Delivering on the frontline is the answer to an AIDS Free Africa

Towards an AIDS Free Africa – Delivering on the frontline: this was the focus of the 13th Paediatric-Adolescent Treatment Africa (PATA) summit, which brought together over 200 delegates including 110 frontline health providers from 15 sub-Saharan African countries between 23 and 25 October 2017.

The PATA 2017 Continental Summit revolved around three pillars: FIND, TREAT and CARE, which align with UNAIDS’ super-fast-track framework for ending AIDS among children, adolescents and young women globally by 2020. The summit provided an innovative and highly unique platform for policy-makers, programme implementers and frontline health providers to link and learn from across sub-Saharan Africa. Delegates shared promising and best practices in HIV case finding, Differentiated Service Delivery (DSD), linkage to care and resilience-building of clients as well as health providers themselves. Their passion and commitment to sharing and learning, reflecting on progress and barriers as well as planning quality improvement action plans will contribute to strengthening delivery on the frontline and galvanizing our collective efforts to reaching global HIV/AIDS targets.

The Summit Programme also featured an array of high-level presentations and plenary speakers from Aids & Rights Alliance for Southern Africa (ARASA), Clinton Health Access Initiative (CHAI), Global Network of Young People Living with HIV (Y+), International AIDS Society (IAS), International Center for AIDS Care and Treatment Program (ICAP), Mzantsi Wakho, National Department of Health South Africa, the Regional Psychosocial Support Initiative (REPPSI), UNICEF, and Zoë-Life South Africa, providing an opportunity for engagement on all levels – from practice to policy. Plenary chairs represented organisations such as AVERT, Ministry of Health and Child Care, Zimbabwe and the University of California San Francisco (UCSF).

The largest PATA gathering yet, the PATA 2017 Continental Summit highlights just how far the organisation has come. From a small, informal knowledge-sharing hub, to the first PATA forum in 2005, PATA is now a growing organisation with a network of over 360 associated health facilities across sub-Saharan Africa. Health providers in the PATA network have access to PATA’s local and regional collaborative learning platforms and opportunities to bring promising practices back to their health facilities through implementation of PATA-supported, local incubation projects. PATA proudly celebrated this growth as part of its 10-year birthday during the PATA 2017 Continental Summit.

With over 40% of health facilities attending a PATA summit for the first time, the PATA 2017 Continental Summit was a collaborative and highly valuable platform to grow the network, where old and new members could connect, build stronger relationships, learn from each other and gain a wealth of knowledge from diverse perspectives and experiences.

The summit also provided an opportunity to learn more about health facilities in the region. Out of the 110 health providers from 58 health facilities who participated in the summit, 52% held a clinical role and 48% a psychosocial role, reaffirming the importance of a holistic response that extends along the prevention, treatment, care and support continuum. According to a facility-based rapid assessment completed by participating facilities, over 248 185 infants, children, adolescents and young people received HIV counselling and testing, 8% tested positive and of these, 86% were initiated on antiretroviral therapy (ART) in the last 12 months. Facilities reported a total of 84 860 infants, children, adolescents and young people currently on ART. When asked about the quality of HIV services at their facilities, facilities cited psychosocial support as being their most challenging and centrally linked to levels of treatment adherence and retention in care.

Dr Nonhlanhla Dlamini from the National Department of Health, South Africa, said in her opening address: “The [PATA] summit comes at an opportune time as we all strive to make sure that this segment of the population is not left behind and that our actions keep pace with what’s happening with the adults. Adults are beating us – we are still lagging behind. We have to meet the same coverage targets, but I would like to ask that we actually beat them.”

Each day of the summit focused exclusively on one of the three themes FIND, TREAT or CARE and featured plenaries for technical guidance and policies; Africa cafés for a rapid showcase of regional and local promising practices; breakaway sessions for peer-to-peer dialogues; cross-cutting conversations in the form of panel discussions and skills-building sessions. There was also an awards ceremony, where health providers, who had been nominated by peer supporters and young people living with HIV from their respective health facilities, were celebrated for their contribution to adolescent- and child-friendly service.

During Africa Café sessions, a variety of best practice strategies and lessons were shared along the themes of FIND, TREAT and CARE and extended from high yield finding and testing practices, paediatric ART scale up and DSD models. Integration of youth-led services, community-clinic collaboration, knowledge sharing platforms and the use of mobile technology for information sharing, programming and monitoring and evaluation were highlighted. PATA and the summit delegation created an opportunity to share what is working and not working along the HIV care continuum across diverse contexts and through meaningful engagement on how best to adapt promising practices discussed at the summit. Each facility left after having developed a simple quality improvement plan for implementation in 2018.

Acknowledgement and recognition of frontline health providers underpinned the summit with a resounding call made for increased attention and investments to be made in health provider resilience building. As AVERT’s Kate Harrison said, “How do we support our own resilience as parents and caregivers? And how do we support those around us? We feel responsible. To be responsible, you need to be able to respond, and to do this, you need to be physically and emotional healthy.”

With a mission to mobilise and strengthen a network of frontline health providers to improve paediatric and adolescent HIV prevention, treatment, care and support in sub-Saharan Africa and a vision that all children and adolescents living with HIV in sub-Saharan Africa receive optimal treatment, care and support and live long, healthy lives, PATA’s 2017 Continental Summit was a significant milestone in its Theory of Change. One of the key speakers commented, “I was blown away by so many of the presentations and the speakers. I am taking back so many learnings. My favourite part of the summit was the Africa Café, which was not only so rich in content, outcomes and lessons learned, but also impeccably run. Team PATA not only understood the issues and the content so well, which helped them do an exemplary job in facilitating the sessions, but were also master time-keepers! I look so forward to participating again.”

Zoe-Life’s Stephanie Thomas said, “In Africa, we have ubuntu which makes us uniquely resilient. Ubuntu means we belong together. You belong to me and me to you. This makes us resilient as an African continent.”

This ubuntu and resilience was palpable during the PATA 2017 Continental Summit, as the PATA network of health providers, partner organisations, policy makers, donors and youth focused on one clear message: We can, together, realise an AIDS free Africa.