Aurélie BONFILS ESTHERAID Project Manager

1. ESTHERAID: a Sub regional PSM Program mobilizing hospital partnerships Aurélie BONFILS ESTHERAID Project Manager

2. GOAL Extend the number of patients accessing pediatric and 2nd line ARV in selected TC by strengthening the supply chain and building the health system capacity Initiated by ESTHER, funded by UNITAID, implemented in full cooperation with each country Ministry of Health

3. The reasons behind the project Low and irrational demand and consumption of pediatrics and 2nd line ARV=> Stock out and expired drugs gaps identified : • Management of the ART supply-chains not yet proven efficient • Weak lab and TCC capacity to diagnose (infants, failure), treat and monitor patients in need of pediatric or 2nd line treatment • Lack of reliable data to ensure accurate ARV quantifications and forecasts

4. OBJECTIVES / STRATEGY Stock out Access to early diagnosis & monitoring of viral load and CD4 Rational use + compliance Accuracy of quantification & ART forecast • % of patients on pediatric ARV • Rational % of patients switched to 2L • Reinforce the supply chain • Optimize the quality of diagnosis, treatment and monitoring of patients • Improve data collection and analysis

5. 2 TYPES OF EXPERTISE ESTHER HQ/ coordinations National key institutions, MoH & decision makers Steering Committee Additional consultancy international, national consultants in collaboration with KOLs Technical workshop (SOPs, guidelines, norms) and recommendations at central level Hospital expertise multi-disciplinary teams of experts Capacity building at treatment center level Complementary approach Synergy Sustainability

6. Hospital Partnership in ESTHERAID • In the North: 14 Hospitals involved in the project. • In the South: 57 health facilities as partners + each country National Reference Lab. 5 partner countries 57 treatment centers

7. Range of hospital partnership Objective: Improve healthcare provision by optimizing the quality of diagnosis, therapy and patients monitoring • Capacity building : on site and workshop trainings, tutoring, seminars (HIV care, therapeutic failure, pediatric,..) • Internships in hospital • Technical training in laboratories • Therapeutic committee • National guidelines • Supervision • Treatment education, dispensing Activities

8. Hospitalpartners interventions since 2011 Hospitalpartners profile: Doctors - Infectiologists - Paediatricians - Gynecologists Biologists - Virologists – Laboratory technicians - Pharmacists - Nurses

9. CONCLUSION • Hospital expertise and additional technical assistance can be mobilized in a complementary way • hospital to hospital & on overall health system • capacity building at hospital level + strategy and recommendations at central level • ITA provides a comparative and brings resourceful “south” public health expertise • Hospital expertise brings legitimacy, trust and continuance with long lasting partnership • Limitations: articulation between types of expertise, limited communication and availability of hospital partners between field missions

10. Acknowledgements to ESTHERAID teams • Focal point Pharmacy: P. Doo-Kingué • Focal point M&E: C. Barberousse, B. Bassirou • Focal point PSS: M. Dieng, M. Touré, M. Dossou-Yvo • Focal point trainings: A. Beugny • Focal point UNITAID & Project coordinator: A. Bonfils