Transcript Consultation on Nutrition and HIV/AIDS in Africa

Nutrition and HIV/AIDS
Overview of agencies' work and
Progress
SCN
Geneva, 14 March 2006
Randa Saadeh
World Health Organization
Nutrition for Health and Development
Contribution to specific MDG
goals:
(1) eradicate extreme poverty
and hunger
(6) combat HIV/AIDS, malaria
and other diseases.
The three diseases "can be
largely controlled through
education, prevention and
when illness strikes,
treatment and care".
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What is the role
of nutrition in
the care and
support of
PLWHA?
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The Goal of the consultation is to:
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Develop evidencebased strategies
Review and
disseminate latest
scientific evidence
and ensure
integration
Identify research
agenda
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Scientific review on nutrition
and HIV/AIDS
1.
Micronutrients
How HIV infection leads to
micronutrients deficiency, and how
deficiencies/supplementation may affect
various transmission and progressionrelated outcomes
2. Macronutrients (Energy and
Protein)
How HIV infection affects energy/protein
requirements, and how
deficiencies/supplementation may affect
various transmission and progressionrelated outcomes
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3. Infant feeding and HIV
transmission
4. Growth faltering and wasting in
children
5. Maternal Nutrition or pregnant
and lactating women
6. Nutrition and ARVs
How nutrition may affect ARV efficacy
and how ARVs may lead to better
nutritional status on the one hand
and dyslipidemia and insulin
resistance on the other
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WHO website – click on
Nutrition and HIV
http://www.who.int/nutrition/topics/consultation_nutrition_and_hivaids/en/index.html
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EXECUTIVE BOARD
116TH Session
EB116/12
117TH Session
EB117/7
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WHO's progress
 Nutrition and HIV/AIDS on EB agenda in
2005 & 2006
 Resolution EB 117.R2 states our policy
and framework for action
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In meeting the challenge,
WHO is developing a
comprehensive evidencebased strategic approach
that will ensure full
integration of nutritional
care in response to the
global AIDS treatment
emergency
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Collaboration with UN & other partners
Co-operation with scientific community
Solid communication strategies
5 pillars of WHO's strategic approach
Strengthening &
integrating policies
/Strategies and
Programmes
M&E
Indicators
Nutrition/HIV/AIDS
Strategic Approach
Norms & Standards
 Science-based
recommendations
 Guidelines/tools
Research to
fill gaps in
clinical &
operational
issues
Capacity Building
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Throughout the stages of disease and age-gender specific
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5 pillars of WHO's strategic
approach (Contd)
1. Strengthening & integrating nutrition
& HIV/AIDS policies, strategies &
programmes
 Build on existing efforts
 Identify nutrition interventions for
integration into HIV/AIDS programming
 Advocacy tools – decision-makers
 Multi-sectoral collaboration
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5 pillars of WHO's strategic
approach (Contd)
2. Developing Norms & Strategies
 Support evidence-based
findings including micronutrient & HIV/IF issues
 Nutrition assessment tool –
stages of disease, sex &
gender-specific
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5 pillars of WHO's strategic
approach(Contd)

Guidelines
 Review existing ones and
develop:
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Generic for nutritional care &
support for PLWHA
Children & HIV/AIDS
Severe malnutrition & HIV
IYCF Global Strategy (HIV/IF,
BFHI)
Guidelines for providing food
assistance in care and
treatment programmes
Guidelines for resource
mobilization efforts
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5 pillars of WHO's strategic
approach (Contd)
3. Capacity Building
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Hospital & community-based health workers
Accelerating training & use of guidelines/tools
for infant feeding programmes & PMTCT of
HIV
Nutrition counselling courses
Revision of curricula & pre-service training
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5 pillars of WHO's strategic
approach (Contd)
4. Research
 Developing and implement
operational and clinical
research to identify effective
science-based interventions
 Document, publish and
disseminate results
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5 pillars of WHO's strategic
approach (Contd)
5. Developing of appropriate M & E
Indicators
 Measuring progress
 Measuring impacts
 Build and complement existing efforts
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Partners
In house
– HIV/AIDS,CAH, RHR, FOS, LEG,
HAC
Other agencies – UNICEF, FAO, UNAIDS, UNHCR
WFP, IAEA, ILO, UNDP
NGOs/Institutions/Universities/National Groups/
Bilaterals/Donors
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FAO, HIV/AIDS, Food Security and
Nutrition
HIV/AIDS leads to food insecurity, poverty and
malnutrition through a number of known pathways at
both farm and individual levels.
And since good nutrition allows PLWHA to feel better
and live longer..
Ensuring food and nutrition security and supporting
livelihoods is central to any response.
To mitigate the effects of HIV/AIDS, FAO
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strengthens local capacities for delivering
nutritional care and support services
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supports food security, livelihoods and
nutrition of the infected and affected
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“Living well with HIV/AIDS: A manual on nutritional care and support” and the
associated Training course with WHO
Guidelines on incorporating HIV/AIDS considerations into food security and
livelihoods projects
Guidelines for HIV/AIDS interventions in emergency settings
HFS and nut projects ongoing in Lesotho and Malawi for orphans LWHA, and in
Ethiopia, Mozambique and Zambia
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Food and Agriculture Sector Strategies
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Ensure access to food
Nutritional care and support
Labour and time-saving technologies
and practices
Gender equality in access and control of
resources
Capacity building
Agriculture Knowledge systems
Policies
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Overview and objectives of WFP’s nutrition and
health related HIV/AIDS programmes
• Four main activity types:
•PMTCT: 13 countries
•ART: 16 countries
•Home based care: 13 countries
•Support to TB patients: 23 countries
(also have activities supporting orphans, prevention
education)
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WFP’s efforts to help build the evidence
base related to nutrition, food support,
HIV/AIDS
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INIPSA study: 3 country study in West
Africa aimed at understanding the
outcomes associated with food support to
patients in treatment programs
Collaborations underway with NGO’s and
research institutions in Mozambique,
Zambia, Uganda, other countries to
answer questions of relevance to
programming.
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UNICEF activities in nutrition and HIV
*UN Framework for priority actions on HIV and IF- (13countries)
*National policies on HIV and IF (72 countries)
*Integrating nutrition interventions into PMTCT scale-up plan –
technical missions in 5 countries
joint
*UNICEF joined WHO in the introduction of IYCF courses
* Jointly with WHO, revised BFHI materials in HIV context
* Support governments in working with OVCs
* Collaborating with WHO in development of guidelines including
micronutrient supplementation
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WHO/ The Global Fund
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Development of a "guidance note" to assist
countries in incorporating nutrition into
funding proposals
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Meeting of UN Agencies, GFATM, national
representatives, other funders and bilaterals
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Funded HIV/AIDS Proposals
# of HIV/AIDS funded proposals reviewed per subregion
42
Total
16
Western Africa
5
Southern Africa
2
Northern Africa
6
Central Africa
14
Eastern Africa
0
5
10
15
20
25
30
35
40
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# of countries reviewed
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Distribution of proposals by sub-region (n=42)
Eastern Africa
(n=14)
Burundi
Djibouti
Eriteria
Ethiopia
Kenya
Madagascar
Malawi
Mozambique
Rwanda
Somalia
Uganda
Tanzania
Zambia
Zimbabwe
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Central/Middle
Africa
(n=6)
Northern
Africa
(n=2)
Southern
Africa
(n=5)
Western Africa
(n=15)
Angola
Cameroon
Central
African
Republic
Chad
Congo-DRC
Gabon
Morocco
Northern
Sudan
Botswana
Lesotho
Namibia
South Africa
Swaziland
Benin
Burkina Faso
Cote d’Ivoire
Gambia
Ghana
Guinea
Guinea- Bissau
Liberia
Mali
Mauritania
Niger
Nigeria
Senegal
Sierra Leone
Togo
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Distribution of food and nutrition activities by program area (n=32
countries)
# of requests per program area
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23
20
17
15
10
5
4
5
0
Prevention
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Care
Treatment
Mitigation
Note: 1 country requested support within all 4 program areas
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Process
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GFATM outlined process by which Board,
Secretariat and Technical Review Panel issue call
for applications, review and evaluate proposals and
manage disbursement of funds
Country presentations of needs re. Nutrition and
HIV
Potential nutrition interventions and frameworks for
integration discussed in plenary and groups
Indicators for individual subject and project
performance monitoring and evaluation considered
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Outcomes
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A framework on how nutrition interventions can
be included in prevention/care/treatment and
mitigation activities in HIV programmes
How (some of) these may be included in
applications to the GFATM
Planning for training/briefing of regional
consultants involved with assisting countries in
their applications
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Challenges
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Need to act now: balance the needs to fill knowledge gaps
and implementing what we know
Building the capacity to make it "universal" and sustainable
Dissemination of information and good communication
strategies
Coordination between partners and different players
Balance between production of normative work and countrycommunity level activities
Adequate human and financial resources to put our
knowledge into practice.
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Thank you
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