THE ZIMBABWE NATIONAL PLAN ON ELIMINATION OF NEW HIV INFECTIONS AMONG CHILDREN BY 2015 AND KEEPING FAMILIES ALIVE

Dr Angela MushaviNational PMTCT and Pediatric HIV Care and Treatment CoordinatorXIX International AIDS ConferenceWashington DC22/07/2012

Outline of presentation The process of developing the

eMTCT strategy Vision and goal of the eMTCT

strategy Outcome and impact results for

eMTCT for the years 2011-2015 Summary and recommendations

for eMTCT in Zimbabwe

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Zimbabwe

Population 12 millionPLHIV 1.1 millionCLHIV 150 000HIV prevalence in ANC 16,1%

Process of Developing the eMTCT Strategy

Process led by the Ministry of Health and Child Welfare’s PMTCT Partnership Forum

Review of the 2006-2010 PMTCT and Pediatric HIV Care and Treatment Plan preceded crafting of eMTCT strategy

The Interagency Task Team on HIV Prevention and Treatment of Pregnant Women and Children; co-chaired by WHO and UNICEF (IATT) supported the review (availed a consultant)

Bottlenecks and success factors identified informed the crafting of the eMTCT strategy; which includes pediatric care and treatment (supported by EGPAF and IATT)

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Process of Developing the eMTCT Strategy

The eMTCT strategic plan dovetails very neatly with the global plan on elimination of new HIV infections among children by 2015; and keeping mothers alive

Costing of the eMTCT strategy is being finalised (with support from the IATT)

Strategy was launched on the 28th of May 2012 with support from EGPAF

2011-2015 Strategic Plan: Vision and Goal

Vision: A new generation free of HIV and families affected by HIV alive and living quality lives

The Goal: To Eliminate new HIV infections in children by 2015 and improve the survival of mothers and children in the context of HIV

Guiding Principles for the Strategy

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Equitable access: Equity in accessing quality services for eMTCT and pediatric care and treatment

Results based management: focusing on achievement of impact and outcomes

Integrated service delivery of PMTCT and Pediatric HIV through a strengthened MNCH platform

Multisectoral and multi-disciplinary approach Evidence based approach that builds on best

practices The “Three Ones” principle – One National

Coordinating Body, One National Strategy and One M&E Plan

Guiding Principles of the eMTCT Strategy

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Meaningful involvement of people living with HIV (MIPA)

Family centred approach: A holistic family centred approach for women, their partners and family

Partnership: Strengthening partnerships across public and private sectors as well as civil society organisations (FBOs, NGO and CBOs)

Gender sensitive Focus on quality

The 7 Strategic Objectives of the eMTCT Plan

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1. Strengthen program leadership, management, coordination and supervision of sites

2. Strengthen provision of quality PMTCT and Paediatric HIV treatment services integrated within the MNCH platform

3. Strengthen human resource capacity

4. Strengthen the supply chain management system for commodities

The 7 Strategic Objectives of the eMTCT Plan

5. Strengthen laboratory capacity to support eMTCT

6. Strengthen community involvement and participation

7. Improve generation, dissemination and use of strategic information

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Zim’s eMTCT Strategy is grounded in the UN Strategic Framework for Prevention of HIV Infection in Infants and Young Children

Prong 2Prevention of

unintendedpregnancies

Prong 4 Provision of care and support for HIV-infected

women, their children, and their families

Prong 3 Prevention of

mother-to-child HIV transmission

Prong 1Primary Prevention

of HIV

Outcome Results

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Reduced new HIV infections among child-bearing women by 50% from 13% in 2009 to 7% by 2015

Reduced unmet need for family planning among

women of child bearing age living with HIV from 13% to 0% by 2015

Reduced MTCT of HIV from an estimated 30% in 2009 to <5% by 2015

Outcome Results

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Increased proportion of treatment eligible HIV positive P&L women initiated on ART for their own health from 10% in 2010 to 90% by 2015

Increased proportion of HIV-infected infants and children initiated on ART before the age of 2 years from 27% in 2010 to 90% by 2015

Impact level 90% reduction in new HIV infections

among children (from 15 000 new HIV infections per annum to less than 1 500)

50% reduction in HIV related maternal mortality (from 26% to 13%)

Implementation strategy for attaining eMTCT stretch goals

Focused on integrated service provision across PMTCT and treatment services (adult and pediatric)

Integration with SRH and HIV; as well as within the broader MNCH platform

Community participation will be key in scaling up follow-up across the PMTCT, EID and early treatment for HIV positive children

To this end, a communication strategy has been developed to support the eMTCT strategy

Summary The Zimbabwe eMTCT strategy is

ambitious; it has stretch goals and focuses on impact

Importantly it focuses on delivery of a comprehensive 4-pronged approach to eMTCT and articulates a continuum of care that progresses to maternal ART and pediatric HIV care and treatment

Indeed, there is optimism that the country will attain the goal of eMTCT by 2015 and keep mothers and children alive

AcknowledgementsPMTCT Partnership Forum-led by PMTCT Program; and with

membership of other departments of MOHCW as well as academic institutions

Provincial and district health teams as well as city health directors

MOHCW Partners in PMTCT EGPAF and the Family AIDS Initiative (ZAPP/KAPNEK/OPHID) WHO/UNICEF/UNFPA/UNAIDS/UNDP CHAI ZVITAMBO MSF NAC JSI/SCMS ZNFPC PEPFAR CIFF ESP (5 partners: DFID, NORAD, SIDA, CIDA, Irish Aid) Global IATT agencies

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Thank youTatenda!

Siyabonga!