2022 Rome Action Plan on Paediatric HIV & TB
EGPAF commits to:
140. In EGPAF programs, strive to achieve 95% of all HIV-exposed infants receive an EID test within 2 months of birth and, if negative, 95% are retested at 9 months and 95% at the end of exposure (post-breast-feeding), preferably using a same visit POC test, and 95% receive immediate linkage to care with ART initiation using an optimal formulation for those testing HIV positive.
141. Ensure that 95% of pregnant and breast-feeding women attending ANC in EGPAF-supported facilities with unknown HIV status and who are at risk for acquiring HIV are offered frequent HIV screening throughout pregnancy and breast-feeding, with linkage to PrEP services for those testing negative and immediate linkage to care with ART initiation using an optimal formulation for those testing positive.
142. In EGPAF programs, strive to achieve 95% of infants, children and pregnant and breast-feeding women on ART are offered viral load testing, as per the WHO recommended treatment monitoring algorithm, preferably using a same-visit POC test, with prompt initiation of adherence counselling and switch to second-line ART, as needed, for those who are persistently unsuppressed.
143. Annual data gathering and analysis on inequalities between children and adults in access to testing, treatment and viral load suppression across EGPAF programs.
All partners commit to:
163. Address inequities by tackling the stigma and discrimination in communities, schools, and healthcare settings that prevent children living with HIV from accessing testing and treatment.
164. Increase literacy about CD4 testing and viral load and promote a client-centred approach to support expansion of access to viral load for pregnant and breastfeeding women and children on treatment, including at the point-of-care.
165. Review and assess emerging co-infections for immunocompromised infants and children, including those with advanced HIV disease, such as severe bacterial infections, fungal infections, and others for country consideration and implementation.
166. Engage affected communities for input and guidance on investment and programmatic priorities, provide support to in-country civil society organizations to engage in advocacy and demand creation for new tools, and ensure data is publicly available to support communities and civil society to monitor progress regarding uptake and implementation of essential diagnostic tools.
EGPAF commits to:
218. Through its Unitaid-funded project CaP-TB, improve paediatric TB care, finding more children with latent (TB infection) or active TB (TB disease), and putting them on appropriate treatment. It includes improving the increased access and use of TB preventive treatment in high-risk populations of child contacts <5 and CLHIV.
EGPAF commits to:
319. Work with MoH to contribute to scale up and sustain access to the full portfolio of WHO-recommended paediatric ARVs, including backbone and alternative products, which are needed to deliver optimal first-, second- and third-line treatment regimens.
320. As co-chair of the GAP-f Product Access and Treatment Delivery working group, sustain and strengthen collaboration among relevant stakeholders to ensure quick access to the most optimal paediatric ARV formulations, in close consultation with civil society and the communities, including the community of people living with HIV.
321. Work with MoH, GAP-f partners and other national and international stakeholders to contribute to scale up and sustain uninterrupted access to pDTG 10 mg along with backbone paediatric formulations in EGPAF countries.
322. Support a coordinated plan with key partners, including GAP-f members, to provide technical assistance in support of ALD fixed-dose combination therapy for children 10kg to 25kg introduction to ensure rapid policy update and effective uptake in EGPAF’s countries.
323. Continue to support the implementation of the STOP-AIDS package of care for advance HIV disease (AHD) in children and develop a paediatric AHD toolkit and training materials with support from the Gates Foundation to further strengthen the identification and management of paediatric AHD.
324. As co-chair of the GAP-f Product Access and Treatment Delivery working group, sustain and strengthen collaboration among relevant stakeholders to ensure quick access to the most optimal paediatric ARV formulations, in close consultation with civil society and the communities, including the community of people living with HIV.
325. With the support and in collaboration with Johnson & Johnson (J&J) and other key partners, the New Horizons Advancing Paediatric HIV Care Collaborative (NHC) will provide support to its participating countries with health systems strengthening and access to Darunavir (DRV) & Etravirine (ETR) through donations (from Johnson & Johnson subsidiary Janssen Products LP). The NHC team commits to seek additional stakeholders to support the expansion of these NHC critical initiatives.
EGPAF commits to:
464. Improve the proportion of children and adolescents living with HIV (CALHIV) initiating and completing TB preventive treatment (TPT) among newly diagnosed CALHIV who access care at EGPAF supported facilities.
465. Improve the proportion of CALHIV that are identified as presumptive TB as well as the proportion finally diagnosed with TB among the CALHIV who access care at EGPAF supported facilities. Improve the linkage to TB treatment initiation among those diagnosed with TB.
466. Develop a paediatric and adolescent TB monitoring and evaluation framework for patient level and programmatic level indicators.
467. At least three public events and/or advocacy products led or co-led by EGPAF in collaborations with other TB stakeholders to sensitize, increase awareness and advocate for childhood TB at the national, regional and global levels in 2023.
468. Provide technical support to National TB Programs for policy change to adopt the new child and adolescents TB guidelines and recommendations released by WHO in 2022.