Fast-tracking delivery of a new set of antiretroviral (ARV) drugs with improved efficacy, tolerability, and safety will improve the health of people living with HIV. In September 2019, the Angolan AIDS National Institute (INLS) agreed to transition people living with HIV in the country to optimized, dolutegravir-based antiretroviral therapy regimens or dolutegravir with lamivudine and tenofovir (TLD). The World Health Organization and ICAP in Angola, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), collaborated with INLS to update the national guidelines on antiretroviral therapy.
This technical assistance and normative guidance included actions for initiating treatment for people newly diagnosed with HIV with dolutegravir-based regimens and transitioning people living with HIV on legacy regimens to those incorporating dolutegravir.
“The transition to dolutegravir-based antiretroviral regimens is a momentous milestone for the Angola HIV National Program,” said Carlos Laudari, MD, MPH, ICAP’s country director in Angola. “We at ICAP are very proud to be part of this crucial process for the improvement of the lives of people living with HIV in Angola.”
From February 1-25, 2021 ICAP supported the training of 252 providers at health facilities in three provinces: Benguela, Cunene, and Huambo. The project team supported the implementation of theoretical and practical training sessions at 13 PEPFAR-supported health facilities and theoretical training sessions at 13 non-PEPFAR-supported health facilities. ICAP also supplied vehicles, fuel, and drivers for each province to transport the INLS teams, collect remaining stock of legacy regimens at health facilities, and store them in provincial drug depots. To ensure providers’ understanding and compliance on the introduction and transition to dolutegravir, the project team conducted daily clinical visits at the PEPFAR-supported health facilities while providing constant mentoring for Municipal and Provincial HIV Focal Points in the supervision of non PEPFAR-supported health facilities.
These actions demonstrate there is potential to improve health outcomes among people living with HIV in Angola. Data collected at 13 PEPFAR-supported health facilities 30 days after the initiation of the transition indicate that trained providers transitioned 4,097 patients (1,518 in Benguela; 2,169 in Cunene; and 410 in Huambo) to TLD. Additionally, trained providers initiated 462 newly diagnosed people with HIV (280 in Benguela; 118 in Cunene; and 64 in Huambo) to TLD. The total of 4,559 patients on TLD represent 44.4% of all reported patients on ART at the end of December 2020.
With support from PEPFAR through CDC and in collaboration with INLS, ICAP put knowledge into action. Its role as an implementing partner on the transition to TLD in Angola made clear ICAP’s vision for healthy people, empowered communities, and thriving societies.