An aggressive global response, particularly over the past ten years, has finally pushed the HIV epidemic into decline. The number of new HIV infections is falling and more people than ever before have access to lifesaving antiretroviral treatment (ART). Breakthroughs in prevention, including vaginal microbicides, vaccine trials, and voluntary medical male circumcision have revived hopes of ending new infections.
While the epidemic is far from over, the right investments now could bring the goal of an “HIV-free generation” within reach for the first time in three decades. Yet, just as a strong push is needed, political will and financial resources are dwindling in the face of the global economic crisis. Thus, there is an urgent need to make existing funds go further, to maximize the effectiveness and efficiency of programs, and increase country ownership of the HIV response.
What We Do
Good policies and a favorable policy environment are key to capitalizing on this moment of opportunity. We work with host-country partners to:
- Strengthen the capacity of government leaders to serve as effective stewards of health programs
- Build local capacity to advocate for a supportive HIV policy environment
- Design policies based on evidence of client needs and programs that work
- Strengthen the efficiency and effectiveness of national HIV programs
- Engage people living with HIV (PLHIV), key populations, women, and civil society groups in the policy process
- Facilitate multisectoral cooperation to plan and carry out HIV programs
- Enhance policy and program monitoring and accountability
- Develop policy decision making tools and use analytical models to understand resource needs, and assess system efficiencies, policy impacts, and equitable access to antiretroviral therapy
We also assist countries to improve health outcomes by addressing barriers due to stigma and discrimination, gender inequalities, socioeconomic status, operational issues, and other factors that prevent people from seeking the HIV prevention, treatment, and care services they need.
All our efforts are designed to increase country ownership of the AIDS response.
Improving Policy Environment for Key Populations at Higher Risk
Biological, behavioral, and structural factors place certain key populations at higher risk for HIV transmission than other individuals. These key populations vary across regions and countries, but often include men who have sex with men (MSM), sex workers, people who inject drugs (PWID), detainees, and sexual partners from populations at lower risk of infection. Meeting the prevention, care, and treatment needs of these key populations and engaging them in the policy process is crucial to maximizing the impact of HIV policies and programs.
We support the implementation of PEPFAR guidance for key populations at higher risk by expanding evidence-based analysis and advocacy resources for PWID and MSM-related policies and programs as part of an overall effort to strengthen HIV policy and prevention.
Monitoring HIV Policy and the Policy Process
High capacity for policy monitoring means being able to effectively and systematically collect, analyze, communicate, and use data related to the process and outcomes of health policy development and implementation. This helps ensure policies are based on sound evidence and better respond to the health needs of the population. HPP strengthens the capacity of governments, individuals, and civil society organizations to play a vital role in policy development, implementation, and monitoring to bolster national efforts in the response to HIV. We facilitate multi-stakeholder dialogues and foster strong relationships across sectors to effectively monitor the full policy process and use that information to improve policy development and implementation. This also enhances the accountability of government institutions to provide services and conditions specified in national and local laws, policies, and regulations.
Reducing HIV-Related Stigma and Discrimination in Healthcare Settings
Reducing stigma and discrimination is crucial to the success of HIV prevention, care, and treatment efforts. Integrating stigma-reduction and rights-based approaches into policies and interventions can reduce vulnerability to HIV and alleviate barriers to service access and use. Yet, stigma and discrimination remain seriously neglected issues in the global response to HIV. One of the main factors hindering efforts to focus attention and resources on stigma and discrimination has been the lack of concrete measurements with which to gauge the effects of stigma and discrimination and the impact of stigma-reduction efforts.
HPP supports greater integration of efforts to reduce stigma and discrimination into health policies and programs. Measuring stigma and developing training protocols in healthcare settings are a major focus within that broader effort.
Maximizing Efficiency and Effectiveness (E²)
The need to maximize the efficiency and effectiveness— also known as E² — of HIV programs has never been clearer. HPP defines E² as decreasing costs without decreasing the quality or quantity of the outputs and/or increasing outcomes without increasing long-term costs. We are working to develop an E² methodology that helps close the gaps in HIV financing and produce better program results.
Promoting Evidence-based Responses for Women and Girls
The global HIV epidemic has fallen particularly hard on women and girls. In Sub-Saharan Africa, which is home to well over half (68%) of people living with HIV, women are more likely than men to contract HIV. This risk is heightened by gender inequalities, which expose women and girls to increased risk of sexual violence and make it harder for them to prevent HIV or access care, support, and treatment services.
With funding from PEPFAR, HPP is collaborating with the Public Health Institute to increase use of evidence in HIV policymaking and programming for women and girls under the What Works for Women and Girls program.
Publications and Resources
Designing a Stigma and Discrimination Reporting System: Assuring Justice for People Living with HIV and Key Populations in Ghana
Drawing on lessons learned from other contexts, the Health Policy Project collated international best practices, research on legal codes and systems in Ghana, and consultations with key stakeholders to determine approaches to monitoring discrimination. Using this information, the report the describes internet- and text message-based platforms for reporting HIV-related discrimination to the Commission on Human Rights and Administrative Justice (CHRAJ), providing a mechanism for civil society organizations to report cases to CHRAJ, track case progress, and use data on stigma and discrimination to guide future advocacy on HIV- and other related policies in Ghana.
Cost of Providing Oral Pre-Exposure Prophylaxis to Prevent HIV Infection Among Sex Workers in Kenya
In collaboration with the National AIDS and STI Control Program and the Sex Worker Outreach Program, the Health Policy Project conducted a study to address the following questions: How much does it cost to provide oral PrEP to one sex worker for a year? And, how much would it cost to scale up oral PrEP to all sex workers country-wide?
Estimated Resource Needs and Impact of Mozambique’s Plano Estratégico do Sector Saúde, 2014-2019
The Plano Estratégico do Sector da Saúde (PESS) 2014-2019 (the Health Sector Strategic Plan), is the overall expression of the priorities, implementation approaches, and resource commitments for health of the government of the Republic of Mozambique (GRM). With support from the USAID-funded Health Policy Project (HPP), the Ministry of Health (MISAU) applied the OneHealth model to estimate the financial and health system resources need to implement the plan, and the likelihood of meeting key indicators in maternal and child health and HIV/AIDS related to the Millennium Development Goals.
National Family Planning-HIV Programme Integration in Jamaica
To heighten efficiency and sustainability, the Jamaican Ministry of Health (MOH) integrated elements of its national HIV program into its family planning (FP) program to create a new national agency for sexual health. In undertaking this reform, the MOH found a dearth of guidance about national HIV-FP program integration. Thus, the MOH collaborated with the USAID- and PEPFAR-funded Health Policy Project to develop this case study assessing lessons to date in Jamaica and next steps.
Demand for and Uses of Geospatial Mapping in HIV Programs: Documenting the Experiences of End-Users in Mpumalanga Province, South Africa
With support from the PEPFAR and in collaboration with the Global Fund, the USAID-funded Health Policy Project is providing technical assistance to ten high-impact countries in Africa and Asia to strengthen their use of geospatial analysis in HIV policymaking and strategic, financial, and program planning. This brief explains how a South African district improved HIV services using maps.
Building Leadership in the HIV Response in Mexico, Central America, and the Caribbean
The USAID-funded Health Policy Project commissioned a case study of the National Institute of Public Health's (Instituto Nacional de Salud Pública – INSP) educational programs to better understand what elements are critical for such programs to be successful, what challenges they face, and to identify opportunities to strengthen and expand regional capacity-building efforts in the future.
Getting to “Stigma-Free” HIV Services in St. Kitts and Nevis: Survey Results
The results of a survey of health facility staff in St. Kitts and Nevis, conducted by the University of the West Indies, the St. Kitts and Nevis Ministry of Health, and the USAID- and PEPFAR-funded Health Policy Project (HPP), illustrated that key drivers of stigma and discrimination in health facilities (fear of HIV infection, negative attitudes and facility environment, including policy) are present across all levels of staff, both medical and non-medical.
HIV/AIDS and Sexual Reproductive Health Among University Students in Ethiopia: A Policy Intervention Framework
In Ethiopia, the Health Policy Project is supporting the Federal HIV/AIDS Prevention and Control Office and higher education institutions (HEIs) to prioritize and target HIV interventions in HEI settings. As part of this effort, HPP assisted the government's HEI Partnership sub-Forum against HIV/AIDS with developing a Planning, Monitoring, and Evaluation Framework for HIV/AIDS and SRH interventions in HEIs.
Policy Analysis for Key Populations at Risk of HIV Infection in Togo
This USAID-funded assessment, conducted in Togo, is the second country application of the Health Policy Project and African Men for Sexual Health and Rights (AMSHeR) Policy Analysis and Advocacy Decision Model for HIV-Related Services: Males Who Have Sex with Males, Transgender People, and Sex Workers.
Policy Analysis and Advocacy Decision Models for Key Populations
The Health Policy Project HIV policy analysis and advocacy decision models are systematic structures and methodologies designed to help stakeholders create an inventory of country policies, analyze these policies against international best practices and human rights frameworks, assess policy implementation, and create a strategic advocacy plan.
Scaling Up Policies, Interventions, and Measurement for Stigma-Free HIV Prevention, Treatment, and Care Services
As part of an ongoing collaborative global effort to develop a standardized set of HIV-related stigma and discrimination measures for use in healthcare facilities, the Health Policy Project released a new working paper focusing on the scale-up of policies and interventions to reduce stigma in healthcare facilities.
Stigma and Discrimination: Key Barriers to Achieving Global Goals for Maternal Health and Elimination of New Child HIV Infections
This new Health Policy Project working paper examines the current evidence on stigma and discrimination and their negative impact on prevention of mother-to-child transmission (PMTCT), as well as the potential benefits of integrating PMTCT into antenatal care and maternal, neonatal, and child health services.
HIV Policy and Advocacy Monitor
The HPP's HIV Policy and Advocacy Monitor is a monthly newsletter focusing on the advancement, development, and analysis of policies, advocacy campaigns and organizations, and policy-related data to inform the response to HIV and AIDS at the global, national, and local levels. It includes news items, resources, advocacy reports, and innovative policy analyses on a wide range of topics such as treatment, key populations issues, gender, and financing for HIV policies and programs.
If you would like to suggest an item for inclusion in the next issue, please send it to: email@example.com.