1 / 16

Nick Hellmann, MD EVP, Medical and Scientific Affairs

Building on the Zimbabwe Experience to Achieve Global Elimination of New HIV Infections in Children. Nick Hellmann, MD EVP, Medical and Scientific Affairs. Global Impact of HIV/AIDS on Children. Together We Will End AIDS (UNAIDS, July 2012).

donoma
Download Presentation

Nick Hellmann, MD EVP, Medical and Scientific Affairs

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Building on the Zimbabwe Experience to Achieve Global Eliminationof New HIV Infections in Children Nick Hellmann, MDEVP, Medical and Scientific Affairs

  2. Global Impact of HIV/AIDS on Children Together We Will End AIDS (UNAIDS, July 2012) * Denominators for percentage calculations are global adult+children estimates

  3. Global Plan for elimination of new HIV infections in children and keeping their mothers alive 2011-2015 GoalsGoal 1: >90% reduction in new HIV infections in children Goal 2: >50% reduction in AIDS- related maternal/child deaths Launched at UN General Assembly Special Session, June 2011

  4. Global Plan: 22 Priority Countries Chad India Ghana Ethiopia Cote d’Ivoire Uganda Nigeria Kenya Cameroon Tanzania D.R.Congo Zambia Burundi Malawi Mozambique Angola Zimbabwe South Africa Namibia Swaziland Botswana Lesotho

  5. EGPAF International Programs: 2011  5,932 sites in 15 countries Chad India Ghana Rwanda Ethiopia Cote d’Ivoire Uganda Nigeria Kenya Cameroon Tanzania D.R.Congo Zambia Burundi Malawi Mozambique Angola Zimbabwe South Africa Namibia Swaziland Botswana Lesotho

  6. EGPAF Strategy: ThreeIntegrated Areas of Focus Global Advocacy Global Program Implementation Global Research

  7. Strategies for Eliminating HIV/AIDS in Children Prevent HIV infection in women PMTCT Stay HIV-negative Women 1 Prevent unintended pregnancies in HIV+ women Become HIV-positive Not intending pregnancy Not pregnant 2 Pregnant Prevent mother-to-child HIV transmission Early diagnosis,care and ART,support HIV testing ARV drugs Infant feeding Uninfected infants 3 Infected infants 4

  8. Country Program Approach • Strategic partnering • Government, implementing partners, community • Increase access to PMTCT/Care &Treatment • Integrated within public facilities and MCH/RH services • Optimize program services/interventions • Increase quality, innovation, monitoring, evaluation to improve effectiveness and efficiency of services • Strengthen health systems • Capacity building for local ownership and sustainability • Address policy and advocacy gaps • Eg, national strategies/guidelines, task shifting/sharing • Engage and support community • Drive service demand, uptake, adherence, retention

  9. EGPAF International Programs2000 – 2011* • PMTCT access – EGPAF-supported sites • Reached 14.2 million pregnant women(nearly 2.5 million in 2011) • Accounted for nearly 20% of pregnant women who received ARV for prophylaxis in low/middle income countries in 2010 • Care and Treatment – EGPAF-supported sites • Enrolled 1,600,000 in HIV care programs • Initiated antiretroviral treatment (ART) in 860,000 adults & children *EGPAF data through Dec 2011

  10. PMTCT Cascade Challenges HIV Infection No infection Receive test results Antenatal clinic Counseling and testing PMTCT services/drugs, CD4 test, ART, partner testing Prevention services Infant PMTCT drugs, breastfeeding support,family planning, infant HIV diagnosis/ART Delivery inhealth facility

  11. TOTAL Infants infected 1 – 3 12 13 – 15 PMTCT: Most Critical Determinant of Effectiveness is Number of Women Completing PMTCT Cascade 100 HIV+ mothers Common cascade efficiency Enrolled in PMTCT program Lost from PMTCT program Attend ANC 92% 8 92 Modified from P. Barker:WHO Mtg Nov 2008 Counseled and tested for HIV80% 74 26 Get ARVs (pre- and perinatal) 70% 52 48 (80-90%)

  12. Loss-to-follow-up on ART (South Africa) Trend consistent across all sites • LTFU by 12 months after ART initiation among women: • 19% if pregnant • 11% if not pregnant p<0.001 (N=29,653 women initiating ART at6 sites in Johannesburg, Cape Town, Durban, and Hlabisa from 2002-9) L Myer, et al: Loss to follow-up and mortality among pregnant and non-pregnant women initiating ART across South Africa. CROI - Seattle Mar 2012

  13. WHO 2010 PMTCT Guideline Scale-up:EGPAF/Kapnek/OPHID/ZAPP approach 2011: 1344 program-supported sites enrolled nearly 370,000 pregnant women • Key 2011 interventions: • National training • Supportive supervision • District-level managers • POC CD4 testing • ART initiation in ANC • Community engagement

  14. GLOBAL HIV/AIDS RESPONSE: Progress Report2011

  15. New HIV infections among children (0-14 years old): 2001-2011 and target for 2015 Global eliminationof pediatric HIV/AIDS can be achieved! A progress report on the Global Plan, 2012

  16. Thank you!

More Related