Category Archives: PEPFAR

July 26, 2012 · 5:48 pm

PEPFAR Announces Together for Girls Partnership against Sexual Violence

By Jane Coaston

Today the U.S. Global AIDS Coordinator Ambassador Eric Goosby announced $5 million from the President’s Emergency Plan for AIDS Relief (PEPFAR) for the Together for Girls ( TfG) partnership.

Launched in 2009, TfG is a public/private partnership including the UN and U.S. government to address violence against girls and boys, with a special focus on sexual violence committed against girls.

Recognizing and combating gender-based violence is essential to ending the AIDS epidemic, which disproportionately affects women and girls.

Read more about the announcement here.

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Filed under Advocacy, IAC 2012, PEPFAR, Public-Private Partnerships

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July 25, 2012 · 5:50 pm

Getting to Six Million: Lessons from the Track 1.0 PEPFAR Treatment Partners

By Robert Yule

Today’s session brought together Track 1.o partners to discuss the progress and accomplishments that HIV programmers have made as part of this eight-year long PEPFAR treatment program.

The Track 1.0 treatment mechanism was the largest single treatment program awarded by PEPFAR, and was administered by the U.S. Centers for Disease Control and Prevention (CDC) Global AIDS Program and the HIV/AIDS Bureau at the Health Resources and Services Administration.

EGPAF’s Dr. Anja Giphart presents on the results of Project HEART.

EGPAF served as a Track 1.0 partner, along with AIDSRelief (Catholic Relief Services Consortium), the Harvard School of Public Health, and the International Center for AIDS Care and Treatment Programs at the Mailman School of Public Health at Columbia University.

The session was led by Deborah Birx, Director of the CDC’s Center for Global Health’s Division of Global HIV/AIDS and John Idoko, Director of Nigeria’s National Agency for the Control of AIDS.

Since 2004, under the Track 1.0 mechanism, partners have initiated more than 1.4 million patients on treatment in sub-Saharan Africa and the Caribbean.

Other accomplishments included contributing to national treatment guidelines, improving diagnostic/laboratory networks to better enroll those found HIV-positive on treatment, strengthening data collection tools and reporting systems (like ICAP’s Unified Reporting System), and building local capacity and transitioning to ensure sustainability of support programs.

Anja Giphart presented on EGPAF’s Project HEART - Help Expand Antiretroviral Therapy to children and families. She discussed how over the past eight years, EGPAF has managed to reach 270,000 HIV-positive women and avert nearly 62,000 pediatric infections in the five Project HEART countries.

Giphart emphasized EGPAF’s work with local partners, and country-specific capacity building. Project HEART trained 7,000 doctors, 11,700 nurses, and 6,900 other health care workers in all 5 countries to support PMTCT and pediatric care and treatment.

She also highlighted our work toward sustainability of programming through transitioning to local NGOs and affiliates in our Project HEART-supported countries.

To learn more about EGPAF’s transition model, click here.

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Filed under Pediatric Treatment, PEPFAR, PMTCT, Track 1.0

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July 24, 2012 · 2:51 pm

Hillary Clinton at IAC: Achieving an AIDS-Free Generation

By Jane Coaston

The biggest message from IAC thus far?

Hope for the end of AIDS.

That was the message of U.S. Secretary of State Hillary Clinton’s address at the International AIDS Conference yesterday. Speaking to an overflow crowd on Monday, Secretary Clinton spoke of the United States’ commitment to ending the AIDS crisis worldwide.

“I am here to set a goal for a generation that is free of AIDS,” Clinton said. She spoke of the past – about how, during the last IAC in the United States in 1990, U.S. Global AIDS Coordinator Dr. Eric Goosby ran a triage center for people living with HIV who became ill during the conference.

She talked about the thousands of people who have worked tirelessly to support and treat people living with HIV.

“Caring brought action,” she said, “and action has made an impact.”

Secretary Clinton also discussed how PEPFAR – the U.S. President’s Emergency Plan for AIDS Relief – is beginning to shift in order to better serve partner organizations and countries, and how the Global Fund is now a key partner in determining how and where to best deliver treatment for HIV/AIDS.

“Now all of these strategic shifts have required a lot of heavy lifting,” she said. “But it only matters in the end if it means we are saving more lives – and we are.”

Secretary Clinton focused much of her speech on the role of women in the HIV/AIDS epidemic. In her remarks, Clinton announced five new funding streams to battle AIDS, including $80 million for PMTCT efforts and $37 million to focus on high-risk populations, including female sex workers.

“Women want to protect themselves from HIV and they want access to adequate health care” she said. “And we need to answer their call.”

She added that family planning efforts were key to keeping women and children healthy.

“Every woman should be able to decide when and whether to have children. This is true whether she is HIV-positive or not. “

Secretary Clinton closed her remarks by talking about her first visit to the AIDS Quilt in 1996 – the last time the quilt could be displayed in its entirety.

“We are all here today because we want to bring about that moment when we stop adding names (to the Quilt), when we can come to a gathering like this one and not talk about the fight against AIDS, but instead commemorate the birth of a generation that is free of AIDS.”

To watch Secretary Clinton’s speech, click here. To read the remarks, click here.

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Filed under Advocacy, IAC 2012, PEPFAR, PMTCT, U.S.

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July 23, 2012 · 3:18 pm

“Eliminating pediatric AIDS and keeping mothers alive from an implementation perspective” – Satellite Session on best practices, programmatic barriers and bottlenecks in the field

By Alex Ekblom

On Sunday, EGPAF, mothers2mothers (M2M) and Johnson & Johnson (J&J) hosted a satellite entitled “Eliminating pediatric AIDS and keeping mothers alive from an implementation perspective – best practices, programmatic barriers and bottlenecks in the field.” This was a four-part/panel series of presentations moderated by John Donnelly, a journalist from GlobalPost.

EGPAF Swaziland’s Caspian Chouraya

The first part had to do with country-level approaches around building capacity of HIV service implementers, which highlighted Kenya’s mentor mothers approach (where HIV-positive mothers are trained to coordinate access to and retention in care among other HIV-positive mothers), EGPAF-Zimbabwe’s experiences in reducing costs of all-level health care worker training by reduction in time of training and facilitators (saving $185.00 per participant), and SAATHI’s experience in engaging the private sector to increase local PMTCT capacity (including collaboration of 17 NGOs to increase private site coverage, which has reached 1.2 million women with PMTCT care).

The second panel focused on supporting continuity of care and featured m2m’s work on mother mentors in retaining women through use of smartphones and SMS reminders, and NASCOPs implementation of a courier system to shorten turnaround time for early infant diagnosis of HIV.

The next panel was centered around how to create demand to increase uptake of PMTCT. Examples included the use of m2m mentor mothers, who increase quality of care to clients by relieving health worker burden/task shifting, EGPAF-Zambia’s integration of syphilis and HIV testing (through innovations in rapid testing) and the use of 8 steps to roll out effective integration, and EGPAF-Lesotho’s implementation of integrated health services and the use of Family Health Days, or mobile health services which offer a variety of testing and treatment options for HIV, opportunistic infections.

EGPAF Zambia’s Susan Strasser

The final panel focused on data use and highlighted m2m’s “let’s SOAR” initiative, which included a quarterly data review component, where site coordinators could review daily recorded data and assess areas for needed improvement, EGPAF-Swaziland’s data collection and review mentorship activities, EGPAF-Rwanda’s implementation of an excel macro tools to issue feedback to supported facilities through reports of facility and district data (from which facilities could see where improvements were needed), and EGPAF-Tanzania’s experience implementing quality improvement initiatives to strengthen pediatric care.

Delegates brought interesting questions into the discussion. One of which was how can we better prioritize the “keeping their mothers alive” portion of the global plan. It’s an important point for upcoming work on elimination of MTCT.

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Filed under EGPAF, Global Plan, Implementation, India, Kenya, Lesotho, MCH, mHealth, Pediatric Treatment, PEPFAR, PMTCT, Rwanda, Swaziland, Syphilis, Tanzania, Zambia, Zimbabwe

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July 20, 2012 · 3:23 am

CDC’s Kevin De Cock on U.S. Leadership Fighting Pediatric AIDS

In advance of AIDS 2012, EGPAF hosted the following guest blog by Dr. Kevin M. De Cock – the U.S. CDC’s Director of the Center for Global Health - about U.S. leadership in preventing mother-to-child transmission of HIV globally:

Dr. Kevin De Cock, U.S. CDC

By Kevin M. De Cock MD, FRCP (UK), DTM&H

From July 22 to 27, Washington, D.C. will host the XIX International AIDS Conference, welcoming more than 20,000 attendees from around the world, representing hundreds of HIV/AIDS organizations and diverse backgrounds.  

 The U.S. Centers for Disease Control and Prevention (CDC) and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) partner with many of these organizations combatting HIV/AIDS through PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief. 
 
PEPFAR is the largest public health program ever mounted for an individual disease, and is celebrating almost a decade since it was established. Now more than 7 million people worldwide are receiving antiretroviral therapy (ART) for HIV. The conference offers opportunity to assess progress in the fight against HIV/AIDS, review research advances and priorities, and recommit to meeting HIV/AIDS specific targets that we have collectively endorsed.
 
It was in the late 1980s that research in the U.S. and other countries such as the Democratic Republic of Congo laid the foundation for our understanding of mother-to-child transmission of HIV. Approximately one-quarter of children born to HIV-infected mothers acquired the infection themselves, with other research subsequently showing that prolonged breastfeeding contributed an additional 14% transmission risk.
 
Overall, up to 40% of children born to and breastfed by mothers living with HIV would become infected. And yet, alternatives to breastfeeding were not realistic options for most African mothers for reasons of poverty, stigma, and the fact that lack of breastfeeding exposed infants to higher risk of malnutrition and other lethal infectious diseases. 
 
The history of research on mother-to-child transmission of HIV and its prevention offers the clearest example of how domestic and global HIV/AIDS work have interacted and benefited from integration, and how research has led to specific program implementation. Communicating this relationship is an overarching contribution of International AIDS Conferences. 
 
In the early 1990s, the groundbreaking ACTG 076 trial showed that prophylactic zidovudine given to the mother during

Photo: EGPAF/James Pursey

pregnancy and labor and delivery, and postnatally to the infant, prevented HIV transmission by two-thirds. The trial initiated an avalanche of research on prevention of mother-to-child transmission in and tailored to low-income settings, the benefits of which we are reaping today. 

Opinion is growing that the World Health Organization’s “Option B+” – under which HIV-infected women start combination ART on detection of pregnancy and stay on it for life – will be an important tool to meet our ambitious goal of virtual elimination of mother-to-child transmission of HIV by 2015.
 
In 2010, 35% (42% in sub-Saharan Africa) of pregnant women in low- and middle-income countries received HIV testing and counseling, and the estimated coverage of antiretroviral drugs for prevention of mother-to-child transmission of HIV among pregnant women was 48%.  In 2011, 57% of pregnant women living with HIV in low- and middle-income countries received effective antiretroviral drugs to prevent transmission to the child.
 
Despite this progress, much remains to be done. Only 28% of exposed infants worldwide received an appropriate test for HIV infection in the first two months of life in 2010, with 22% coverage of ART for infected children. In 2011, treatment coverage for ART in infected children rose to 28%, yet treatment coverage among children is still substantially lower than the estimated 57% coverage among adults living with HIV.
 
The U.S. Administration’s Global Health Initiative has refocused attention on the health of women and children. Now we have unrivalled opportunity for synergy and integration – harmonizing programs for maternal and child health, HIV/AIDS, and family planning for the greater good of women and children’s well-being. 
 

Photo: EGPAF/Jon Hrusa

Re-commitment to the worthy goals of an AIDS-free generation would be a good outcome of the XIX International AIDS Conference. The targets are to reduce the number of children newly infected with HIV by 90% by 2015, reduce mother-to-child transmission of HIV to below 5% everywhere, and reduce maternal mortality related to HIV by 50%. 

 
Looking back to the dark days – when AIDS was a death sentence, life expectancy was declining in southern Africa, under-five mortality was rising because of AIDS, and hopelessness prevailed – the 2012 International AIDS Conference should be an occasion of pride, re-engagement, and forceful determination to achieve what was once thought impossible: an AIDS-free generation
 
To learn more about EGPAF’s collaboration with the CDC on global HIV treatment and PMTCT programs, click here.

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Filed under Countries, Democratic Republic of Congo, IAC 2012, Implementation, Pediatric Treatment, PEPFAR, PMTCT, Research, U.S.

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