Global 90-90-90 HIV strategy: Ghana’s Campaign

2017-12-01-HIV AIDS2016 worldwide estimates indicate that there were 36.7 million people living with HIV (PLHIV) out of which 1.8 million were newly infected. Only 53% of the PLHIV were receiving treatment globally. An estimated 1.0 million deaths was also recorded from HIV related events in the year. The WHO African Region is the greatest affected holding about two-thirds of PLHIV and newly infected people in the duration. Estimates for mid-2017 show that 20.9 million people are on ART.

The UNAIDS’s 90-90-90 HIV strategy summarizes the 2020 targets of;

  • 90% of people living with HIV to know their HIV status;
  • 90% of people who know their HIV status are accessing treatment; and
  • 90% of people receiving treatment achieving viral suppression within 12 months

As the world aims to eliminate this menace by 2030, the World Health Organization (WHO) recommends immediate initiation of antiretroviral treatment (ART) after diagnosis. The WHO has revised the eligibility limitations for ART across population and age groups to facilitate treatment. UNAIDS estimates that with the implementation of fast-tracking and treatment in low and middle-income countries, over 21 million deaths and 28 million new infections would be prevented by the 2030 deadline. Countries are encouraged to implement early testing and treatment and make logistics readily available, which will reduce the burden of disease, lessen the risk of transmission to other partners and also bring with it huge economic benefit.

Ghana’s HIV campaign overview

Ghana’s response to achieving global goals of the 90-90-90 HIV strategy is the development 5-year roadmap of Locate, Test, Treat and Retain (L2TR).

This National AIDS/STI Control Programme (NACP) policy document sets out to focus on lower level health workers, volunteers and other stakeholders to Locate, Test, Treat and Retain PLHIVs in ART. The focal areas of the Campaign are HIV testing services, treatment of PLHIV, and Strategic Information management.

In the first area of HIV Testing services, the campaign aims at revising guidelines based on the WHO updated guidelines of 2016, training of lower level health workers and volunteers for case finding in households, provision of logistics for HIV testing and also improving laboratory diagnostics of viral load in treatment facilities and the specimen referral system. The policy also encourages routine provider initiated testing for all out and in-patients and for all special clinics including mothers and infants attending child weighing clinics.

In the areas of treatment, the campaign aims at creating a national policy framework that would support the treatment of PLHIV irrespective of their viral loads. This would include the revision of the ART guidelines providing training to service providers as well as the necessary commodities and infrastructure for treatment. A scale-up of ART sites is also envisaged by the campaign.

Last but not least, the campaign will seek to strengthen reporting mechanisms to ensure accurate data is received timely. This would involve the leveraging technology advancements to track clients and monitor the quality of care provided while ensuring that data quality is improved and reliable for tracking the achievement of the 90-90-90 targets.

Conclusion

The journey to 2020 is short and a rapid scale-up of case finding, treatment and monitoring is key to meeting the 90-90-90 targets and further more ending HIV menace by 2030. Even though the global target may be ambitious, it is very practical and achievable if every Ghanaian living everywhere recognizes their role in hitting the target. As we mark Worlds AIDS Day, let us remember everybody counts. Action must start NOW!!

 Authors

  • Dr Anthony Enimil (HIV/TB Specialist),
  • Evans Xorse Amuzu (Health Research Officer)
  • Obed Nyarko Ofori (Clinical Student)

References

  1. The World Health Organization: Who | Treat All People Living with HIV, offer antiretroviral as additional prevention choice for people at “substantial” risk: http://www.who.int/mediacentre/news/releases/2015/hiv-treat-all-recommendation/en/: accessed 2017-12-01 11:51:13.
  2. Cheret , Bacchus-Souffan C., Avettand-Fenoel V., Melard A., Nembot G., Blanc C., Samri A., Saez-Cirion A., Hocqueloux L., Lascoux-Combe C., Allavena C., Goujard C., Valantin M.A., Leplatois A., Meyer L., Rouzioux C., Autran B. Combined ART started during acute hiv infection protects central memory CD4 T Cells And Can Induce Remission: The Journal Of Antimicrobial Chemotherapy, Volume 70, Issue 7 pg 2108-2120, Jul 2015.
  3. UNAIDS: Fast-Track Ending The Aids Epidemic By 2030: www.unaids.org/sites/default/files/media_asset/jc2686_wad2014report_en.pdf: accessed 2017-12-01 11:54:13
  4. Steven Ayisi Addo:Locate, Test, Treat And Retain (L2TR) Ghana Campaign 90-90-90 Ending The Aids Epidemic By 2030 Roadmap to Treat All, July 2016:http://www.ccmghana.net/index.php/strategic-plans-reports?download=92:90-90-90-roadmap- to-treat-all, accessed 2017-12-01 11:54:13.