Côte d’Ivoire

ICAP is collaborating with local and international partners to conduct an analysis of out-of-pocket spending by patients on antiretroviral therapy (ART) in Côte d’Ivoire. Out-of-pocket spending represents a critical barrier to accessing health services and often results in marked disparities in access to health. Even in countries where people living with HIV are exempt from user fees and ART is free, studies have shown that transportation costs and other expenses can require substantial out-of-pocket expenditure. In West African countries, such as Côte d’Ivoire, where people living with HIV are not exempt from user fees, this challenge is compounded. 

The HIV Coverage, Quality, and Impact Network (CQUIN) is a multi-country learning network designed to accelerate the implementation of high-quality differentiated service delivery for HIV. CQUIN’s goal is to increase the number of people living with HIV initiating and sustaining highly effective HIV treatment with sustained viral suppression. Find out more at cquin.icap.columbia.edu

Optimizing Momentum Toward Sustainable Epidemic Control (OpCon) is a global initiative led by ICAP at Columbia University and funded by PEPFAR through HRSA. OpCon can assist countries in addressing the challenges they face in reaching epidemic control, sustaining achievements, and exploring innovations to measure progress.

ICAP is providing technical assistance to the Ministry of Health to conduct the Côte d’Ivoire Population-based HIV Impact Assessment (CIPHIA) survey to assess HIV prevalence, incidence, and access to HIV prevention, care, and treatment services. The survey includes household-based interviews and HIV counseling and testing for adults and children. Survey findings will be used to assess the impact of Côte d’Ivoire’s HIV response at the national level, and to help guide and target future investment and programs. (funded by PEPFAR through the CDC)

Find out more at phia.icap.columbia.edu

Building on its long-standing partnership with Côte d’Ivoire’s Ministry of Health, ICAP supported HIV prevention, counseling, treatment, and support services in 12 districts prioritized by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and at the University Teaching Hospital of Cocody. The project leveraged evidence-based targeted HIV testing and differentiated service delivery models, with innovative capacity building approaches in laboratory and pharmacy support, quality improvement, and monitoring and evaluation. The aim of the project was to ensure comprehensive HIV services for patients, while strengthening the capacity of national health structures to reach the 90-90-90 HIV treatment targets. (funded by PEPFAR through the CDC)

The Global Nurse Capacity Building Program (GNCBP) is a global health initiative that was administered by the Health Resources and Services Administration (HRSA), under the U.S Department of Health and Human Services, with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). It was implemented by ICAP at Columbia University’s Mailman School of Public Health (ICAP) from 2009 to 2018. GNCBP’s goal was to advance the HIV response toward epidemic control and to improve population health in sub-Saharan Africa by fostering individuals, institutions, and networks to expand, enhance, and sustain the nursing and midwifery workforce. The program used a holistic approach to strengthen nursing and midwifery education and practice through two complementary sub-projects: the Nursing Education Partnership Initiative (NEPI), which expanded the health workforce by producing new nurses and midwives; and the General Nursing (GN) project, which supported the maintenance of a skilled health workforce through continuing professional development (CPD), in support of HIV care and treatment scale up and sustainability. Together, NEPI and GN interventions increased the quantity and quality of the nursing and midwifery workforce by addressing seven domains of health workforce development: infrastructure; curriculum; faculty; clinical skills; production; in-service training; and partnership for policy and regulation. Find the GNCBP final report here Find out more about General Nursing

ICAP worked with the Ministry of Health and health authorities in the regions of Abidjan 2, Agneby-Tiassa, and Loh Djibou to build capacity and strengthen the provision of HIV testing and counseling, treatment and prevention of mother-to-child transmission, TB/HIV integration, and linkage and adherence support, and support monitoring and evaluation systems and laboratory strengthening. (funded by PEPFAR through the CDC)

ICAP provided intensive technical assistance and logistical support to 192 health facilities in four regions of Côte d’Ivoire and two tertiary care facilities in Abidjan, measurably increasing the uptake and quality of HIV prevention, care, and treatment services. Gains were achieved through a dynamic partnership with the Ministry of Health, capacity strengthening of decentralized health management teams and multidisciplinary teams of health care workers, and direct engagement of people living with HIV in the design and implementation of health services. (funded by PEPFAR through the CDC)

View the End-of-Project Report here.

Columbia University’s role in implementing PEPFAR began in 2003, when it received funding from the Global AIDS Program of the Centers for Disease Control and Prevention (CDC) under the University Technical Assistance Projects (UTAP) to support the development of important components of national HIV programs, including treatment protocols and training. In 2004, ICAP was founded and was awarded a new cooperative agreement from CDC under the PEPFAR framework, the Track 1.0 funding mechanism, to provide comprehensive HIV care and treatment in five countries: Kenya, Mozambique, Rwanda, South Africa, and Tanzania, with programming in Côte d’Ivoire, Ethiopia, and Nigeria subsequently added. This initiative, the Multicountry Columbia Antiretroviral Program (MCAP), rapidly expanded programs for HIV care and ART by promoting early diagnosis of HIV infection, maintaining the health of those living with HIV, and preventing further transmission of HIV within the community. MCAP programming between 2004 and 2012, in addition to being focused on rapidly scaling up care and treatment in partnership with host-country governments, also emphasized the full continuum of HIV-related services, continued capacity building and health systems strengthening, and transition of operations to host governments and local nongovernmental organizations. Find the MCAP End-of-Project Reports here.

The MTCT-Plus Initiative, the world’s first multi-country HIV treatment program, aimed to demonstrate to a disbelieving world that it was possible to provide care and antiretroviral (ARV) treatment in resource-limited settings, using programs to prevent mother-to-child transmission of HIV (PMTCT) as an entry point. In December 2003, the MTCT-Plus Secretariat in New York (the precursor to ICAP, headed by ICAP’s Wafaa El-Sadr and Elaine Abrams) received its first grant from the new President’s Emergency Program For AIDS Relief (PEPFAR). Four years later, the MTCT-Plus Initiative of Columbia University’s Mailman School of Public Health was providing HIV care and treatment for nearly 17,000 people at 14 sites in nine countries. MTCT-Plus received expansion funding from USAID in 2003 and 2006. By 2010, ICAP had provided HIV care and treatment to more than one million people. Find the MTCT-Plus and MTCT-Plus Expansion reports here.

In September 2002, the Mailman School of Public Health (MSPH) at Columbia University (CU) entered into a Cooperative Agreement with the Centers for Disease Control (CDC) for the University Technical Assistance Projects (UTAP) in Support of the Global HIV/AIDS Program. Situated within ICAP, UTAP was originally envisioned as a single-country program for the provision of technical assistance, but rapidly grew to include long-term and short-term technical and administrative assistance to the national responses to HIV/AIDS in five countries: Mozambique, Rwanda, South Africa, Tanzania, and Zambia. As the original UTAP project drew to a close and PEPFAR moved into its second phase—focused on sustainability—ICAP entered into several, follow-on Cooperative Agreements, called UTAP-2. Four were country-focused (in Côte d’Ivoire, Democratic Republic of Congo, Swaziland, and Tanzania) and the fifth—UTAP-2 Atlanta—became a flexible mechanism for providing a wide range of technical assistance and other support to PEPFAR countries. After beginning in 2009 as a means to help CDC conduct surveillance training more efficiently through distance education, UTAP-2 Atlanta grew over the next six and a half years to comprise 11 distinct projects addressing needs and gaps in the HIV response and answering important research questions to inform the response going forward. Find all UTAP and UTAP-2 resources here.