Malawi Country Operational Plan 2017 Strategic Direction Summary
Malawi Country Operational Plan 2017 Strategic Direction Summary April 26, 2017 1 1.0 Goal Statement While there has been significant progress in the fight against HIV, Malawi still has 980,000 people living with HIV (PLHIV), including 350,000 undiagnosed. The Malawi Population-Based HIV Impact Assessment (MPHIA) showed significant progress toward the globally endorsed targets of 90-90-90. The number of new adult infections each year continues to decline (28,000/year in 2016), coinciding with an increase in ART coverage. With the number of annual HIV-related deaths reduced to 27,000/year in 2016, Malawi continues making progress toward epidemic control. However, MPHIA also highlights a disproportionately high HIV incidence among adolescent girls and young women (AGYW) with point estimates for HIV incidence 8 times higher among females aged 15-24 than males. Therefore, the overarching goal of COP17 is to interrupt HIV transmission by reducing incidence among AGYW through testing and treatment of potential sexual partners (men 15-40) and primary prevention (e.g., expansion of DREAMS and AGYW targeted interventions), thereby interrupting the lifecycle of HIV transmission and accelerating progress to epidemic control. The 1st 90 remains the greatest challenge and requires a number of key strategy shifts: Targeting testing and treatment strategies: Increased focus on targeting men and youth with the most efficient testing modalities (e.g., index case testing) and treatment strategies (e.g., same-day ART initiation) to achieve saturation across all age and gender bands in scale-up districts by the end of FY18. Increasing focus in five “acceleration” districts: Per the MPHIA, the epidemic is most intense in population-dense regions of Southern Malawi, especially Blantyre; therefore, PEPFAR will focus on Blantyre and four other high burden, scale up districts (deemed “acceleration” districts) that include 70% of the national gap to saturation.
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