of testing services for people most at risk for HIV

Transcription

1 call for proposals on datadriven improvement of testing services for people most at risk for HIV May % of the people with HIV lack access to treatment because they are not aware of living with the virus Page 1 van 10

2 Data is key in ending the AIDS epidemic In November 2014, an independent advisory group to UN Secretary-General Ban Ki-moon published a report on how to use data for sustainable development. New technologies are leading to an exponential increase in the volume and types of data available, creating unique possibilities for informing and transforming society. Data are bigger, faster and more detailed than ever before and governments, companies, researchers and civil society all have their role in collecting, using and analyzing these data. Open data initiatives promote the unrestricted use of all types of scientific, organizational and project data to improve or accelerate innovation. From 2016, will contribute to open data by making project information available in the IATI Standard. This is a format and framework for publishing data on development cooperation activities, intended to be used by all organizations in development. In addition to this structured data, there has been an enormous growth in unstructured data in the past years caused by an increase in the use of internet and mobile technologies and devices. This type of data is normally called big data and can provide information on behaviour, attitudes or sentiments. Combining and analyzing data sets can provide new insights or discover unexpected patterns in human behaviour. To be able to end the AIDS epidemic, access and quality of data needs to be improved. In many countries it is unknown which people are most affected by HIV and important aspects are not measured. In addition, existing data remain unused because they are not released, not well-documented, or not available at the level of detail needed for decision-making. New or existing data can be used for better informed or improved service delivery, decisionmaking and impact monitoring. With this call for proposals aims to stimulate data-driven improvement of HIV testing services. Hotspots The concept of concentrated, mixed and generalized epidemics is currently being replaced by a model that recognizes the importance of locations and populations. The AIDS epidemic is a sum total of several local epidemics that are interconnected. Within the local epidemics, specific populations are affected. Because countries and regions have multiple and varying micro-epidemics, tailored solutions are needed that will help to reach people better and faster. Many countries already focus on local epidemics using the data available from household surveys combined with other epidemiological data to sharpen the focus on delivering HIV services. For example, they map the distribution of people living with HIV against the availability of services. Page 2 van 10

3 Innovative use of existing data In Mozambique, mapping of HIV prevalence clearly shows that the districts with the highest density of people living with HIV are located along transport corridors and important seaports in the center and in the southern regions of the country. These areas are associated with rapid economic growth and high levels of migration and mobility that may lead to increased transactional sex. Ensuring that HIV services are available in these places is a very cost effective approach to AIDS programming. A recent study investigated the relationship between HIV-related online discussions on Facebook and requests for a home-based HIV testing kit among men who have sex with men (MSM) i. The study found that MSM shared a tremendous amount of personal information through social media, and showed that participants posting about HIV Prevention and Testing (compared to those who did not) were significantly more likely to request an HIV testing kit. The researchers conclude that policymakers and public health departments can use social media data to predict, prepare for, and respond to healthrelated events. In another study the same researchers extracted psychological and behavioral characteristics from tweets in an attempt to predict behavior and disease transmission. This work showed that tweets can be extracted and identified to suggest that people are currently or about to engage in sexual- and drug-related risk behaviors and tweets suggesting the occurrence of these behaviors can be mapped to indicate their origin. ii For the United States, AIDSVu iii provides a visualization of the HIV epidemic through an interactive map. This shows how the HIV epidemic affects communities differently, and that epidemic severity can differ from state to state and across county and city lines. The website combines HIV surveillance reports from state and local health departments with ZIP code and census tract data. The map lets users filter HIV prevalence data by race/ethnicity, sex and age, and see how HIV prevalence is related to various social determinants of health, such as educational attainment and poverty. More people should know their status Three out of five people living with HIV are still not accessing antiretroviral therapy. The major reason for this is that 19 million of the 35 million people living with HIV do not know their HIV-positive status iv. These figures indicate that 85% of the people with HIV lack access to treatment because they are not aware of living with the virus. Better testing for HIV is therefore the most important intervention to close the gap in the treatment cascade. Of course all efforts to increase and better focus HIV testing should include effective linkages to treatment, care and support services. Earlier detection of new infections is important The benefits of HIV treatment are greatest for those who start treatment as soon as possible after infection. In addition, early treatment of infected persons substantially reduces their risk of transmitting HIV to others. Data analysis demonstrates that for every 10% increase in treatment coverage there is a 1% decline in the percentage of new infections. UNAIDS targets The UNAIDs targets mean that by 2020, 90% of people living with HIV should know their HIV status, 90% of people living with HIV who know their status should receive HIV treatment and 90% of people on HIV treatment should have a suppressed viral load. Page 3 van 10

4 UNAIDS has formulated 8 action points v to reach the targets and to end the AIDS epidemic. This call for proposals is based on several of these actions points to reach the first 90 90% of people living with HIV will know their HIV status: Invest in Communities: innovation in community delivery of services and community leadership can ensure that the AIDS response is people-centered and take it to new levels that are out of the reach of traditional HIV programs. Focus on local epidemics and populations: Evidence informed programs are essential in reaching the targets, especially for key populations 1. It is important to continue to collect and analyze data from districts and cities to identify areas of high incidence of HIV infection. With better data and better use of existing data, responses can be tailored to the local epidemics, giving customized service options according to the specific needs of the area or population. Expand the choices for HIV services: bringing services to the doorsteps of people can vastly increase coverage levels. Decentralized delivery of services can also contribute to reducing the stigma and discrimination faced by people living with HIV and key populations. Combining HIV testing along with other routine screening, such as that for diabetes or pregnancy testing can tackle people s reluctance to ask for an HIV test. Home or self-testing for HIV can potentially change how risk is assessed and provide increased opportunities for people to access HIV treatment and prevention services. Setting milestones In 2014, STOP AIDS NOW! Soa Aids Nederland developed a new longterm strategy, entitled Setting Milestones. This ambitious strategy includes an integral vision on ending AIDS and creating a world in which everybody has access to prevention, treatment, care, and support services for HIV and other sexually transmitted infections (STIs). Much has been achieved in the past years. But to realize our final objective, we need to overcome a large number of obstacles first. This is why we focus on four strategic milestones concrete steps that steadily bring us closer to the realization of our vision. One of these four goals is to increase the number of people who are tested for HIV. Increased testing is not about having the same people tested more frequently, but it is about taking a targeted approach to identify risks and getting the right people to test at the right moment. Targeted testing with innovative ways to identify people most at risk To identify HIV infections earlier, testing should be better targeted towards certain geographical areas or populations most at risk. Through this call for proposals we would like to find innovative ways to tackle data gaps and to seek novel approaches in identifying people most of risk for HIV, to be able to implement a strategy to reach those people with HIV testing services. This can be done by collecting new data or by a better use of existing data. To stimulate innovative data use and to be sure that this data will be actually used to improve HIV services, we call for combined applications from a knowledge institute and a civil society organization providing HIV services. 1 Children, young women, migrants, prisoners, people who inject drugs, men who have sex with men, sex workers and transgender people Page 4 van 10

5 Call for proposals Objectives With this call for proposals aims to stimulate data-driven improvement of HIV testing services to increase the number of people with HIV that know their status as early as possible after infection. This includes the following objectives: To find innovative ways to tackle data gaps in knowledge on HIV prevalence and incidence. To seek novel approaches in communicating to people most at risk for HIV, incentivizing them to know their HIV status and promote health among their peers, diagnose people living with HIV earlier in their infection, and link people to care more effectively and efficiently. To identify geographical or population related hotspots for people newly infected with HIV within a country or town To develop and implement effective testing strategies to reach people most at risk (including but not limited to outreach services, home-based testing, self-testing, routine testing in new settings, indicator condition guided testing etc.). Strategies should include strong linkages to treatment, care and support, and can also include prevention interventions. To advocate for better targeted prevention and treatment services for people most at risk To stimulate partnerships between knowledge institutes, civil society organizations and governments, including innovate ways to integrate research into community outreach and services. Type of programs The main goal for all programs under this call should be to find more people with HIV that don t know their status yet, and to find them earlier. To be able to do so, more focus is needed on certain geographical areas or populations. We ask for programs with both a data component and a service delivery component, with a civil society organization in the lead. The program could include one or more of the following activities: - Analyzing structured data (government, UNAIDS) and/or unstructured data (websites, social media) to be able to map HIV prevalence or risk behavior. - Research to fill data gaps in currently available data sets to identify people most at risk for HIV in a certain geographical area and analyzing the data during implementation of the testing program - Develop, implement and monitor a testing program that diagnoses and serves larger numbers of people living with HIV who don t yet know their status. This could include a wide range of activities such as (but not limited to) expansion of outreach activities, incentives for people to come for testing, distribution of selftests, training of healthcare workers on indicator condition guided testing, etc. An example By combining data from HIV clinics on distribution of PLHIV with data from household or sms surveys on uptake of HIV testing, areas can be mapped with high HIV prevalence and low percentage of people tested for HIV. In these areas a program could be started that combines self-testing, mobile testing and routine testing in the local clinics. Page 5 van 10

6 Eligible countries Globally, the following 15 countries account for 74% of all new HIV infections and 73% of all AIDS deaths: South Africa, Nigeria, Uganda, India, Kenya, Mozambique, Russia, Indonesia, Tanzania, Zimbabwe, Zambia, China, Cameroon, Malawi, and Ethiopia. vi Programs under this call for proposals should take place in one of these countries. % of global numbers South Afrika Nigeria Uganda India Kenya Mozambique Russia Indonesia Tanzania Zimbabwe Zambia China Cameroon Malawi Ethiopia Monitoring and Evaluation Monitoring the results of a project is not always easy, but applicants should indicate how they will define and measure the progress and impact of their activities. The format for the activity plan and budget includes indicators for outcome and output (appendix). If proposals are rewarded with a grant, the proposal will become the basis for further monitoring; Annual financial statements and information on progress are required. Aids Fonds explicitly values information with regard to the outcome of the activities, which means that applicants commit to reporting about this after the grant period has ended (since this is often the moment wherein outcome can be observed). Projects that receive support as part of a specific call will be evaluated in coherence with the other projects that receive a grant under the same call. Eligibility criteria for proposals Applications have to be submitted before the deadline of 21 June Programmes should take place in one or more of the following countries: South Africa, Nigeria, Uganda, India, Kenya, Mozambique, Russia, Indonesia, Tanzania, Zimbabwe, Zambia, China, Cameroon, Malawi, Ethiopia Programmes should include a research component to identify people most of risk for HIV and a service delivery component providing HIV testing services. Page 6 van 10

7 Applications should describe how to avoid violations of human rights. Especially around confidentiality, privacy and forced or mandatory testing. Applications should describe how they will guarantee effective linkages between HIV testing, treatment and care Applicants should use the specific online application form which will be available from May You can find an example of the application form on the website of. For specific questions please contact. The application and all correspondence should be in English. Applicants should use the specific format provided in appendix I to describe objectives, outcomes, indicators, activities and the budget. The framework has to be uploaded in Microsoft Excel together with the application. Eligibility criteria for applicants Funding will only be provided to registered organisations and not to individuals. Funding will only be provided to an alliance that includes both a knowledge institute and one or more civil society organizations. (One of) the civil society organization(s) in the consortium should act as the lead agency and will be responsible for reporting and (financial) administration. The consortium should describe how they will work together with their government, and indicate how their plans fit into national programs and plans Lead applicants must be non-profit and non-governmental organisations. Technical support from international organisations specialised in this type of work can be included in the proposal. Applicants should have a strong track record. For the knowledge institute this should be a track record in HIV data management and research. For the civil society organizations this should be a track record in providing HIV services Organisations should provide their latest annual narrative and financial report together with the application Organisations must have strong management and the capacity to formulate a proposal, to carry out the proposed activities and to effectively manage award funds. Budget For each programme a maximum budget of is available for the duration of three years (maximum of per year). The total available budget is approximately Page 7 van 10

8 Procedures Publication NGO s from the selected countries are asked to submit a proposal through this call. NGO s are reached via global networks and partners of. The call is published on the website and will be actively distributed at international events. Language All communication will be in English. Quality review Proposals that are submitted before the deadline of 21 June, 2015, will be checked on the above mentioned eligibility criteria for proposals and applicants. Proposals that fulfil these criteria will be reviewed by experts in the field. The submitting organizations receive the anonymous reviews and are given the opportunity to write a rebuttal. Based on the reviews and the rebuttals, an external commission will give its advice to the Board of. The Board will make a final decision. Evaluation criteria The reviewers will assess all eligible proposals on the following evaluation criteria: Overall quality of the proposal Quality of the context analysis Track record of the applicants in HIV research and/or service delivery Innovativeness of the proposed activities, such as in combining existing data sets, collecting new data or strategies to improve HIV testing. Evidence that testing strategies include strong linkages to treatment, care and support Evidence that confidentiality issues will be addressed and privacy will be protected Coherence and feasibility of the proposed 3-year project and long term outcomes Impact of the proposed activities on barriers that prevent people living with HIV to access HIV testing services Complementarity to existing activities on data collection or HIV testing by the applicant or other organisations. Budget in line with the proposed activities Sustainability: links with other stakeholders and other sources of funding Quality of the M&E system. Capacity and planning to monitor outcomes of the proposed activities Strategy to share results and lessons learned Apart from these criteria, aims for a diverse portfolio which means that programmes of comparable quality may be assessed differently in order to cover different subjects, different target groups and different regions within one call. Page 8 van 10

9 Timeline 21 June :00 am CET - Deadline for submitting proposals 16 September 2015 Proposals reviewed by experts, anonymous reviews sent to submitting organization 1 October :00 am CET - Deadline for rebuttal by submitting organization 16 October 2015 Advice of the external advisory committee based on reviews and rebuttals 30 October 2015 Decision by the board of, acknowledgements immediately afterwards Page 9 van 10

10 Appendix activity framework and budget i Sean D. Young and Devan Jaganath. Online Social Networking for HIV Education and Prevention: A Mixed Methods Analysis. Sex Transm Dis February ; 40(2) ii Young, S.D. et al. (2014) Methods of using real-time social media technologies for detection and remote monitoring of HIV outcomes. Prev. Med. 63, iii iv GAP report, UNAIDS v GAP report, UNAIDS vi GAP report, UNAIDS Page 10 van 10