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In in Eastern and Southern Africa Report IN EASTERN AND SOUTHERN AFRICA JULY 2018 CATALYSING THE HIV RESPONSE FOR ADOLESCENTS INSIDE : 5 A GLOBAL CALL TO ACTION Case StuDIES BLOGS - 14, 22, 30 Next steps 37 © UNICEF © UNAIDS This report brings together information and data from the All In process in Eastern and Southern Africa. The report was led by Anurita Bains, and compiled by Alice Armstrong. It benefited from reviews and editing by colleagues from the UNAIDS Regional Support Team for Eastern and Southern Africa and the UNICEF Eastern and Southern Africa Regional Office. The report incorporates contributions fromAll In country assessment reports and in-person and virtual interviews with over 40 government officials, UN partners and other organizations. The insights and technical contributions by all those interviewed were invaluable. Graphic design and layout by Edgar Mwakaba Cover image: © UNICEF/UN0145555/Schermbrucke CATALYSING THE HIV RESPONSE FOR ADOLESCENTS CONTENTS ALL IN FOR IMPACT FOREWORD Effects on HIV programming for adolescents 3 from the Regional Directors © UNICEF/UN070642/Hatcher-Moore 9 © UNICEF/Jasper J Van Zyl Van J © UNICEF/Jasper 5 10 Adolescent engagement A GLOBAL 11 Collaboration and partnerships CALL TO ACTION 12 Strengthening strategic information 6 All In to end adolescent AIDS – A collaborative platform 20 Informing national policy and plans All In in East and Southern Africa 6 21 Evidence-based programming 29 Mobilizing resources 7 CASE STUDIES © UNICEF/UN025515/Schermbrucker KENYA Strengthening adolescent COUNTRY ASSESMENTS 16 strategic information Building blocks for change Botswana 24 Building capacity for sub-national data driven programming Next steps NAMIBIA for adolescent HIV programming in 32 Leveraging resources for 37 Eastern and Southern Africa adolescent HIV programming BLOGS 14 22 30 © UNICEF/Julio Dengucho © UNICEF/Julio © UNICEF/Alessandra Silver © UNICEF/UN016830/Noorani MOZAMBIQUE RWANDA United Republic of Tanzania Adolescent participation Developing an Adolescent Ensuring a healthy future for Operational Plan Tanzania’s adolescents 1 CATALYSING THE HIV RESPONSE FOR ADOLESCENTS © UNICEF/UNI157565/Ose 2 CATALYSING THE HIV RESPONSE FOR ADOLESCENTS from the Regional Directors, FOREWORD UNICEF and UNAIDS The Eastern and Southern Africa Region take stock of the health and well-being (ESAR) is home to approximately 60 of adolescents. Through intensive per cent of the world’s adolescents data reviews and consultations at both aged 10-19 years who are living with national and district levels, policymakers HIV. Nearly half of the 254,000 new HIV and programmers identified critical data infections among adolescents globally in gaps on adolescent health and discussed 2016 occurred in the region. Yet, only a strategies to address the unique needs few short years ago, adolescents were of adolescents living with HIV and barely visible in the global HIV response. those at risk of infection. Central to All So, when data became available in In was the meaningful engagement of 2014 showing that HIV-related health adolescents. During All In consultations, outcomes had improved for other adolescents spoke of the challenges age groups but had worsened for they faced in being able to access HIV adolescents, we knew it was time to act. treatment, of wanting to take an HIV test but being afraid to, and the stigma they Building on the collaborative effort faced as a child of a parent living with that resulted in tremendous progress HIV. in scaling up lifesaving anti-retroviral treatment and preventing mother-to-child We are proud to launch this report, transmission of HIV in ESAR, UNAIDS which highlights how All In mobilized and UNICEF launched a campaign titled partners, engaged adolescents and All In to End Adolescent AIDS (All In) young people and influenced policies in 2015 in Nairobi, Kenya. The aim was and programmes. The report documents to inspire governments and partners to the progress made in a few short collaborate across sectors and accelerate years on adolescent HIV, and offers the HIV response for adolescents by suggestions and recommendations on reducing AIDS-related deaths and new how to strengthen strategic information, HIV infections among 10-19 year olds. apply evidence-based programming and mobilize resources for adolescents in the Since then much has been achieved. HIV response. In the 14 high-burden HIV countries in ESAR, UNAIDS and UNICEF have With this report, we hope partners in supported governments to convene ESAR will be better equipped to apply key stakeholders - including donors, and support efforts to end adolescent UN agencies, and young people - to AIDS. Leila Pakkala Catherine Sozi Regional Director Director United Nations Children’s Fund UNAIDS Regional Support Team for Eastern and Southern Africa Eastern and Southern Africa 3 CATALYSING THE HIV RESPONSE FOR ADOLESCENTS © UNICEF/Gina Figueira 4 CATALYSING THE HIV RESPONSE FOR ADOLESCENTS © UNICEF/Shehzad Noorani A GLOBAL CALL TO ACTION our years ago adolescents were factors that contribute to HIV infection, or live positive, healthy lives with HIV. a forgotten population in the age- and sex-disaggregated data, modes This flurry of interest in adolescent health Fglobal HIV response. In Eastern of HIV transmission, barriers to treatment was welcome news to researchers, civil and Southern Africa and other regions, adherence and access to anti-retroviral society and adolescent activists who for programmes typically targeted either therapy and other services. Data for the years had been advocating for targeting infants and young children or adults, youngest adolescents (aged 10-14) was adolescents as a distinct population group. neglecting the needs of this unique group particularly limited, due to the challenges The new findings also spurred global of adolescents aged 10 to 19 years. of designing age-appropriate surveys leaders into action. Building on other and to age-related consent barriers. As a Adolescence is a critical life stage initiatives, UN partners initiated a series result, countries did not have a complete characterized by rapid biological and social of consultations with civil society groups, picture of how adolescents were affected changes. Adolescents require targeted youth-led organizations, researchers by HIV and how interventions could HIV programmes, but as recently as 2014 and governments to identify key address their needs.2 many adolescents had only limited access issues, gaps in the current response to information, services and testing. Then, in 2014, the HIV community was and urgently needed solutions. The Adolescents living with HIV often struggled confronted by new modelling indicating Global Strategy Consultation on All In to adhere to treatment regimens, due that AIDS was the leading cause of death to End Adolescent AIDS meeting held to lack of support and understanding of for the 10-to-19 age group in Africa, and in Geneva, Switzerland, in December their treatment. Uptake and coverage of the second most common cause of death 2014 highlighted several key problems, basic HIV prevention interventions – such among adolescents globally.3 While HIV- including the lack of adolescent-specific as comprehensive sexuality education, related health outcomes had improved health data. Other challenges noted were condoms and sexual and reproductive for other age groups, they had worsened the lack of adolescent engagement in health (SRH) services – among adolescents for adolescents. Suddenly everyone - policy and programmes, the absence was low in many places.1 from local-level programmers to national of sufficient resources and the need for policymakers - was discussing how to programme changes at all levels of the In addition, countries lacked critical do more for adolescents, so that young response. information and data on adolescent boys and girls could avoid HIV infection health, including the socio-economic 1,3 World Health Organization, Health for the World’s Adolescents: Second chance for a second decade, WHO, Geneva, 2014. http://www.who.int/maternal_child_adolescent/topics/ adolescence/second-decade/en/. 2 Idele P, et. al, Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps. J Acquir Immune Defic Syndr. 2014 Jul 1;66 Suppl 2:S144-53. 5 CATALYSING THE HIV RESPONSE FOR ADOLESCENTS A GLOBAL CALL TO ACTION All In – a collaborative platform The result of these global deliberations was All In to End All In focused on four action areas: Adolescent AIDS (All In) – a joint initiative launched in February 2015 by UNAIDS and UNICEF that aimed to inspire actors to Engage, mobilize and support adolescents as collaborate across sectors to accelerate reductions in AIDS- 1 leaders and agents of social change related deaths and new HIV infections among adolescents. Aligning with the UNAIDS Fast-Track Strategy, the goal is to end Sharpen adolescent-specific elements of national the AIDS epidemic by 2030.4 Although All In was convened by AIDS programmes by improving data collection and UNAIDS and UNICEF, its approach depends on leadership and 2 analysis and using evidence to drive programming active engagement by countries at every step of the process, as well as on meaningful participation by adolescents.5 Foster innovative approaches that improve the reach of services for adolescents and increase the impact of Three years after its launch, countries in ESAR have experienced 3 prevention, treatment and care programmes far-reaching progress across multiple areas of adolescent HIV programming, laying the groundwork
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