Efficiencies for Clinical HIV Outcomes (USAID ECHO)

Speeches Shim

BACKGROUND
Mozambique has the eighth highest HIV prevalence in the world, with a prevalence estimated at 13.2% according to the latest national Indicators of Immunization, Malaria and HIV/AIDS survey (IMASIDA - 2015). As of 2020, 2.1 million people were estimated to be living with HIV in Mozambique, 13.8 percent of women and 8.8 percent among men. Among adolescent girls (ages 15-19) prevalence is estimated at 3.3 percent and among young women (ages 20-24) at 9.3 percent, compared to 1.6 percent and 3.7 percent among adolescent boys and young men, respectively. While the country has made strides in testing  and treating HIV, systemic challenges such as the need to travel great distances to access care, long wait times in facilities, stigma, poor quality healthcare, and inadequate communication about the importance of staying on treatment have resulted in a high proportion of HIV-positive individuals discontinuing their treatment. Consequently, Mozambique continues to have among the highest HIV mortality rates in the world.

PROGRAM DESCRIPTION
ECHO is the USAID five-year flagship clinical program for HIV/AIDS clinical care and treatment. The project works in 148 health facilities in Sofala, Manica, Tete and Niassa provinces, providing support to the government of Mozambique to expand targeted HIV testing, ensure HIV-positive individuals receive treatment, stay in treatment, and reduce their viral load to bring the virus under control.  ECHO achieves this by providing technical assistance, deploying hundreds of health workers, community workers, and data analysts to sites with poor performance, training government health workers, giving grants to community outreach organizations, and supporting the government to strengthen crucial laboratory, transport, and information systems. As the project progresses, ECHO will build sustainability by gradually transferring more responsibility to local stakeholders, including the Government of Mozambique, especially at the health facility, district, and provincial levels.  

EXPECTED RESULTS AND IMPACTS
By 2024, ECHO will have contributed to HIV epidemic control in the four project provinces, meaning that 95% of Mozambicans with HIV know their status, 95% of HIV-positive individuals receive treatment, and 95% of those on treatment are virally suppressed. As a result, fewer people will get HIV or die from AIDS, and people with HIV will live healthier, more productive lives. The project will reach these goals by improving targeting of HIV testing, strengthening linkage to treatment once individuals are diagnosed, keeping more patients on treatment, and strengthening the viral load laboratory system to increase requests for tests and receive results more quickly. By the end of the project, ECHO will have supported the government to develop the capacity and systems to sustain these results. 
As of Quarter 4 (Q4) of Fiscal Year 2021, ECHO achieved the following results: 

  • Improved optimization of pediatric regimens in all supported provinces, with the optimization with DTG increasing from 89% in Y3Q1 to 95% at the end of Y3Q4,
  • Increased number of people in treatment 246,256 to 301,446 between Years 2 and 3, with an impressive growth of 7,3% in the last quarter of FY21,
  • Surpassing of Pre-exposure prophylaxis (PrEP) targets, increasing the number of individuals on PrEP from 95 at the beginning of Year 2 to 2,109 by the end of FY21,
  • Continued improvement in early retention, with one-month retention consistently increased during Y3 from 91% in Q1 to 95% at the end of Q4, and three-month retention increased from 91% % in Q1 to 96% in Q4. 
Issuing Country 
Date 
Tuesday, January 25, 2022 - 1:30am

Last updated: January 25, 2022