Brochure was created after the inaugural countries leading the Global Alliance to end AIDS in Children met together with community representatives, UN agencies, stakeholders and partners gathered in Dar es Salaam, Tanzania on February 1st, 2023. This was done to discuss our progress and our plans to end AIDS in Children by 2030 and this brochure highlights each AU country's Global Alliance action plan.

The Republic of Uganda Ministry of Health has released its National Pediatric and Adolescent HIV Advocacy Strategy And Road Map 2022-2026, disseminated in Kampala during October 2022. 

The overall objective of this strategy is to complement and catalyze the ongoing national programs targeted at improving pediatric and adolescents HIV outcomes by addressing the policy and resource allocation gaps. This will be through putting in place a uniform and harmonized technical approach to advocacy across the national response stakeholders. The strategy provides standardized practical approaches to guide stakeholders in planning, designing, implementing and evaluating advocacy initiatives in support of pediatric and adolescents HIV. The strategy will institute systems to keep truck of ongoing and new advocacy initiatives to ensure they are aligned to the advocacy issues highlighted in the strategy for continuous process quality improvement and mitigate risks associated with uncoordinated advocacy initiatives. 

This report presents the results of a mapping of HIV-sensitive social protection programmes in 15 'fast track' countries in eastern and southern Africa. The exercise, commissioned by WFP and ILO, aimed at understanding how existing social assistance and social security programmes in the region are integrating the vulnerabilities exacerbated by HIV.

Social protection can be a critical enabler of efforts to reduce HIV risks, mitigate their impacts, and increase the capacity of households to cope and respond to the risks. Social protection can also be used as an entry point to address deeply rooted social vulnerabilities and structural factors faced by those who are vulnerable to HIV infection.

For adolescent boys and girls, transitioning to adulthood means facing significant social, health and economic risks. These include a lack of economic opportunities, early marriage and pregnancy, sexually transmitted infections including HIV, violence, abuse and exploitation. To support a safe, healthy and productive passage to adulthood, the Tanzania Social Action Fund (TASAF), the Tanzania Commission for AIDS (TACAIDS), UNICEF and other key stakeholders have developed, implemented and evaluated an intervention where social protection and economic empowerment interventions are combined with sexual and reproductive health education and services as part of the Tanzanian government’s cash transfer programme, the Productive Social Safety Net (PSSN).

The resources available include a project brief with a summary of the programme components and impact evaluation, as well as research briefs and reports from the baseline, midline and third wave of data collection.  

An opportunity to reshape gender norms on sexual and reproductive health in Rwanda: Learning from a pilot project on male partner self-testing for HIV. Rwanda conducted a research study on using self-testing and other means to improve male partner testing and engagement in PMTCT.

This document outlines the fundamentals of PMTCT impact determination and provides considerations for development of pragmatic, streamlined and resource-efficient systems for MTCT estimate generation in high burden settings. The guidance attempts to acknowledge the current reality of PMTCT programme data and the need for reliable MTCT rates while also encouraging a forward-looking approach towards sustainable PMTCT programme data improvements.

Note that this document is intended for countries in sub-Saharan Africa with a high prevalence of HIV among women of reproductive age. Although many of the underlying principles are relevant to settings with a lower burden of HIV, the guidance is not targeted for those programmes.

The tools in appendix 2 can be accessed here.