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.

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.

The Republic of Uganda Ministry of Health: The National Pediatric and Adolescent HIV Advocacy Strategy And Road Map 2022-2026

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. 

HIV Treatment, Care, and Support for Adolescents Living with HIV in Eastern and Southern Africa: A review of interventions for scale

Adolescents in Eastern and Southern Africa (ESA) are key to achieving the global goal of ending the AIDS epidemic by 2030. ESA is home to 1.74 million adolescents living with HIV (ALHIV), representing 60 per cent of this population globally. In 12 ESA countries, AIDS is the leading cause of adolescent mortality. While there is an increasing focus on adolescents, the pace of progress remains slow, especially when compared with the growing needs of ALHIV.

It is time to deliver programmes at scale to address the needs of ALHIV, accelerating evidence of interventions producing results or showing significant promise for scale. This document examines and consolidates the current experiences of ALHIV programming in the region to support further implementation and scale-up of evidence-driven models. The findings serve as a call to action and the key considerations as a guide for governments and funding and implementing partners in scaling up service delivery to ALHIV.

Programming for Adolescents and Young People in Eastern and Southern Africa: UNICEF-GFATM partnership

In partnership with the Global Fund for AIDS, Tuberculosis and Malaria, UNICEF has supported the governments of Botswana and Lesotho to implement targeted programmes for adolescent girls and young women. In Lesotho, a national multi-sectoral referral framework is strengthening community-facility linkages and is catalyzing increased access to HIV/SRH services by guiding adolescent and young people to appropriate services and care. In Botswana, a radio drama series together with peer education components is tackling tough issues adolescents are facing in love, life and relationships. Documentation of both experiences are available for download.

Integrated Testing for TB and HIV using GenExpert Devices Expands Access to Near-Point-of-Care Testing

This brief summarizes lessons learned from Zimbabwe’s pilot implementation of integrated or multi-disease testing. Partnerships in the country focused on leveraging existing GeneXpert platforms for both TB and HIV testing to improve access to early infant HIV diagnosis and viral load testing. These findings describe the benefits of integrated testing for clients, health providers and the health system and are a resource for other countries scaling up point-of-care integrated testing.

Accelerating Access to Point-of-Care Viral Load Testing for Pregnant and Breastfeeding Women Living With HIV

This brief highlights the current scenario of policies and programmes related to point-of-care viral load testing among pregnant and breastfeeding women living with HIV. In many countries, viral load policies are not differentiated for pregnant and breastfeeding women despite evidence that point-of-care viral load testing is helpful for this population. Same-day results for pregnant and breastfeeding women can help ensure timely initiation of ART, improved rates of viral suppression and retention in care to support efforts of preventing vertical transmission of HIV.