Strategic CT Scale Up group

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Strategic CT Scale Up group
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Strategic CT Scale Up

• Key Issues
• Matching scale up strategy to your epidemic (and
  budget)
• Are we reaching the right populations? Reach
  highest risk first (TB/STI/ANC/HIV-exposed
  children/MARPs)
• Where are we providing CT (stand-alone, mobile,
  integrated)
• How are we providing CT (PITC, campaigns,
  client-initiated)
• Reaching couples and families

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Contd

• National policies to support scale up
• Task shifting
• Sample collection (finger-prick or oral fluid)
  and rapid tests
• Innovative models

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Strategic CT Scale Up

• Key Issues, cont.
• Human Resources
• Quality
• Testing
• Counseling
• Commodities/Supply chain
• Waste Management
• How to link CT to other services (care and
  treatment, prevention, ongoing counseling) and
  ensure referrals

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Strategic CT Scale Up

• Key Issues, cont.
• Demand creation (matching supply with demand)
• Targeting/IPC/mass media
• Sustainability and cost-effectiveness
• Research to guide scale up
• How to improve prevention, adolescents

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Strategic CT Scale Up

• Key Issues, cont
• Commodities/Supply chain
• Linking CT to other services (care and treatment,
  ongoing counseling, male circumcision)
• Demand creation
• Sustainability and cost-effectiveness

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Strategic CT Scale Up

• Prevention Issues
• How to tailor prevention messages in CT to the
  epidemic (IDU, multiple concurrent partnerships)
  and to the clients reported risk
• How to maximize prevention effect of CT? For
  positives? For negatives? For discordant couples?
  
• How to better link CT to other prevention
  activities (BCC, male circumcision)

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Strategic CT Scale Up

• Lessons Learned from Workshop
• Countries need to use a variety of models in
  order to scale up. There is no single solution.
• Start scaling up now, but be prepared to adjust
  based on new evidence/program experience
• Alternative approaches may need piloting
• Couples, children and family CT needs greater
  emphasis
• In order to scale up we need appropriate policies
  based on evidence
• Tailor communication messages to the country

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Strategic CT Scale Up

• Key Priorities
• Help countries develop strategic CT scale up
  plans based on their epidemic and budget, using
  multiple service delivery models
• Build capacity of institutions and human
  resources to scale up CT (task shifting,
  training, supervision/support)
• Sustainability/cost effectivenessneed to involve
  govt. and other sectors
• Policies that impede scale up (age of
  consent/sample collection/rapid testing/task
  shifting)
• Role of CT in prevention

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Strategic CT Scale Up

• Next Steps/Specific Action Items
• Country delegations re-assess national CT program
  and develop country specific scale up plan (based
  on their epidemic and their resources)
• Need clear guidance from WHO/UNAIDS/PEPFAR to
  guide scale-up plan (to overcome barriers to
  scale up related to rapid testing, scale-up and
  task-shifting)
• Involve implementing partners in PEPFAR CT
  Technical Working Group. Develop website and
  listserv to share evidence/best practices and
  list of technical experts available to provide TA
  to countries
• Advocate for more money to be put in CT

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Thank you