Evidence and data

The report outlines the progress and achievements in the triple elimination of vertical transmission of HIV, syphilis, and hepatitis B in Eastern and Southern Africa (ESA) over the last two decades. The data mentorship programme aims to strengthen national health management information systems, improve data quality, and build the analytical skills of government staff working towards elimination. It employs a unique partnership model with the private sector, academia, and government officials, focusing on capacity building through virtual and in-person mentoring, online learning platforms, and workshops. The programme has shown early successes, with mentees from various countries implementing operational plans to improve data quality and analysis in their respective countries.

Empowered mentees are taking up leadership roles that directly support national programmes and 'Path to Elimination' validation processes. The geographical expansion of the programme and the continuous exposure of mentees to technical learning opportunities will further enhance each country’s preparedness towards the 'Path to Elimination' and validation. The design, approach and delivery of this programme can be used as a blueprint for building national and regional capacity, skills building, and mentorship. While this particular data mentorship programme focuses on vertical transmission and the Path to Elimination, the principles of data quality, data sources, collection and reporting, data visualisations, and data use remain consistent across healthcare programmes and can be applied more broadly to build data use capacity in maternal, newborn, child and adolescent health and sexual and reproductive health.

This advocacy report discusses the HIV epidemic among young people in the Middle East and North Africa (MENA) region, particularly among key populations. The report emphasizes the challenges faced in collecting HIV-related data and the need for comprehensive efforts to address the epidemic, including targeted prevention programmes, improved access to testing and treatment, and addressing social and structural factors. It also discusses the presence of punitive and obstructive laws that contribute to stigma and discrimination and calls for their removal or reform. The report advocates for increased investment in HIV programmes, improved access to sexual and reproductive health services, comprehensive sexuality education, and community engagement. It highlights the importance of community health systems, data collection, and involving young people in the development of HIV and other health programmes.  ​

This is the first report on progress towards the triple elimination of mother-to-child transmission (EMTCT) of HIV, syphilis and hepatitis B virus (HBV) across 23 countries in the Middle East and North Africa/ Eastern Mediterranean (MENA/EM) region.

Countries included in this report: Algeria, Afghanistan, Bahrain, Djibouti, Egypt, the Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, State of Palestine, Saudi Arabia, Somalia, Sudan, the Syrian Arab Republic, Tunisia, United Arab Emirates, Yemen.

To support countries in the region to achieve triple elimination goals, this report collects and assesses national policies and key indicators on EMTCT efforts against WHO criteria for validation of the EMTCT of HIV, syphilis and HBV. Based on analysis and consultations with national policymakers, the report provides a Road Map  for countries at different stages of readiness to follow towards triple elimination goals. The report also provides a set of recommendations for all countries to prioritize EMTCT policy and programming actions over the short, medium, and long term.

Despite global progress in HIV treatment for children, the gap between adult and paediatric treatment coverage continues to widen. This gap is driven primarily by barriers to HIV diagnosis in children, but in the past decade those barriers have shifted.

Scaling-up HIV case-finding efforts for children presents several challenges, including limited access to testing services, lack of provider preparedness to offer testing to children, stigma and discrimination, policy barriers related to age of consent, and inadequate health systems. The aim of this technical brief is to offer countries a guide to address these challenges and enhance HIV case-finding for children to improve testing coverage for children at risk for HIV. This technical brief focuses primarily on how programmes can identify those children who may have missed out on EID testing, who were never tested after breastfeeding or whose mothers were not enrolled in care.

UNICEF's annual global and regional epidemiological and response snapshots of Eastern and Southern Africa, West and Central Africa, and the Middle East and North Africa, based on the UNAIDS 2023 HIV estimates.

The snapshots describe where we are in terms of vertical transmission, the treatment gap, and the impact on adolescents.

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.

It is clear that the AIDS epidemic is not over. The pace of progress is too slow to meet the 2030 SDG targets. To promote faster and more consistent improvement, the new UNICEF Strategic Plan emphasizes differentiation, integration, partnership and innovation to address barriers to inequalities.

Reasons for stalled progress in 2021:
Inequalities that are leaving too many behind: