The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating
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HIV. Fragile health systems are further stressed as health workers navigate an increased client load and demands at work while also being concerned for their own health and that of their families. Health facilities have been redesigned to care for patients with COVID-19, posing challenges to other services. Governments and civil society organizations have redirected scarce resources and shifted programming priorities to respond to the pandemic. Several countries have reported intermittent declines in HIV testing and diagnosis, antenatal care visits, collection of antiretroviral medicines (ARVs) by people living with HIV, and attendance at clinic appointments. Community-based education and support programmes have had to rapidly adapt to restrictions on movement and public gatherings. Children, adolescents, and women have experienced multiple deprivations due to the adverse impact of the pandemic.
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This document synthesizes key elements of the World Health Organization (WHO) normative guidance on health policy and system support for community health worker (CHW) programmes and their applicatio
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n for HIV programmes. Building on relevant elements of HIV guidelines, tools and evidence identified by experts, it provides recommendations on tasks and roles that can be performed by CHWs (including for HIV), identifies the policy and system supports to optimize CHW performance, and gives examples of best practice. Its purpose is to inform the optimal design and delivery of CHW programmes targeting – either specifically or as part of a broader approach – the scale-up and sustainability of HIV services.
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Practical considerations
It provides more detailed and practical guidance for continuing services for each life stage across the life-course continuum. As such, both documents should be read and us
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ed together. The countries in South-East Asia and the Pacific regions would like to adapt the guidance within the national and sub-national continuity plans, based on the local situation of COVID-19 transmission, containment response and health system capacity.
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1 February 2021 to 31 January 2022
1 July 2021; Report shows big COVID-19-related HIV prevention programme service disruptions, but
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highlights that HIV service innovations and adaptations are possible.
A synthesis report on programme disruptions and adaptations during the COVID-19 pandemic in 2020
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Why bold action against inequalities is needed to en AIDS, stop COVID-19 and prepare for future pandemics
The COVID-19 pandemic arrived in an evolving epidemiological context where some countries are experiencing a progressive decrease in HIV positivity
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in their testing programme as they are moving closer to the first 95 target. Distinguishing changes in HIV testing services due to the COVID-19 pandemic from those resulting from evolving HIV testing strategies is crucial for adapting services and helping countries define their strategic mix of testing options moving forward. There is a need to focus, prioritize and plan for strategic efforts to prevent going further off the track toward achieving global targets and goals.
To support these efforts, WHO in partnership with ministries of health conducted an in-depth analysis of HIV testing services and antiretroviral therapy (ART) initiation prior to and during reported COVID-19 disruptions. Additional publicly available Global Fund and PEPFAR data was also reviewed and analysed. This analysis, and coordination with ministries of health, identified key service delivery adaptations utilized during COVID-19-related disruptions and formed the basis of this strategic guide.
This document focuses on current country needs, as well as plans for prioritization and potential surge support needs in the event of future disruptions. Although the data and implications are specific to sub-Saharan Africa, key principles and lessons can be applied elsewhere.
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UNAIDS report on the global AIDS epidemic shows that 2020 targets will not be met because of deeply unequal success; COVID-19 risks blowing HIV pro
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gress way off course. Missed targets have resulted in 3.5 million more HIV infections and 820 000 more AIDS-related deaths since 2015 than if the world was on track to meet the 2020 targets. In addition, the response could be set back further, by 10 years or more, if the COVID-19 pandemic results in severe disruptions to HIV services.
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2021 UNAIDS Global AIDS Update. UNAIDS report shows that people living with HIV face a double jeopardy, HIV and
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COVID-19, while key populations and children continue to be left behind in access to HIV services
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PEPFAR Malawi’s Country Operational Plan 2022 (COP22) embodies joint priorities from national and subnational dialogues building on the 2020-2025 National Strategic Plan for HIV/AIDS. The interage
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ncy team has developed a person-centered, district-tailored and Malawi Population-Based HIV Impact Assessment (MPHIA)-informed strategy through extensive engagement with Government of Malawi (GoM) and Civil Society Organizations (CSOs) to sustain HIV epidemic control. At the end of COP21, PEPFAR Malawi was commended for contributing to reaching epidemic control in strong collaboration with GoM and stakeholders including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). This includes enrollment of 88% of recipients of care on three or more months of antiretroviral treatment (ART), better outcomes for Malawian children through remarkable efforts in Orphans and Vulnerable Children (OVC) programming and progress made towards reaching men with more intentional and focused programming.
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PEPFAR Malawi’s Country Operational Plan (COP) 2021 reflects a culmination of strong interagency collaboration between the PEPFAR Malawi team, Government of Malawi (GoM), and civil society organizations (CSOs) to mitigate the devastating impacts o
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f COVID-19 and sustain progress achieved over the last two decades towards HIV epidemic control.
At the conclusion of the March 2020 Johannesburg Regional Planning Meeting, the PEPFAR Malawi team presented a COP20 surge strategy to improve client-centered care, mitigate treatment disruption, scale prevention programs to key and vulnerable populations, and strengthen national health systems.
Following this meeting, the first three COVID-19 cases were reported in Malawi and immediately thereafter, adaptations to the COP20 strategy became imperative to deliver safe, client-centered care.
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The brief concludes that sustaining the continuity of EHS requires policies that ensure a whole-society and systems strengthening approach. This involves increased health care investment, community engagement, disease control regulations,
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and multisector approaches to improve resilience, EHS quality, and equity.
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Almost half (46%) of the world’s 1.7 million children living with HIV were not on treatment in 2020 and 150 000 children were newly infected with HIV
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, four times more than the 2020 target of 40 000
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The UNAIDS 2020 global report is a call to action. It highlights the scale of the HIV epidemic and how it runs along the fault lines of inequalities.
Background paper 8
The Independent Panel for Pandemic Preparedness and Response
May 2021
The application of digital health technology is growing at a rapid rate in Africa, with the goals of improving the delivery of healthcare services and more effectively reaching out to remote and und
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erserved communities. The lack of enabling guidelines and standards across the continent, on the other hand, makes it difficult to share data in a meaningful way across the continent.
Considering this, Africa Centres for Disease Control and Prevention (Africa CDC) established a task force of 24 members to provide expertise and guidance in the development of AU HIE guidelines and standards. Members of the task force were subject matter experts working in Africa and internationally on the collection, analysis, and exchange of health information. Some of these experts had been involved in previous consultations on defining Africa CDC’s health information systems strategy. A chairperson, co-chairperson, and secretary were elected to engage the task force members in different technical working groups.
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The COVID-19 pandemic has affected everyone, including key populations at higher risk of HIV. And
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the gains made against other infectious diseases, including HIV, are at risk of being reversed as a result of disruptions caused by COVID-19. This is the background to a new report published by FHI 360, in collaboration with UNAIDS, which gives advice on how to minimize the impacts of COVID-19 on key populations.
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This progress report reviews recent gains, new developments and remaining challenges as countries approach the 2020 targets of the Start Free Stay Free AIDS Free framework.
TB remains one of the world’s deadliest infectious diseases, second only to COVID-19, and drug-resistant TB strains are still a major concern. In
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the fight against TB, urgent investment is critical, especially in the context of the ongoing pandemic.
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