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
28. Equip, mobilize, and support faith leaders, FBOs, people in places of worship, and the wider community to create demand for testing of infants and children.
29. Combat stigma and discrimination among faith leaders and within communities of faith.
30. Further collaborate and coordinate community mobilization, education and outreach to find otherwise hard-to-reach children, adolescents, youth and adults for age appropriate prevention education, testing and linkage to treatment and health and social support services and integrate into the national system.
31. Ensure FBO participation in local and national diagnostic product/supplies forecasting.
32. Support and participate in national efforts to improve the use and impact of pediatric diagnostics and develop national strategies to optimize the use of new technologies and interventions.
33. Work to implement new HIVST modalities (such as oral fluid testing) in communities and homes, where national polices and regulations allow for lay implementation with children.
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38. Support and participate in national efforts to improve and integrate the use and impact of pediatric diagnostics for TB and HIV and develop national strategies to optimize the use of new technologies and interventions.
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71. Equip, mobilize, and support faith leaders, FBOs, people in places of worship, and the wider community to create awareness of the importance of HIV testing of infants and children of people living with HIV. Demand that national school curricula include scientifically appropriate information on HIV prevention, testing and treatment.
72. Combat stigma and discrimination among faith leaders and within communities of faith around HIV prevention, testing and treatment. Create demand for client-centered and stigma-free care within health facilities as well as access to community-based treatment.
73. Further collaborate and coordinate community mobilization, education and outreach to find otherwise hard-to-reach children, adolescents, youth and adults for age appropriate prevention education, testing, and linkage to and continuity of treatment, health, psycho-social and spiritual support services and integrate into the national system.
March 2022
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Last July, 2021, we were blessed to gain access to DTG 10mg, the first program in Kenya and in Africa to be able to optimise our young children on this ARV.
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Currently, we have 213 children eligible to access DTG 10mg. To date, we have managed to optimize 97%. as below:
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208 on DTG 10mg
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5 sadly Lost to Follow Up
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We continue to try to trace the LTF.
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Feedback from caregivers and children:
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Children are happy and co-operative as they take the drug since it is sweet and palatable.
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Care givers are happy too since their children remind them when it is time to take their medicine unlike before when it was a struggle even for them to administer the LPV/R syrup and LPV/R Pellets.
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The once a day dosage administration of the DTG 10mg drug has also turned out to be more convenient for both caregivers and children.
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This has also improved adherence and compliance to medication.
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Appreciate that DTG 10mg is easy to administer
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Improved viral suppression among children on DTG.
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There is a notable lower rate of opportunistic infections amongst the children.
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Notable weight gain among a number of children who were initially struggling to gain weight while others keep gaining weight gradually.
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Easy to store since it only requires room temperatures.
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Excellent 90 tablet package especially for children 14kg-20kg.
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October 2021
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Since the National AIDS Conference in Durban, July, 2016, when DTG for younger children was considered, I have been lobbying for access for our children, in particular at the annual Rome High-Level Dialogue on Pediatric Formulations and Diagnostics. For World AIDS Day, 2020 when UNITAID would announce their landmark agreement with the Clinton Health Access Initiative (CHAI) to make DTG 10mg, I was requested to send a response: ‘At last, what we have been waiting for since our adolescents accessed DTG - a DTG dispersible formulation for our babies and little children. Having watched these little children struggling to drink the bitter syrup and the older children trying to swallow several big bitter tablets, words are inadequate to express our relief for our little ones and our gratitude'.
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Following a communication from Gelise McCullough, MPP, on 5thMay, 2021, that, at last, DTG 10mg was going to be available in Africa, I made a passionate appeal at the Rome High-Level Dialogue on June 21st for access for our children. To my unbelievable joy, I had an almost immediate response from CHAI: My appeal was noted by the CHAI representative at the meeting; then came a visit from John Mungai, CHAI, Kenya, and a following visit on 5th July from Dr. Catherine Ngugi, Head NASCOP, Kenya. On 8th July, Dr. Gitonga, NASCOP arrived to present 500 phials of DTG 10mg. To date 132 of our children have been optimized while 76 others are waiting to have a viral load test done, a requirement for optimization. Happily, at last we have got the needed VL reagents which have been out of stock
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Already our medical staff and caregivers are giving us very positive feedback:
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Both the clients and caregivers are happy since the DTG 10mg is more child friendly.
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It is sweet as compared to LPV/R syrup and less tedious as compared to LPV/R pellets.
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Storage of the drug is also room temperature friendly unlike Kaletra syrup.
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Notable weight gains within the month of DTG 10mg uptake.
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No side effects reported.
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Improved adherence to treatment.
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It is expected that viral suppression will also be better achieved.
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Parents and caregivers whose young ones are still on LPV/r based regimen have a desire that their children be switched to DTG 10mg as well.
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On 21st September, the Ministry of Health chose Nyumbani Children’s Home to host the Dolutegravir (DTG) 50 and 10 Mg Handover Ceremony DTG 50 Mg from the United Nations Family and DTG 10Mg from the Clinton Health Access Initiative
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Once again, I am unable to express adequately our unbelievable joy that Nyumbani younger children can now access DTG 10mg, - and are the first in Kenya and in Africa.
April 2021
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As part of the PEPFAR Faith and Community Initiative (FCI) program: Enhancing partner notification service approaches targeting the sexualy active adolescents and teenage mothers in reaching out to the unreached population of children and adults especially men.
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In HIV paediatric treatment, Nyumbani has been lobbying for access to the 10mg DTG. They are hearing that Kenya will be one of the pilot countries, but no action so far. It is the usual story: the children are left behind. They have 244 children waiting to start 10mg DTG.
52. Ensure FBO participation in local and national forecasting of optimal paediatric drug formulations.
53. Collaborate with GAP-f partners to develop, test, and disseminate training tools for treatment initiation with LPV/r and other optimal pediatric formulations.
54. Support and increase family treatment initiation and retention for children, adolescents, and families by:
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Increasing identification and provision of same-day/same-appointment mother/infant pair treatment through FBO clinics;
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Promoting male/father engagement in EMTCT programmes; and
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Increasing stigma reduction interventions through mobilized faith leaders and faith communities
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Providing social work interventions to assist fathers to support treatment and adherence of their partners and children living with HIV.
55. Foster and more actively participate in coordinated and collaborative advocacy to:
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Increase funding for research & development, introduction and scale-up of priority pediatric drugs and formulations;
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Accelerate regulatory processes for rapid adoption and uptake of optimal paediatric drugs and formulations; and
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Ensure sustainable access to optimal testing and treatment for infants and children.
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Action 10: Promote the revision of national procurement plans to align with WHO recommended regimens and the Optimal Formulary, and support the provision of reliable forecasts and the consolidation of orders.
Action 22: Support the early adoption of priority formulations and diagnostics and take steps to facilitate their wider roll-out, including by developing introductory guidance, materials, and other tools for health facilities.
Action 27. Mobilize their networks and work with communities to help build treatment literacy, generate demand, and expand access to ARVs among children.
Action 28. Raising awareness in global fora about the unmet diagnostic and treatment needs of children with HIV.
Action 29. Promote uptake by mobilizing their networks of hospitals and community structures to distribute paediatric medicines in hard to reach places and in situations of conflict and crisis.
Action 34. Increase efforts to share information on the roll-out of new paediatric formulations, including lessons learned.
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119. Advocate for and support Ministries of Health to rapidly transition to optimal paediatric formulations as outlined by the latest WHO guidelines, provide coordinated support for the development and implementation of transition plans, inform clinicians and patients of the value of transitioning to new formulations, and ensure communication of reliable information on the availability of new formulations in-country.
120. Support the scale up of access to priority formulations and diagnostics and take steps to facilitate their wider roll-out, including by performing operational research, developing introductory guidance and education, materials, and other tools for health facilities and local community health structures.
121. Promote the revision of national procurement plans to align with WHO recommended regimens and the EML-C, and support the provision of reliable forecasts and the consolidation of orders.
122. Mobilize their networks and work with communities to help build treatment literacy, generate demand, and expand access to TB diagnosis and treatment among children in close collaboration with other stakeholders.
123. Raise awareness in local, national, and global fora about the unmet diagnostic and treatment and prevention needs of children with or at risk for TB.
124. Foster and more actively participate in coordinated and collaborative advocacy to:
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Increase funding for TB research & development, introduction and scale-up of priority paediatric drugs and formulations;
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Accelerate regulatory processes for rapid adoption and uptake of optimal paediatric TB drugs and formulations; and
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Ensure sustainable access to optimal TB testing and treatment for infants and children.
125. Tackle the TB stigma and discrimination in communities, schools, and healthcare settings that prevent children and adolescents living with TB or at risk of TB from accessing testing and treatment, including promotion of awareness of the difference between infection and disease and include messages of hope regarding treatment of both HIV and TB.
126. Promote uptake by mobilizing their networks of hospitals and community structures to distribute paediatric medicines in hard to reach places and in situations of conflict and crisis.
127. Support and increase TB treatment initiation and retention for children, adolescents, and families by:
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Identifying all TB-exposed children and connecting them to treatment and preventive TB treatment through FBO clinics and within communities of faith;
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Reducing TB stigma and discrimination through mobilization and evidence-based education and training of faith leaders and faith communities
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