Policy/Enabling Environment

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.

Learn more in the Foreword and download the briefs below. 

• Addressing the service delivery needs of children of key populations

• Strategies to improve retention of mother-baby pairs in PMTCT programs

• A child-centred approach for HIV programs

• Providing differentiated service delivery to children and adolescents

• Point-of-care testing as a solution for timely early infant diagnosis

• Complementary and connected: Engaging community and faith-based organizations to deliver PMTCT and pediatric HIV services

• Sensitizing health workers to providing responsive care for adolescents and young people living with HIV

• Family-based index case testing to identify children with HIV

• Meaningful engagement of adolescents and young people in national and local HIV programming

• Scaling up optimal antiretroviral treatment for children: A long overdue intervention

• Preventing and treating tuberculosis among children living with HIV

• Providing peer support for adolescents and young people living with HIV

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. 

More women are accessing antiretroviral therapy than men, transferring the benefits of their good health to their families and economies. When young women are empowered and have their rights fulfilled, HIV prevalence falls, there are fewer unintended pregnancies, fewer maternal deaths and fewer dropouts from school and more women join the workforce.

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. 

In follow-up to the 2017 Continental Summit in October 2017, Pediatric-Adolescent Treatment Africa (PATA) released a summary report with key highlights and recommendations from the meeting. Towards an AIDS Free Africa – Delivering on the frontline was the focus of the 2017 Summit, which brought together over 200 delegates across 15 sub-Saharan African countries along with programme implementers and policy-makers from across the globe. The recommendations provided are centred around three pillars – FIND, TREAT and CARE – that support the UNAIDS superfast-track framework. Attending health facility teams drafted new quality improvement plans and will be commencing 53 projects improving service delivery at the frontline in 2018.

For civil society organisations, youth activists, parliamentarians and journalists

This document puts forward a framework with new strategic directions for 2016–2021 on voluntary medical male circumcision (VMMC) for HIV prevention as the follow-on to the Joint Strategic Action Framework 2012–2016. The new directions focus on adolescent boys and men, and take into account a range of physical and psychosocial health issues. They highlight the need for innovative approaches to overcome current barriers to services, increase acceptability, and address inequalities in access and coverage. This document will be used to inform, both regionally and globally, an action-oriented and operational framework on VMMC and men’s health, with overlapping benefits for women’s health.

This brief offers a concise account of current knowledge respond to the overlapping vulnerabilities of young people concerning the HIV risk and vulnerability of young people who inject drugs or the specific legal challenges and ethical who inject drugs; the barriers and constraints they face concerns in working with children. These vulnerabilities to appropriate services; examples of programmes that require responses that may go beyond the harm-reduction programmes recognized as effective for adults.