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NACP NATIONAL AIDS CONTROL PROGRAMME NATIONAL AIDS/STI CONTROL PROGRAMME ANNUAL REPORT NACP NATIONAL AIDS CONTROL PROGRAMME NATIONAL AIDS/STI CONTROL PROGRAMME NACP NATIONAL AIDS CONTROL PROGRAMME TABLE OF CONTENTS Lists of Abbreviations Executive Summary 1.0 Introduction 1.1 Brief History of NACP 2.0 The Package of Interventions to Reduce HIV Transmission 2.1 HIV Testing and Counselling 2.2 Prevention of Mother-To-Child Transmission 2.3 Condom Promotion and Distribution 2.4 Blood Safety 2.5 HIV Exposure Prevention in the Health Care and other Settings 3.0 The Delivery of the Package of Care and Support Services for PLHIV 3.1 Management of Opportunistic Infections 3.2 Antiretroviral Therapy 3.3 New Initiatives under Care and Support 4.0 Laboratory Systems Strengthening 4.1 Proficiency Testing (PT) Programmes 4.2 Basic Laboratory Information System (BLIS) 4.3 Site Improvement Monitoring System 5.0 The Delivery of Strategic Information on HIV and AIDS 5.1 Publications and Reprinting 5.2 HIV Sentinel Surveillance 5.3 Sexually Transmitted Infection Surveillance 6.0 Provision of Essential Technical Support to All MDAs in the Implementation of their Programmes 7.0 Financial Information 8.0 Administration 8.1 Human Resource 8.2 Vehicles 8.3 Programme Management 9.0 Monitoring and Training 10.0 Challenges 11.0 Way Forward 12.0 Conclusion NACP NATIONAL AIDS CONTROL PROGRAMME Appendices 1. List of Health Facilities 2. List of Laboratories offering HIV Services, 2017 3. List of NACP Staff as at December 2017 4. Summary of Key Service Indicators NACP NATIONAL AIDS CONTROL PROGRAMME List of Abbreviations ABC Abacavir HIVDR HIV Drug Resistance ACE Adverse Clinical Event HSS HIV Sentinel Surveillance AIDS Acquired Immune Deficiency ICD Institutional Care Division Syndrome IDSR Integrated Diseases Surveillance and ART Antiretroviral Therapy Response ARV Antiretroviral IEC Information, Education and Communication AZT Zidovudine IMAI Integrated Management of Adult and AZT/3TC Zidovudine/Lamivudine combination Adolescent Illnesses drug IMCI Integrated Management of Childhood BSS Behavioural Surveillance Survey Illnesses BD Becton Dickinson JICA Japan International Co-operation CBO Community Based Organisation Agency CCM Country Coordinating Mechanism LPV/r Lopinavir boosted with Ritonavir CME Continuous Medical Education MDA Ministries Departments and Agencies CPD Continuous Professional Development MOH Ministry of Health CHAG Christian Health Association of Ghana NACP National AIDS/STI Control Programme DBS Dried Blood Sample NHARCON National HIV/AIDS Research Conference DfID Department for International Development NMIMR Noguchi Memorial Institute for Medical Research DMoC Differentiated Models of Care NVP Nevirapine DNA Deoxyribonucleic Acid OIs Opportunistic Infections DSD Differentiated Service Delivery PCR Polymerase Chain Reaction EFV Efavirenz PH Public Health EID Early Infant Diagnosis PI Protease Inhibitors EPP Estimation and Projection Package PLHIV Persons Living with HIV EMTCT Elimination of Mother-to-Child Transmission PMTCT Prevention of Mother-To-Child Transmission EWI Early Warning Indicators PU Procurement Unit FHI Family Health International STI Sexually Transmitted Infections GFATM Global Fund to fight AIDS, TB & Malaria TB Tuberculosis GHS Ghana Health Service TWG Technical Working Group GIPA Greater Involvement of Persons Living UNICEF United Nations Children’s Fund with HIV and AIDS USAID United States Agency for International HAART Highly Active Antiretroviral Therapy Development HIV Human Immunodeficiency Virus WHO World Health Organization HTC HIV Testing and Counselling WHO/AFRO World Health Organization Africa Regional Office NATIONAL AIDS/STI CONTROL PROGRAM Executive Summary In 2017, HIV prevalence was 2.1% as against that of 2.4% During the year, NACP organized trainings for health care in 2016 and 1.8% in 2015 amongst pregnant women workers in HIV Testing and Counseling, PMTCT/EID & DBS, attending Antenatal Care. (2017 HIV Sentinel Survey ART, LMIS in all ten regions as part of the plan to improve Report, May 2018) access to HIV services. A total of one million, two hundred and seventy-one TB/HIV COLLABORATION thousand, three hundred and forty-seven (1,271,347) out of a targeted two million, six hundred and thirty- The TB/HIV Collaboration continued, and in 2017, the five thousand, and forty-nine persons 2,635,049( ) were number of PLHIV who were screened for TB symptoms tested for HIV; giving a coverage of 48%. Approximately was ninety-one thousand, one hundred and seventy- 14% were males (179,667), 21% were non-pregnant seven (91,177) as against that of seventy-four thousand, women, and the remaining 65% were pregnant women. two hundred and twenty-six (74,226) in 2016. There were one thousand, four hundred (1,400) HIV Positive Clients Three thousand, seven hundred and fifty (3,750) sites with TB on ART. Sixty-two DOTS corners were assessed to were providing PMTCT services by the end of 2017. offer ART in Brong Ahafo, Central, Northern, Upper East, Upper West and Volta Regions. Out of the 62 DOTS sites Out of a targeted 1,158,263 pregnant women, eight assessed, 46 qualified for training to offer ART. hundred and twenty thousand, one hundred and ninety- one (820,191) were tested and counselled for HIV and Under the Cooperative Agreement between the Ghana also received their results. This represents 71% coverage Health Service and the United States Centers for Disease of expected (1,158,263) pregnancies for the year. Fifteen Control and Prevention (CDC), the Programme procured thousand, eight hundred and twenty-nine (15,829) out of two blood chemistry and two haematology analysers, 12 the 820,191 were HIV positive (1.9%), and 10,568 (67% heavy duty UPS (8kVA), ten heavy duty stabilisers (10kVA). of positives) were provided ARVs to Prevent Mother-To- Child Transmission of HIV (PMTCT). The National AIDS/STI Control Programme would sustain collaboration with other Divisions and Programmes, About 51% of the 15,829 expected HIV Exposed Infants i.e. the NTP, FHD, and PPME to ensure more integrated (HEI) received Early Infant Diagnosis (EID). Eight percent service delivery. (8%) of the 8,082 HEIs were positive (643). The programme is appreciative of all the support from Twenty-six thousand, nine hundred and sixty-nine the DG-GHS, Director PHD, MOH, GAC, Development (26,969) adults and children were initiated on ART in 2017 Partners, other government & non-governmental comprising 7,502 males and 19.467 females in 375 ART stakeholders, service providers and the association of sites. The ART initiation target for the year was 26,000 PLHIV. Our focus is to work together till we attain zero and the total number of clients on ART was 125,667. new infections, deaths, stigma and discrimination. Out of the 375 ART sites, 330 currently report in DHIMS. The number currently on treatment is being validated by PPMED to account for loss to follow-up. Currently, the estimated HIV population in Ghana is Dr. Stephen Ayisi Addo approximately 313,000 (EPP Spectrum Estimates 2017). Programme Manager The estimated ART coverage is therefore 45%. 8 NATIONAL AIDS/STI CONTROL PROGRAM 1.0 Introduction The National AIDS/STI Control Programme (NACP) is a programme in the Disease Control and Prevention Department of the Public Health Division of the Ghana Health Service (GHS). NACP is mandated to coordinate and implement HIV and AIDS-related activities of the Ghana Health Sector Strategic Framework. 1.1 Brief History of NACP • The provision of essential technical support to all Ministries, Departments, and Agencies (MDAs) in The National AIDS and STI Control Programme started as the implementation of their HIV programmes. a National Technical Committee on AIDS later became The 2017 Annual Report gives us a summary of activities National Advisory Council on HIV and AIDS in 1985 and and projects that were undertaken in the year. The areas National AIDS/STI Control Programme (NACP) in 1987. can be considered under the following broad performance NACP has since been the lead agency in the health sector’s themes. response to HIV and AIDS in Ghana. • HIV Testing Services (Including Behaviour Change NACP is responsible for implementing the health sector Communication, Condom promotion, and aspects of the National HIV and AIDS Strategic Plan Information, Education, and Communication) (NSP 2016-2020). This NSP is designed to fast-track the country’s efforts towards ending AIDS by 2030. • Elimination of Mother-To-Child Transmission (EMTCT) services The National AIDS/STI Control Programme is empowered • Antiretroviral Therapy to carry out the following activities: • Sexually Transmitted Infections Management • The delivery of a package of interventions to • Opportunistic Infections Management reduce HIV transmission. • Blood safety and Laboratory Quality Assurance • Provision of care and support services for Persons Living with HIV (PLHIV). • Activities undertaken under the Cooperative Agreement (CoAG) between GHS/NACP and • The delivery of Strategic Information on HIV and CDC. AIDS and other STIs. 9 NATIONAL AIDS/STI CONTROL PROGRAM 2.0 The Package Of Interventions to Reduce HIV Transmission One of the core tasks for NACP is to reduce new HIV infections. Various interventions were undertaken to prevent the spread of new infections. These include the provision of HIV Testing and Counselling (HTC) as well as the Prevention of Mother-To-Child Transmission (PMTCT) of HIV services. Activities undertaken to reduce HIV transmission in 2017 to know their status
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