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
2022 Rome Action Plan on Paediatric HIV & TB
THE GLOBAL FUND
Funders commit to promote the implementation of the Call To Action principles through their investments, this includes:
52. Fund clinical trials of adequate size to assess the safety in pregnancy of high priority new agents with expected broad use by young women for treatment and prevention of HIV such as CAB LA, LEN and ISL.
53. Support country action and a global platform to strengthen active surveillance of safety of HIV agents (such as TAF, DRV/r and CAB LA) in pregnancy, building harmonization and linkages between surveillance networks, with a focus on the most-affected countries and populations.
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The Global Fund to Fight HIV, TB and Malaria commits to:
111. Support the procurement of commodities and operational costs to maintain and further scale-up POC infant diagnosis, as well as viral load testing for infants, children, and pregnant and breastfeeding women and advanced HIV disease diagnostics, through cross-cutting diagnostic and health systems strengthening interventions as an integral part of optimized and integrated national diagnostic networks and in accordance with national plans and targets.
112. Continue to work with the WHO PQ Team to expand supplier base of quality assured products.
113. Encourage and support countries to adopt innovative contracting mechanisms designed to improve maintenance and servicing of laboratory devices (including those used for paediatric HIV and TB diagnosis and management); a shift towards all-inclusive pricing and reagent rental programs should be explored whenever possible.
114. Support improved global and national coordination across donors to reduce disease funding silos for pediatric HIV and TB diagnostics, and where possible, pooling procurement volumes in negotiations with diagnostic manufacturers, and other activities.
115. Support national, multi-disease diagnostic network optimization mapping exercises to maximise efficiency and increase access to paediatric HIV and TB diagnostic services.
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.
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The Global Fund to Fight HIV, TB and Malaria commits to:
194. Prioritise funding investments aimed at improving case detection by increasing access (new procurement and improved networks) to molecular WHO-recommended diagnostics (including the use of non-sputum testing, devices and consumables for non-sputum sample types), LF-LAM assays, and digital x-ray technologies for screening for adults and children
195. Support implementation of Global Fund Program Essentials and operational and implementation research aimed at increasing case-finding through new tools, testing procedures and algorithms, and the scale-up of WHO recommended guidelines and product procurement in high TB burden countries.
196. Encourage and support countries to adopt innovative contracting mechanisms designed to improve maintenance and servicing of laboratory devices (including those used for paediatric HIV AND TB diagnosis and management); a shift towards all-inclusive pricing and reagent rental programs should be explored whenever possible.
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The Global Fund to Fight HIV, TB and Malaria commits to:
273. Support GAP-f partners’ plan for the accelerated introduction and rollout of the DTG 10mg dispersible tablet formulation, paediatric ALD, and paediatric darunavir/ritonavir in priority countries to ensure early and wide uptake.
274. The Global Fund commits to streamline and shorten critical quality assurance processes (such as sample testing) to accelerate the GF’s ability to place a first order via the Pooled Procurement Mechanism for a new paediatric product.
pALD introduction planning: Global Fund is working with procurement teams and has issued internal guidance for anticipated pALD introduction later this year in addition to co-creating GAPf memo with partners of Rome Action Plan
Global Fund to Fund HIV, TB and Malaria commits to:
420. Support the procurement of child-friendly formulations for all TB treatments (DSTB, DRTB and TPT) in line with the Program Essentials promoting short, all oral regimens.
421. Encourage countries to use pool procurement mechanisms, such as GDF, for quality assured paediatric products.
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