WHO is calling for National HIV/AIDS programme reviews

Field visit by members of review team to district health center in Cambodia, WHO

WHO in the Western Pacific Region is supporting countries to conduct comprehensive reviews of their HIV/AIDS programmes.

Countries that conduct a review gain an immediate snapshot of their progress in fighting the epidemic, while also seeing clearly where improvements can be made.

“The programme review was very encouraging. We know that we are on target to achieve our goals,” said Dr Mean Chhi Vun, Director, National Center for HIV/AIDS, Dermatology and STD, Ministry of Health, Cambodia. “But it also showed where we need to keep up the fight, in particular with certain key populations.”

WHO offers extensive experience in conducting these reviews in other regions and with programmes such as tuberculosis, malaria and immunizations. WHO has a model for reviews that produces useful results immediately, based on the needs of the specific country.

“We wanted to bring this approach to the Western Pacific Region because we know how effective it can be,” said Dr Ying-Ru Lo, who leads the WHO HIV programme in the Western Pacific Region and has conducted similar reviews in the WHO South-East Asia Region. “Countries that do the reviews learn where they can gain efficiencies, where activities are duplicated, hear from experts in financing, in procurement. The end effect is that fewer people get HIV infected and more people get treatment.”

The process begins with local partners preparing key data about a range of topics. They bring forward issues of concern and questions for further work. Based on these issues, WHO sources the relevant international experts to be part of the team. The country’s national HIV/AIDS programme guides the team with support from WHO and technical experts, civil society, key affected populations and donor agencies.

  “We appreciated that it was not outsiders coming in and imposing a view but rather all of us working on questions that we needed answered”, said Dr Jose Gerard Belimac, Programme Manager, National AIDS and STI Prevention and Control Program, Department of Health, Philippines National HIV/AIDS Programme.

Over a period of about 10 days–the exact length depends on the size of the country and the issues—the team conducts extensive field visits and meetings with stakeholders. Sub-teams focus on themes such as treatment, prevention, and HIV testing and counselling. They meet with policy-makers, patient groups, service providers and civil society. The review is an opportunity to address HIV and health systems issues such as mid- to short-term health financing, health laboratory and procurement supply management, blood safety, co-infections such as tuberculosis and HIV, hepatitis and HIV and other sexually transmitted infections.

The field visits are an essential part of the process. In one country, one of the visiting team members met truck drivers at a rest stop and learnt they were not receiving information about the risks of sexually transmitted infections. Yet they are an at-risk population. This chance encounter led to changes in counselling and the distribution of information on prevention to these drivers.

At the end of the visit, the team presents its results to the minister of health or other senior government representatives, and a wide range of stakeholders seeking their endorsement. A formal report is subsequently issued.

The resulting recommendations are relevant to a country’s specific context and can be implemented for immediate improvements in their HIV/AIDS programmes and services, thereby improving the lives of people living with HIV/AIDS and reducing the spread of the disease. By providing support to countries conducting these reviews, WHO is able to ensure they are not over-burdened with multiple reviews, but rather conduct a comprehensive one that meets the needs of the country and donors alike.

In 2013, programme reviews were conducted in Cambodia, Mongolia, Papua New Guinea and the Philippines. Further reviews are planned for 2014.

Date: 4 June 2014