2 egpaf approach and activites who_vienna 2010
TRANSCRIPT
WHO Guidelines: 2010 d B d2010 and Beyond
Christian Pitter, MD MPHC s a e ,Director, Global Technical Policy
Elizabeth Glaser Pediatric AIDS FoundationElizabeth Glaser Pediatric AIDS Foundation
Eliminate Pediatric HIV Now.
EGPAF International Programs: 2000 8 sites in 6 countries
2010 >4865 sites in 16 countries2010 4865 sites in 16 countries
ChinaUnited States
India Rwanda
UgandaCote
Kenya
TanzaniaCameroon
Cote d’Ivoire
South
D.R. Congo Malawi
Mozambique
SouthAfrica
Zambia
ZimbabweSwazilandLesotho
*Program initiated with EGPAF support and transitioned to other implementers
60 00050 000
70 000Estimate of the annual number of infant infections averted 50 000
40 000
20 00030 000
10 000
through the provision of ARV prophylaxis to HIV-positive pregnant women, globally, 1996–2008
1996 1998 2000 2002 2004 2006 20080
10 000
70,000 infections averted in 2008
Estimated number of new pediatric infections with and without PMTCT prophylaxis globally, 1996-2008
Four Linked Guidelinesetc.)
nse
ARVs for
H,TB, e
Respon ARVs for
Vertical Transmission
Pediatric ART
m (M
CH
e HIV R Transmission
ystem
ensive
ealth
Sy
mpreh
Adult & Ad l t ARTIYCF
He
Com Adolescent ART
What the New Guidelines RepresentRepresent
• Progress of knowledge in provision of g g pHIV services
Th fi t t i dif i k l d• The first step in codifying knowledge into standards of care
• Opportunity to improve approaches, service delivery, and outcomesy,
• A relatively rare “leverage point” to f i d fffocus attention and effort
Overall Major Changes
• ↑ logis cal and supply‐chain needs
• ↑ need for long‐term follow‐up and integration between PMTCT and HIV care gand treatment
• ↑ need for treatment↑ need for treatment
• Advancement of monitoring and evaluationevaluation
If implemented at scale, the virtual If implemented at scale, the virtualelimination of pediatric HIV
Guidelines as a Leverage PointGuidelines as a Leverage PointElimination of Pediatric HIV
Concerted Efforts
National Systems Partners and Communities Current
ImplementationAdvocacyResearch Concerted Efforts
I l iNational Systems, Partners and Communities Success
WHO
ImplementationAdvocacyResearch
Guidelines
8
What We Need to Do: Be of ServiceBe of Service…
1. To our host countries’ HIV response1. To our host countries HIV response o Assist/Advise in adaptationo Assist/Advise in implementation
2. To districts and facilities we serveo Implementation planning and supporto Implementation planning and support
3. To our MissionS 1 & 2 bo See 1 & 2 above
o Evaluate o Document & Shareo Document & Share
Supporting Guideline Adaptation & Implementation& Implementation
• Toolkits phases I, II, and IIIp , ,
• Technical advocacy/support at national l llevel
• Technical support at implementation levelTechnical support at implementation level
• Inter‐country support
• Global sharing and leadership
• DOCUMENT, EVALUATE, DOCUMENT
Phase 1 ToolkitToolkit
Phase 2: District Implementation Planning ToolsPlanning Tools
• Site profiling/ mapping tools
• Programming cost estimate tools
i i i fl l i• District patient flow analysis
• District work planning
• Assessment staffing training needs
• Planning standard tool revision
• Partnership landscape analysisp p y
• Package of BCC/IEC planning tools
Phase 2: Facility Implementation Planning ToolsPlanning Tools
• Site Patient Flow Analysis
• Linkage and Integration Site Assessment Tool
• Standard Operating Procedures Templatesp g p
• Site Transitioning Mentoring Tool
T l t A I t f N ti l G id li• Tool to Assess Inventory of National Guidelines Currently Available at Sites
• Facilitator’s Guide for Briefing Healthcare Workers on Content of Revised WHO Guidelines
• M&E Implementation Planning Tools
Phase 3 Overview
• Ongoing planningg g p g
• Monitoring and evaluationg
• Quality improvementQ y p
Continuing the Cycle
• Revisions planned for 2012p
• What direction for the next revisions?
• What do we need to know to inform the decisions?
• Who will do the research?
Continuing the Cycle
• Revisions planned for 2012p
• What direction for the next revisions?
• What do we need to know to inform the decisions?
• Who will do the research?
Final Thoughts• Challenges
o Accelerate scale‐up and improve quality
o Fundamental changes to health system functioning (Integration! Supply chain! Funding! Human resources!)
o Monitoring & evaluation
• Opportunities
o Collaborate in a new wayo Collaborate in a new way
o Move closer to elimination: believe, plan, communicate & executecommunicate & execute
o Bring non‐clinical elements to the fore
Thank You
• US Centers for Disease Control and
Thank You
Prevention• USAID• Johnson & Johnson• ViiV Healthcare• Host Governments• EGPAF Country Teamsy• International and local partners
Eliminate Pediatric HIV Now.