Road Map for Driving Results with Science

Science has brought us to the point where we can actually call for an AIDS-free generation. And it is science that will underpin all our efforts to achieve this goal and save even more lives. To deliver the greatest response,

PEPFAR will continue to support programs guided by scientific evidence—we will go where the science takes us, translating science into program impact. Specifically, this road map outlines PEPFAR’s plan to:

1. Leverage greatest impact by continuing to invest in implementation

science.

2. Support implementation research.

3. Evaluate the efficacy of optimized combination prevention.

4. Support innovative research to develop new technologies for prevention

(e.g., microbicides, vaccines) and care (e.g., new treatments or treatment regimens).

5. Develop evidence-based approaches to reaching people early enough in their disease progression to help maintain a strong immune system, stave

is using an implementation science framework that focuses on methods to improve the delivery, uptake and translation of research findings into real-world use and to ensure that science is ultimately

driving results. The objective is to identify opportunities for improving program performance that can be translated into immediate answers by addressing what worked, why and under what circumstances.

Acceleration of this effort will permit PEPFAR to support strategic interventions and focus them where they will have the most impact while simultaneously improving implementation effectiveness, efficiency and sustainability.

An implementation science framework also positions PEPFAR to actively develop and contribute knowledge about HIV/AIDS program implementation to the global community.

To implement this goal, PEPFAR is and will:

1. Leverage greatest impact by investing in continued implementation science through agency-specific mechanisms, rigorous evaluations of new PEPFAR programs, and promotion of innovative methods of delivery. The implementation science agenda examines methods that:

a) Achieve scale as measured by population level impact.

b) Ensure that program data are sufficient to support rigorous evaluations, simple to collect and useful (e.g. electronic health information systems).

c) Rigorously analyze and rapidly apply program data and newly generated knowledge through continual feedback loops to and from:

i. The field for adoption of new knowledge.

ii. Decision-makers including PEPFAR and country governments for accountability, resource allocation, and program improvement.

iii.Global and local normative agencies to inform WHO and national guidelines.

iv. The global research community to improve the field of implementation science.

d) Reach multiple populations (including key populations) in different settings.53

e) Deliver programs effectively and efficiently in combination.

f) Examine comparative health-systems strategies for optimal program delivery

2. Support implementation research:

a) On decentralization strategies to help reach and retain more people in care (and put people more in charge of their care), such as community-based testing and treatment strategies

b) On interventions that can help address gaps in the continuum of care—plugging the holes in the leaky cascade—including ways to testing, improve linkage to care for people testing positive, and reduce attrition by helping people remain in care.

c) Test interventions, including innovative technologies and other strategies to reduce the burden on patients, the cost of the package of care and the requirements of the health system to deliver.

3. Evaluate the impact of optimized combination prevention.

4. Support innovative research to develop new technologies for prevention

a) Work with NIH and others to move forward the scientific agenda to develop new technologies including the search for a cure.

5. Develop evidence-based approaches to reaching people early enough in their disease progression to help maintain a strong immune system, stave off opportunistic infections, particularly TB, and

reduce new HIV infections.

6. Support the deployment of suitable technology for measurement of viral load, both through tiered laboratory networks and ‘point-of-care’ tests as they become available. This technology is particularly important in helping people on ART and their care providers monitor how their treatment is working and assist them in achieving an “undetectable” level or virus in their bodies.

7. Assist countries in adopting breakthrough new technologies with proven impact, such as new molecular-based TB tests that have dramatically reduced time of diagnosis and treatment for

people living with TB and HIV.

This is NOT A HEALTH PROBLEM THIS S A SOCIAL STIGMA AND

DISCRIMINATION PROBLEM.

Road Map to End AIDS

UNITED STATES PRESIDENTS EMERGENCY AIDS RELIEFPEPFAR-Our Nation is at a crossroads.. When one of our fellow citizens becomes infected with the human immunodeﬁciency virus (HIV) every nine-and-a-half minutes, the epidemic aﬀects all Americans.ROAD MAP FOR SAVING LIVES.

This road map addresses the Secretary’s call in her November 8, 2011 speech to scale up combination HIV prevention and treatment interventions to save more lives.

Specifically, the section outlines PEPFAR’s plan to:

1. Work toward the elimination of new HIV infections among children by 2015 and keeping their mothers alive. GOMOJO understands allowing anger to motivate compassion will helps us do a better job.

2. Increase coverage of HIV treatment both to reduce AIDS-related mortality and to enhance HIV prevention. So far GOMOJO brings awareness to over 187 countries around the world with facts, stats and prevention tools. Our goals included a heavy focus on prevention and empowering those infected to prevent new infections.

3. Increase the number of males who are circumcised for HIV

prevention. GOMOJO has not yet expanded into this area of awareness, yet we are seeking health providers such as Dr. ZDog at Turntable Health in Downtown Las Vegas.

4. Increase access to, and uptake of, HIV testing and counseling, condoms and other evidence based, appropriately-targeted prevention interventions.

GOMOJO has followed 58 Billion dollars around the world and gathered the information of local organizations in Las Vegas, NV and 100's of cities across the country.

GOMOJO not only promotes the female condom as an essential part of an overall condom strategy, but is looking to partner with programs that account for each community's broader condom market and that consider the unique attributes and benefits of the female condom for various populations.

ROAD MAP FOR SMART INVESTMENTS

To achieve an AIDS-free generation, countries must target efforts where the virus is—reaching and supporting those populations at greatest risk and urgently needing services.

WE HAVE TO GO WHERE THE VIRUS GOES." HILARY R CLINTON

1. Target HIV/AIDS reduce co-morbidity and mortality.

2. Increase access to, and uptake of, HIV services by key populations.

3. Partner with people living with HIV to design, manage and implement HIV programs to ensure that they are responsive to, and respectful of, their needs.

4. Strengthen PEPFAR’s continued focus on women, girls and gender equality.

5. Reach orphans and vulnerable children (OVC) affected by AIDS, and support programs that help them develop to their full potential.

6. Strengthen programmatic commitment to and emphasis on reaching and supporting young people with HIV services. will continue to grow and plan includes sharing our stories to better support the efforts of the organizations on the ground.

7. Strengthen PEPFAR supply chains and business processes to increase the efficiency of our investments.

8. Increase efficiencies through innovation and greater integration of services with other U.S., bilateral and multilateral global health investments.

Accordingly, PEPFAR will work with countries to scale-up activities that have a strong evidence base to produce a population-level impact.

We will not support interventions that fail to target the epidemic. Concurrently, we will work to realize efficiency gains to deliver greater results for our investment. We have vastly increased PEPFAR’s value for money by reducing the cost of antiretroviral drugs (ARVs), streamlining supply chains, and working with partner countries to increase their investments, and this work will remain a PEPFAR priority.

We will also continue to lead efforts to strengthen the Global Fund. Did you know that for every dollar donated by the U.S., approximately $2.50 has been leveraged from donor governments, philanthropy and the private sector for the Global Fund? This road map outlines how we will follow the epidemic, invest in evidence

As stated earlier, the goal of creating an AIDS-free generation is a shared responsibility with partner countries in a convening role. e-based interventions, and continue to generate value for money in our fight against AIDS. Specifically, this road map outlines PEPFAR’s plan to:

ROAD MAP FOR SHARED RESPONSIBILITY

Neither the U.S. nor any other single entity can accomplish this goal alone. Rather, it requires a Country, State, City, Community, Companies, Organizations and Individuals to demonstrate political will and effective coordination of multiple partners that are providing financing and carrying out interventions both inside and outside of the health sector, and most importantly, meaningfully involve those living with and affected by HIV in all aspects of the response. Specifically, this road map outlines PEPFAR’s plan to:

1. Partner with countries in a joint move toward Country, State, City, Community, Companies, Organizations and Individual-led, managed, and implemented responses.

2. Increase support for civil society as a partner in the global AIDS response.

3. Expand collaboration with multilateral and bilateral partners.

4. Increase private sector mobilization toward an AIDS-free generation.