We have entered an era of HIV epidemic control, and the end of the pandemic is within reach. The World Health Organization (WHO), the President’s Emergency Plan for AIDS Relief (PEPFAR), the Joint United Nations Programme on AIDS (UNAIDS) and the Global Fund to Fight AIDS, TB and Malaria (GFATM) have set global goals that call for 95% of people living with HIV (PLHIV) to be diagnosed, 95% of these to be initiated and retained on antiretroviral therapy (ART) and 95% of these to be virally suppressed (95-95-95). Reaching these goals will require laser-focused strategies that can rapidly identify new infections and effectively interrupt transmission patterns across all age bands, genders and risk groups. Populations at particularly high risk and currently experiencing disparities in care and prevention cannot be left behind. To attain this level of efficiency, programs need high-quality, real-time data in order to target the
right interventions to the right populations at the right time and demonstrate impact.
As the global response moves closer to achieving 95-95-95 and epidemic control, efforts to identify and respond to remaining pockets of transmission need to be intensified. To do this successfully, emerging HIV prevention and clinical interventions require robust strategic information (SI) systems that can deliver high-quality data in real-time. For example, effective delivery of prevention interventions, such as pre-exposure prophylaxis (PrEP), voluntary male medical circumcision (VMMC), DREAMS and condom distribution, requires on-going analysis and use of data to track the current epidemic and target interventions toward high risk HIV-uninfected individuals. Customized testing, including self-testing, requires robust surveillance systems to target interventions towards hot spots of transmission among the hardest-to-reach populations. Scaling up same-day initiation, differentiated service delivery models and multi-month prescription fulfillment requires enhanced monitoring to track commodities, retention and impact on health system efficiency.
The University of California, San Francisco (UCSF) and its partners, which include Imperial College London and the Association of Public Health Laboratories (APHL), propose to lead the Strategic Information for Quality HIV Implementation and Learning consortium (SIQHIL), which aims to build capacity within multiple high burden PEPFAR countries to develop, validate and strengthen SI activities to ensure effective prevention and treatment cascades for children, young men and women and key populations (KP). We propose an approach that fast-tracks development, validation and improvement of SI activities, with the ultimate goal of adapting effective and proven innovations aligned with PEPFAR priorities into national health information systems. The overall goal is to advance SI activities including surveillance, M&E, health information systems (HIS), including Laboratory Information Management Systems (LIMS) and statistical methodologies for HIV and TB diagnosis, treatment and prevention. The project will be implemented in several PEPFAR countries to help reach and the 95-95-95 targets. To achieve its goal, SIQHIL will focus on three objectives
• Objective 1: To strengthen countries’ capacity to conduct enhanced M&E activities and strengthen HIS in support of evidence-based decision making and program improvement.
• Objective 2: To enhance capacity for developing and implementing HIV/TB surveillance and surveys to provide information for measuring epidemic reach and impact.
• Objective 3: To build capacity for statistical analysis and modeling for HIV/TB data with the aim of using data to help reach 95-95-95 targets and document the impact of PEPFAR programming on reaching epidemic control.