HIV TREATMENT
2020
Action 27. Mobilize their networks and work with communities to help build treatment literacy, generate demand, and expand access to ARVs among children.
Action 34. Increase efforts to share information on the roll-out of new paediatric formulations, including lessons learned.
Paediatric HIV & TB : Rome Action Plan
53. Support POC EID as well as case-finding through enhanced testing in inpatient, TB, and nutrition wards.
54. Promote family HIV testing as a strategy for identifying children with HIV.
55. Provide additional investments and support in West and Central Africa through Bridge to Scale POC diagnostics (including optimizing multiplexing) to close the diagnostic and paediatric ART treatment gaps.
Commitment 53:
June 2022
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UNICEF supports adoption of new WHO updated guidance on testing in the context of our ongoing POC work. The paediatric service delivery framework has been deployed in the field with the support of an industry-funded coalition that brings together UNICEF, the Elizabeth Glaser Pediatric AIDS Foundation, the Paediatric AIDS Treatment for Africa network, and Aidsfonds, a Dutch civil society organization. Dubbed the ‘breakthrough partnership’, this coalition has advanced programming for children in seven subnational regions across Mozambique, Nigeria and Uganda. Now entering its third year, the work of the partnership has generated strong support from Governments and communities alike, and offers a unique and practical model of cooperation among implementers, ministries and civil society organizations
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UNICEF and CHAI are supporting the transitioning of the initial UNITAID supported POC countries (Malawi, Mozambique, Uganda, Kenya, Ethiopia, Tanzania, Senegal, DRC, Cameroun, Zimbabwe) to other sources of funding for strategic scale up of efforts.
Commitment 54:
June 2022
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Across three countries (Uganda, Mozambique and Nigeria), in partnership with a coalition of implementers and community organizations, UNICEF is using its innovative paediatric service delivery framework to promote a model of differentiated services for infants, children and adolescents living with HIV. UNICEF and partners advocated for and implemented tools and guidance for identifying undiagnosed children including through family HIV testing (index testing).
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In collaboration with WHO, UNAIDS and partners, UNICEF is supporting the national roll-out of Family Index Case Testing in WCA (focus countries: Burkina Faso, Cameroon, CAR, Chad, CDI, DRC, Equatorial Guinea, Ghana, Nigeria) within the context of regional catch up plans to close the paediatric testing gap. As part of this support UNICEF has developed operational guidance on Family Testing and a draft toolkit. UNICEF is also providing direct country technical assistance within the region, including for global fund reprogramming to align investments with paediatric testing and treatment needs.
Commitment 55:
June 2022
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UNICEF work on HIV point-of-care (POC) testing has revolutionized the laboratory landscape across West and Central Africa through investments that have strengthened national capacity to test for HIV in infants and monitor viral load in patients on ART as well as test for Ebola virus disease, tuberculosis and, most recently, severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, advocacy towards the broader use of dual testing (HIV/syphilis) linking diagnostics to interventions to eliminated MTCT of HIV and syphilis. Leveraging the importance of POC as a multiplex platform, UNICEF supported the procurement of POC covid tests to be used on existing POC platforms. Importantly, the strategic use of multi-disease POC testing platforms has already paid dividends as they are being extensively used for COVID-19 diagnosis all around sub-Saharan Africa.
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UNICEF is supporting the expansion of POC through an innovations to scale POC project in 10 countries (Burkina Faso, Cape Verde, CAR, Chad, Congo, Equatorial Guinea, Gabon, Ghana, Mali, Nigeria) beginning this quarter with landscape analysis in 3 countries (Mali, Chad, Ghana) and laboratory systems strengthening training of technical teams from the countries. This project builds on the earlier POC UNITAID project lessons and experiences that are harnessed and shared through a collaborative POC community of practice.
68. Expand the demand for optimal paediatric ARVs in Western and Central Africa, increasing coverage of ART from 24% to 30% by adding 3,000 children on treatment by end of 2021 through enhanced case identification of children and expanded provider capacity.
69. Through dialogue and negotiation with manufacturers to implement flat pricing for pediatric drugs and to issue voluntary licenses or commitment to non-enforcement of patents with respect to pediatric ARVs.
70. Support national governments to implement targeted and differentiated services deliveries for children and adolescents anchored in continuous quality improvement through the rollout of the service delivery framework.
Commitment 68:
June 2022
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UNICEF contributed towards revising national PMTCT and pediatric HIV treatment guidelines and protocols to scale up use of pediatric 10 mg pediatric dolutergravir formulation.
Commitment 69:
June 2022
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In partnership with the Supply Division, the UNICEF global HIV programme worked to rapidly introduce dolutegravir as one of the antiretroviral drugs in the preferred first-line treatment option for all children and adolescents with HIV.
Commitment 70:
June 2022
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Differentiated service delivery models to improve outcomes for adolescents living with HIV.
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Expand roll-out of multiplex testing at point of care for HIV, COVID-19, cervical cancer and hepatitis B.
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Digital engagement to promote adolescent retention in care.
27. UNICEF commits to collaborate with GAP-f partners to develop, test, and disseminate training tools for treatment initiation with LPV/r and other optimal pediatric formulations
49. Support Ministries of Health to expand paediatric care and treatment within broader MCH services
Commitment 49:
June 2022
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Roll-out of the paediatric service delivery framework to identify gaps and implement best practice solutions.
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Within the child health platform UNICEF and partners advocate for use HIV programme learning to develop approaches for chronic disease management in children.
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Roll-out of the HPV vaccine in low- and middle-income countries is supported by Gavi, the Vaccine Alliance, and strategically managed by a consultative stakeholder group at the global level, in which UNICEF is a member along with other United Nations agencies and partners.
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In Mozambique UNICEF coordinated and supported the design and development of the new National HIV/AIDS Strategic Plan by advocating for the mainstreaming of adolescent engagement and the establishment of a Youth Advisory Group on HIV/AIDS to encourage systematic youth participation in strategic processes and decision-making.
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In Nigeria UNICEF provided technical and financial support to strengthen strategic information, including the coordination and preparation of a national investment case for action for adolescents and young people with HIV; an operational framework to collate the evidence base and strategic guidance; and an assessment and profile of the HIV prevention response among adolescent girls and young women
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UNICEF continues to engage with the paediatric ARV working group and PADO - led by WHO and partners, to ensure targeted and rapid development of priority commodities for pediatric HIV, and has supported the creation and utilization of practical guidance to promote uptake
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UNICEF has participated in the rollout of new WHO guidelines for HIV testing and treatment in children through a number of fora including within national pediatric HIV technical working groups and at regional meetings such as the HLM in Dakar, Senegal
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UNICEF continues to advocate and define models for scaling up high quality pediatric treatment through effective and supported integration within MCH
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Working with UNAIDS on improving data disaggregation for children and adolescents
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working with UNAIDS on analysis to see impact of PMTCT on estimates of children living with HIV
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plan to convene a meeting of all partners working on implementation to help countries optimize service delivery for children
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Action 25. Work with countries on creating demand for paediatric HIV treatment services including generation of age disaggregated data to inform the better planning and supply forecasting.
Action 26. Through UNICEF supply Division, support rapid country adoption of new recommended regimens by including them on the UNICEF procurement services product lists and tenders for long term agreements.
Action 25:
June 2022
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Supporting by UNICEF and other partners 30 countries had age-disaggregated at the end of 2020/beginning of 2021.
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In Lesotho UNICEF, with financial support from the Clinton Health Access Initiative, supported and convened the Government of Lesotho, multiple relevant ministries and partners on the ground, including adolescents and young people themselves, introduced a national referral framework to guide adolescents and young people to appropriate services. The framework institutionalizes and simplifies referrals across the HIV, health, child protection, social protection and education sectors, and strengthens linkages with non-governmental and community-based organizations for maximum impact.
Action 26:
June 2022
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In Botswana, Cameroon, the Democratic Republic of the Congo, Eswatini, Lesotho and Zimbabwe, UNICEF provided technical assistance to the Global Fund grant-making process and collaborated with other United Nations agencies to provide technical support to countries receiving Global Fund grants to advance supplies and delivery of combination prevention interventions for adolescent girls and young women (aged 15–24 years).
128. Support countries to collect and report data on TB-HIV co-infection and TB treatment initiation and outcomes in children living with HIV.
129. Advocate for increased pediatric TB case-finding and access to child-friendly treatment as a core member of the TB Child and Adolescent Working Group and the TB PADO.
130. Support national governments to optimize the integration of TB with child health, HIV, and nutrition services.
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