Brazzaville ‒ In sub-Saharan Africa, only half (50%) of children living with HIV are on life-saving treatment, far behind adults (82%) receiving treatment. In West and Central Africa, ART coverage is very low at 35%. The Global Alliance to End AIDS in Children was launched in 2022 as a Strategic Global Initiative with a diverse spectrum of stakeholders to bridge these unacceptable gaps and ending AIDS in children by 2030.
Since its inception, the Global Alliance has seen significant momentum, with Ministers of Health from the 12 Alliance countries formally endorsing the Dar es Salaam Declaration for Action to End AIDS in Children by 2030. The 12 countries are: Angola, Cameroon, Cote d’Ivoire, Democratic Republic of Congo, Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, Zimbabwe.
Through the support of The Gates Foundation, WHO implemented a project to accelerate the implementation of country action plans towards achieving the overall goal of the Global Alliance to end AIDS in children in 6 countries (Kenya, Cameroon, Tanzania, Uganda, Côte d'Ivoire, Zambia).
Led by Ministry of Health, the project was implemented through an overarching strategy along four prongs: ASSESS, PROVIDE, COORDINATE AND COLLABORATE with the objective of providing technical and capacity building support to Global Alliance countries based on priorities identified through a needs-based assessment. The project has shown great results dealing with issues on case finding, linkage to care and mental health.
Kenya’s project contributed to the Kenya Plan to end AIDS among children by 2027. This plan was launched in September 2023 by the Health Cabinet Heath Secretary in Homa-bay County alongside the unveiling of the 100-day Rapid Results Initiative (RRI). The RRI was conducted in a total of 1688 health facilities from across the 47 counties contributing to tracing back 45% of verified missed opportunities for maternal treatment, re-suppression of 57% from a total of 1,894 pregnant and breastfeeding women who were verified to be unsuppressed at the start of the RRI, and also tracing back 39% of 1,499 HEIs verified as missed for infant prophylaxis.
‘’Kenya planned and implemented a Rapid Results Initiative (RRI) themed ‘Wakati ni sasa!’ (The time is now!) as a mitigation strategy for the challenges experienced in the race to ‘The Global Alliance to End AIDS in Children by 2030”. On behalf on the 47 counties in Kenya, I wish to pass my gratitude for the immense support from the Global alliance for trainings that went a long way in helping attain desirable outcomes for the RRI’’. Dickson Kigwenay, National Chair Council of County AIDS and STI Coordinator (CASCO)
‘’The Ministry of Health (MOH) welcomes the immense technical support of the World Health Organization in the achievement of its objectives of the Rapid Results Initiative. Through the support of the WHO, we have trained and provided capacity support to critical human resource staff and developed a data driven report of the RRI that allows us to track performance, challenges, and lessons learnt to chart way forward’’. Dr Nelly Pato, Program Manager PMTCT, National AIDS and STI Control Program, Ministry of Health, Nairobi, Kenya.
In Côte d'Ivoire, 11 high burden health centers in 4 districts were prioritized for review of vertical transmission cases and high viral load records. A comprehensive analysis and review has now been done to identify factors contributing to poor outcomes of HIV exposed infants. In addition, trainings on the new WHO guidelines on the 3-test HIV screening algorithm was achieved. Ten orientation sessions for health providers and community stakeholders was done and a total of 242 providers trained, comprising 150 clinical care providers and 92 community providers.
‘’This project has been very successful and key to helping us have a better understanding of the barriers and factors affecting the cascade of care for pregnant women from pregnancy, to childbirth and beyond. Importantly, these finding will contribute to our eMTCT validation Pre-assessment survey." Ms Djeneba Boro, in charge of the eMTCT department at the National AIDS Control Programme (NACP), Côte d'Ivoire.
Tanzania focused on psychosocial interventions and support for children adolescents living with HIV. A thirteen-session module was used for training and orientation 36 national mentors on psychosocial support and mental health needs for children and adolescents living with HIV across 6 regions. The training module was participatory using recently adopted Mental health and psychosocial support services (MHPSS) training package.
Dr Kwilasa Sylvester, the Ministry of Health (MOH) National AIDS, STIs and Hepatitis Control Programme (NASHCoP) Pediatric HIV Coordinator emphasized the importance of this training through WHO support for the 6 regions to the national strategy of decentralization to improve access to services for children and adolescents and thereby strengthening national efforts to achieve much needed access for all regions.
Uganda developed and implemented a harmonized site mentorship tool that integrates Global Alliance activities with all HIV management undertakings targeting children and adolescents. This enabled contextual capacity strengthening and targeted site mentorship and monitoring. In all, the tool was implemented in 15 health facilities in 15 districts in 4 regions. A total of 76 individuals were directly impacted through this exercise. These included medical and clinical officers, nurses and midwives, mentor mothers and peer support members. In addition, this activity strengthened program gap analysis capacities and skills in tools development for the 30 technical team members at national level that brainstormed and developed the mentorship tool.
“From the mentorship exercise, we have identified a critical need to develop a Standard Operating Procedure (SOP) for identifying and tracking HEI (HIV-exposed infants) to ensure timely follow-up and care”, noted one of the technical experts. Presentation of a Module by the Head of Pediatric and Adolescent Care at Comité National de Lutte contre le SIDA (CNLS)