West and Central Africa

Building on previous summaries, this brief summarizes the current evidence and lessons learned from the Transfer Project after more than a decade of research on cash transfers in sub-Saharan Africa.

Since 2009, the Transfer Project has generated rigorous evidence on the impacts of cash transfers in sub-Saharan Africa (SSA) and has supported their expansion. It aims to provide evidence on the effectiveness of cash transfer programmes, inform the development and design of cash transfer policy and programmes, and promote learning across SSA on the design and implementation of research and evaluations on cash transfers. The Transfer Project is a collaborative network comprising UNICEF (Innocenti, Regional and Country Offices), Food and Agriculture Organization of the United Nations (FAO), the University of North Carolina at Chapel Hill, national governments and researchers. 

In the global quest to end the AIDS epidemic as a public health threat by 2030, meeting the HIV-related needs of children, adolescents and pregnant and breastfeeding women represents a critical piece of unfinished business. To inject a sense of urgency in to global efforts to end the epidemic among children, adolescents and young women, global partners joined together in 2015 to launch the Start Free, Stay Free, AIDS Free framework. Unveiled as the global community was embracing a series of 2020 targets intended to Fast-Track the HIV response, Start Free, Stay Free, AIDS Free called for a super-Fast-Track approach to end AIDS as a public health threat among children, adolescents and young women by 2020.

Since the deadline for achieving the targets passed in December 2020, this is the final Start Free, Stay Free, AIDS Free progress report. Although the targets were global, partners identified 23 countries for intensified focus under the framework. This report specifically highlights progress against the targets in focus countries. The only focus countries outside sub-Saharan Africa (India and Indonesia) do not report data on Start Free, Stay Free, AIDS Free targets and are not covered in this report. 

HIV testing and treatment remains low among children in West and Central Africa. Various barriers prevent the scale-up of services and improved coverage for children, including limited coverage of early infant diagnostic capacity, limited decentralization of pediatric treatment including task-shifting/sharing from paediatricians to nurses and community actors, as well as prevalent HIV stigma at individual, family and community levels. Family-based HIV index testing has been identified as a game changer that can deliver quick gains for the paediatric HIV response in both high- and low prevalence settings. By using an individual family member living with HIV as an entry point to reaching the entire family unit, several underlying factors can be addressed, which limit access to HIV testing services especially for children.

This operational guidance is meant for use by national programme managers, implementers, advocates and health care providers in collaboration with partners, supported by national, regional and global experts. The guidance draws off the experience in family testing from within and outside West and Central Africa. It combines recommendations from the Dakar Expert consultation, which took place in June 2018, as well as lessons learned from the pilot of the Family Testing Operational Guidance in Liberia in June 2018. It is a living document that will be enriched as evidence on family Testing in the region grows. The use of this guidance will be complemented by a toolkit and a community of practice. It is a regional document drafted for the countries in West and Central Africa to guide country teams to design country-contextualized family HIV testing roll-out.

This guide developed by Pediatric-Adolescent Treatment Africa (PATA) draws on lessons learned on integrating peer support strategies across several programmes in sub-Saharan Africa. It has been designed as an informative resource for the integration of peer support into HIV models of care for adolescents and young people in facility- and community-based settings. This toolkit is aimed primarily at health providers, specifically health facility managers and organizations engagement peer support programmes to strengthen health care./p>

Adolescents have the lowest rates of retention in HIV care and ART adherence when compared to other age groups. It is essential for programmers to better understand the adolescent HIV care pathways in sub-Saharan Africa, where public HIV services have been decentralised throughout the region. This evidence and programming brief is the first in a new series focusing on programming for adolescents living with HIV developed in collaboration with Oxford University and the University of Cape Town. It provides a summary of evidence from a systematic review of adolescent care pathways in low- and middle-income countries, a longitudinal community-traced cohort of ART-initiated adolescents in South Africa, and qualitative interviews with HIV care providers. The brief additionally highlights key considerations for strengthening programming and services for adolescents living with HIV.

Global and regional epidemiological and response snapshots based on the UNAIDS 2019 HIV estimates.

At a high-level meeting in Dakar, Senegal in January 2019, UNAIDS, UNICEF and WHO urged countries in Western and Central Africa to strengthen their commitments towards EMTCT and universal coverage for paediatric testing and treatment for HIV.

Countries and partners renewed their commitment to the 2015 Dakar Call to Action for Accelerating the Elimination of New HIV Infections in Children and Access to Treatment for Children and Adolescents Living with HIV by 2020.

Innovative Approaches for Eliminating Mother-to-Child Transmission of HIV: Experiences from Côte d’Ivoire, the Democratic Republic of the Congo, Malawi, and Uganda

This report documents several promising practices focused on community engagement for PMTCT implemented under the Optimizing HIV Treatment Access for Pregnant and Breastfeeding Women (OHTA) Initiative. OHTA, a UNICEF-supported initiative with funding from the Governments of Norway and Sweden, aimed to accelerate access to Option B+ for the elimination of mother-to-child transmission in Côte d’Ivoire, the Democratic Republic of the Congo, Malawi, and Uganda. 

Find out more here. 

Innovative Approaches for Eliminating Mother-to-Child Transmission of HIV: Experiences from Côte d’Ivoire, the Democratic Republic of the Congo, Malawi, and Uganda

This report documents several promising practices focused on community engagement for PMTCT implemented under the Optimizing HIV Treatment Access for Pregnant and Breastfeeding Women (OHTA) Initiative. OHTA, a UNICEF-supported initiative with funding from the Governments of Norway and Sweden, aimed to accelerate access to Option B+ for the elimination of mother-to-child transmission in Côte d’Ivoire, the Democratic Republic of the Congo, Malawi, and Uganda. 

Find out more here.