With new major awards from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC), ICAP at Columbia University will continue and expand on its support for HIV programs in Tanzania, Rwanda, the Democratic Republic of Congo, and Mozambique. Working closely with host government ministries of health and other partners, ICAP is committed to advancing innovative, sustainable HIV services, and strengthening the health system, particularly laboratory and strategic information systems.
“For nearly two decades, ICAP has been supporting the global HIV response with innovative solutions and dynamic partnerships with ministries of health, civil society groups and community member in the countries where we work,” said Wafaa El-Sadr, MD, MPH, MPA, founder and global director of ICAP. “With the new awards, we look to address critical gaps and support progress towards the UNAIDS 95-95-95 goals on the path toward epidemic control.”
Leveraging HIV Program Innovations in Tanzania
Building on 17 years of support for the national HIV response in Tanzania, ICAP will collaborate with the government of Tanzania and other stakeholders to advance HIV testing, care and treatment, and prevention services in both health facility and community settings.
The project will expand on ICAP’s pioneering work under the five-year, CDC-funded FIKIA (“to reach” in Swahili) project, which developed community-based, client-centered services in order to reach individuals by matching their preference for where, when, and by whom the services are delivered. For example, ICAP piloted and scaled up community ART (antiretroviral therapy) initiation and refills, pre-exposure prophylaxis (PrEP), HIV self-testing, and multi-month dispensing of ART to reduce crowding in health facilities during the COVID-19 pandemic.
Leveraging these innovations, ICAP will scale up comprehensive programs tailored to the needs of people living with HIV. Under this new award, ICAP will support comprehensive implementation of HIV prevention, testing, care and treatment, lab, and VMMC interventions at the community and facility levels in Mwanza region in Tanzania. Named the FIKIA+ (FIKIA Plus) Project, this initiative aims to accelerate, expand, and improve the quality of HIV prevention, care, and treatment in order to meet UNAIDS 95-95-95 targets in intervention districts.
“In FIKIA, we learned so much about making HIV care accessible, respectful, and responsive to people’s needs and preferences as we worked with groups and communities that are deeply impacted by HIV in Tanzania,” said Haruka Maruyama, MPH, ICAP’s country director in Tanzania. “Now, we are taking those lessons learned from community settings into health facilities, with the goal of improving both the quality and the continuity of services provided, especially in the context of the evolving response to the global COVID-19 pandemic.”
Providing Technical Assistance to Enhance HIV Services in Rwanda
In Rwanda, ICAP will provide technical assistance to strengthen the systems and capacities that will accelerate client-centered, sustainable HIV services. The five-year project builds on ICAP’s global work enhancing in-country laboratory and strategic information capacity and strengthening health systems to accelerate HIV epidemic control. For example, ICAP has supported Population-Based HIV Impact Assessment (PHIA) surveys in 15 countries, including Rwanda; helped implement secure health information systems to ensure actionable data to inform decisions and improve services; and improved laboratory operations for optimal patient care and treatment, as well as disease surveillance and response.
“We see this project as an opportunity to use our experience and the partnerships we have established to lead, to enhance data, diagnostic and quality improvement systems,” said Veronicah Mugisha, MBcHB, DPH, MMed (PH), country director for ICAP in Rwanda, and principal investigator for the project. “We believe this is the moment to emphasize these critical areas as Rwanda aims for reaching the UNAIDS 95-95-95 targets.”
Building on Successes in DRC
In the Democratic Republic of Congo (DRC), ICAP will build on its successful HIV interventions in that country under a new five-year project. Continuing ICAP’s longstanding collaboration with the ministry of health and the health zone management teams in Haut-Katanga, the project will aim to support the delivery of comprehensive HIV services while developing and sustaining innovative differentiated service delivery models. In addition, ICAP will collaborate with partners to strengthen the systems and processes – such as surveillance, diagnostics, and quality improvement – that support the delivery of HIV services in DRC.
Over the past five years, ICAP has achieved major successes in Haut-Katanga. For example, ICAP enabled the achievement of the highest viral load suppression among people living with HIV at the facilities it supported. ICAP also introduced pre-exposure prophylaxis (PrEP) services at three ICAP-supported health facilities, the first in DRC to offer PrEP. Project outcomes reduced stigma and discrimination and increased access to HIV testing services, PrEP, and post-exposure prophylaxis (PEP), ART, treatment for sexually transmitted infections, and viral load monitoring.
“ICAP’s strong partnerships in DRC has enabled meeting people where they are at, offering them services that meet their needs,” said Faustin Malele, MD, MS, ICAP’s country director in DRC. “This has been the key to our success.”
Advancing Sustainable HIV Services in Mozambique
With 17 years of experience in Mozambique and longstanding partnerships with national, provincial, district authorities and civil society groups, ICAP will continue its proven approaches while integrating the latest science and best practices for client-centered HIV/TB services in facility and community settings. Since 2004, ICAP has played a pivotal role in the design and expansion of HIV programs in Mozambique, supporting direct service delivery and providing technical assistance to strengthen areas such as health care worker competencies, laboratory networks, and data systems.
Now, ICAP will build upon its successful strategies and collaborations to strengthen the capacity of the national health system to deliver comprehensive, client-centered HIV/TB prevention, care, and treatment services for all sub-populations, aiming to implement innovative HIV prevention strategies for those at highest risk and expand differentiated service delivery models to improve access and continuation in care. During the first year, ICAP will support comprehensive HIV/TB services in Mozambique’s largest province, Nampula, and voluntary medical male circumcision services in Zambezia, Maputo and Maputo City.
“A client-centered focus has made all the difference in addressing HIV among Mozambique’s diverse population,” said Mirriah Vitale, MPH, ICAP’s country director in Mozambique. “Looking ahead, we will expand and scale up our innovative approaches to HIV service delivery, aiming to meet clients where they are and strengthen national efforts to meet the UNAIDS 95-95-95 goals and control the epidemic.”
A major global health organization that has been improving public health in countries around the world for nearly two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 30 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at www.icap.columbia.edu