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.

Transforming Vision Into Reality: The 2024 Global Alliance Progress Report on Ending AIDS in Children by 2030

This status report shows how far we have come—and how much further we must go—if we hope to meet the global commitments to end AIDS in children. It offers a snapshot of global progress and permits an early assessment of the impact of the Global Alliance’s work. This report highlights the transformative work that is being undertaken in Global Alliance countries to accelerate gains towards ending AIDS in children, underscoring the urgent need to apply good practices, emerging innovations and critical lessons learned to overcome the barriers that slow progress.

For additional information, consult the joint press release and the video created for the report launch at AIDS 2024.

Ending HIV for Every Child, Every Adolescent: An investment opportunity for the public and private sectors

This document highlights opportunities for both public and private sectors to engage in the global HIV response for infants, children, and adolescents in partnership with UNICEF. 

UNICEF is a key partner and leader in the AIDS response for children, adolescents, and women. It collaborates with governments and partners worldwide, offering innovation, technical expertise, data and evidence, programme excellence, coordination, and convening power.

UNICEF is 100 per cent voluntarily funded, and is seeking support to deliver ambitious HIV results for children and to ensure the world can reach Sustainable Development Goal Target 3.3, to end the epidemic of HIV by 2030. 

Spotlight on the UNICEF HIV/AIDS Fund: Results achieved in 2022 to achieve an AIDS-free future for children and adolescents

UNICEF’s HIV/AIDS Thematic Fund is a global flexible funding pool. It enables us to strengthen systems to ensure an AIDS-free future for children and adolescents. This offers donors an exciting opportunity to target funding specifically to HIV/AIDS outcomes, while also giving UNICEF the flexibility to allocate funds based on where the need is greatest for children, including critically underfunded priorities at the country level, humanitarian response activities, and where funds will have the greatest impact. Thanks to our generous donors UNICEF’s Global HIV/ AIDS Thematic Fund income in 2022 reached over $5.7 million.

This document features the results achieved in 2022, when supporters of the HIV/AIDS Thematic Fund enabled UNICEF to allocate resources to 45 countries and territories. Funds were allocated to countries based on several measures determining the burden of HIV/AIDS on the population. These included the number of AIDS-related deaths in the country and the number of new infections among children and adolescents in the country. Funds were also allocated to UNICEF’s regional and global headquarters, supporting the vital work that allows thematic funding to unlock wide-scale results and impact the world over.

Strengthening capacity in translating evidence to action: Data mentoring and the journey to triple elimination of HIV, syphilis, and hepatitis B

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.

Progress Report and Road Map for the Triple Elimination of Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B in the MENA and EM Region

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.

Technical Brief on Paediatric HIV Case-Finding: Beyond Infant Testing

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.

Key considerations for fast-tracking EMTCT in lower-prevalence settings

This key considerations document, developed by UNICEF and WHO, expands on the 2020 “last mile” operational guidance, with specific considerations for countries with lower HIV prevalence. It builds on the experiences of countries that have been validated for EMTCT of HIV and syphilis and translates the valuable lessons and promising practices of these countries into an operational framework for national programmes, consisting of 12 strategies and enablers to guide efforts towards Fast-Tracking EMTCT in lower prevalence countries.

It is based on a review of experiences, key lessons learned and promising practices in implementation of EMTCT interventions in lower prevalence countries, including Sri Lanka and Thailand, which have been validated by WHO for having eliminated vertical transmission of HIV, and three countries with the potential to achieve EMTCT by 2030: the Democratic Republic of the Congo, Ghana and India.

Best practices and common bottlenecks in EMTCT in seven priority countries

This brief reviews existing resources and analyses potential bottlenecks for the processes in applying for EMTCT/Path to Elimination and to strengthen ongoing PMTCT programmes in such applications. Eight UNICEF priority countries were selected for the review: Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Ukraine, and Uzbekistan.

HIV Couples Testing in Rwanda

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.