EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 PROJECT SUMMARY June 30, 2020 TABLE OF CONTENTS Background.........................................................................................................................................P3 Key Achievements / Activities............................................................................................................P3 Collaboration with National Stakeholders.........................................................................................P9 Challenges / Key Lessons Learned....................................................................................................P10 Political Context.................................................................................................................................P11 Next Quarter Planned Activities........................................................................................................P11 1 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 LIST OF ACRONYMS AAS Association Africain Solidarité ART Antiretroviral Therapy BCC Behavior Change Communication CCM Country Coordinating Mechanism COPCT Continuum of Prevention, Care and Treatment CSO Civil Society Organization DIC Drop-in Center EVT Espoir Vie Togo FAMME Forces en Action pour le Mieux-etre de la Mère et de l'Enfant FSW Female Sex Worker GBV Gender-Based Violence GFATM Global Fund to Fight AIDS, Tuberculosis and Malaria HIP High Impact Practice HTC HIV Testing and Counseling IPS Implementing Partners KP KeyPopulations KPCoE Key Populations Centers of Excellence M&E Monitoring and Evaluation MoH Ministry of Health MSM Men Who Have Sex with Men NACC National Commission for the Fight against HIV/AIDS NGO Non-Governmental Organization PE Peer Educator PLHIV People Living with HIV PMP Performance Monitoring Plan PSSLS Programme Sectoriel Santé de Lutte contre le Sida et les IST REVS+ Responsabilité, Espoir, Vie, Solidarité RHO Regional Health Office SBC Strategic Behavior Change SOP Standard Operating Procedures STI Sexually Transmitted Infections TA Technical Assistance TOCAT Technical and Organizational Capacity Assessment Tool UNAIDS Joint United Nations Program on HIV/AIDS USAID United States Agency for International Development USG United States Government WAHO West African Health Organization 2 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 Section 1. BACKGROUND The Ending Aids in West Africa (#EAWA) project is a five-year cooperative agreement between the United States Agency for International Development West Africa Mission (USAID/WA) and Family Health International (FHI 360). #EAWA was initiated with the goal of accelerating progress across the region towards Ending AIDS in West Africa through the implementation of high impact practices in prevention, care and treatment, focusing on Key Populations. The main programmatic approach was the setting up of Key Populations Centers of Excellence (KPCOE), with improved service delivery, research, and learning activities, in the targeted countries to aim for the achievement of UNAIDS 90-90-90 targets. The project was launched in 2017 for a 5-year period with focus countries that are Togo, Burkina Faso, Guinea, and Benin. With the validated PEPFAR Regional Operational Plan that occurred in May 2019 and has granted game changer funds to Togo and Burkina Faso for FY 20 and FY 21, #EAWA has been mandated to implement the (i) the service delivery component, (ii) the laboratory system strengthening component, and (iii) the monitoring and evaluation component, of the program, starting FY 20, exclusively, in these two countries. This Game Changer Fund was awarded to support the intensification of case finding strategies, linkage to care and retention, and viral load suppression (VLS), thus significantly improving the HIV/AIDS clinical cascades in two years (FY20 and FY21). With the Game changer funds, the project will go beyond KP programing and will target also general population. Therefore, the goal of #EAWA is to: “achieve HIV epidemic control in West Africa by accelerating progress across the region towards Ending AIDS through prevention, care and treatment, and accelerating of achievement of UNAIDS 90-90-90 targets with a focus on PLHIV and Key Populations”. #EAWA is mandated to work with all stakeholders in-country to support the targeted countries (Burkina Faso and Togo) reach nationally the first and second 90 in FY20, and achieve the third 90 in FY21 through direct service delivery, with a targeted focus on the highest burden sites for PLHIV and KP (Centre, Hauts Bassins, and Centre Ouest Regions in Burkina Faso; Lomé Commune, Maritime, and Plateaux Regions in Togo), and with technical assistance to other sites. This report is an overall summary of the achieved performance level and implementation of activities in the third quarter (April-June) of the FY 20 (October 19 - September 20). Section 2. KEY ACHIEVEMENTS/ACTIVITIES · Achievement on core indicators by country This third quarter of fiscal 2020 was marked by the consolidation of the promising results obtained in the first and second quarters of this year. And this was achieved despite the COVID 19 outbreak that persisted through the quarter. The project has proven to be resilient as it mitigated the negative impact of COVID 19 on the continuation of activities and the achievement of objectives on the project's key indicators. In both countries, restrictive measures due to COVID 19 have been gradually lifted from the last 2 weeks of the quarter. 3 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 Figure 1.a: Number and Percent of FY20 annual targets achieved in Q3 (Togo) Figure 1.b: Number and Percent of FY20 annual targets achieved in Q3 (Burkina Faso) 4 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 · Key strategies and innovations Detailed information on the strategies that were implemented to achieve Q3 results are provided in section 2. Strategies for reach: - The involvement of additional Peer educators (PE) from FSW and MSM population groups in Togo as part of the implementation of the KPIF project, - The assignment of granular specific targets to Peer educators (PE) in their geographic area, ations; - The organization of EPOA (Enhanced Peer Outreach Approach) campaigns in both countries; - The implementation of online prevention and referrals (mainly for MSMs) in Togo. Strategies for HIV testing, linkage and ART initiation - The partnership with surrounding private clinics for the referral of patients suspected of being HIV positive; - The implementation of diversified case finding strategies such as index testing including partner notification services, risk network referral (RNR), and targeted PITC; - The intensification of targeted community testing to those most at risk; - The provision of transportation fees for ART initiation; - The involvement of case managers and peer navigators as HIV testing counselors and first contact in the linkage to ART for HIV positive; - Tailored supervision and coaching to health facilities staff involved in the project; - The implementation of test and start strategy. Strategies for ART retention, adherence support and viral load improvement - Differentiated follow-up and home visits by health providers and case managers; - Individual and/or group counseling on treatment adherence by health providers; - Appointment reminders through SMS and phone calls or home visits by case managers; - The use of the e-tracker to track those lost to follow-up ART patients and re-engage them on treatment; - The implementation and scale-up of community ARV refills; - The transportation of viral load samples to the laboratory. 5 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 Detailed performance results by country TOGO Figure 2a: Trend of weekly achievements by end of June 2020 in Togo Figure 3.a : HIV testing to ART initiation cascade in Togo – FY20/Q3 6 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 Figure 4.a : Togo Cascade of Key Populations Q3/FY20 Figure 5.a : Togo Cascade of Index testing Q3/FY20 7 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 BURKINA SASO Figure 2.b Trend of weekly achievements by end of June 2020 in Burkina Faso Figure 3.b : HIV testing to ART initiation cascade in Burkina Faso – FY20/Q3 8 APRIL - JUNE 2020 EAWA SUMMARY PROGRESS REPORT QUARTER 3 - PROJECT YEAR 3 Figure 4.b: Burkina Faso KP Cascade Q3/FY 20 Figure 5.b: Burkina Faso Cascade of index testing Q2/FY20 Section 3. COLLABORATION WITH NATIONAL STAKEHOLDERS During this quarter, the Ministry of Health (through the PNLS and the PSSLS) and the CNLS in Burkina Faso and Togo demonstrated their commitment to project activities by actively organizing monthly meetings of the project steering committee. in both countries. In Togo, the PNLS acts as the main technical partner of the project with responsibilities in national supervision, quality control, training and laboratory strengthening activities. The monthly steering committee meetings were held regularly under the leadership of the CNLS with the participation of all stakeholders to discuss the overall implementation of the program and address bottlenecks. In Burkina Faso, the framework for collaboration with the PSSLS was finalized and a consensus was reached on the operationalization of the program steering committee with USAID and the SP / CNLS. Working closely with national stakeholders since the