Helping Expand Antiretroviral Treatment for Families and Children (Project HEART) (CDC/PEPFAR)

Overview

Project HEART was launched in 2004 in Côte d’Ivoire, South Africa, Tanzania, and Zambia, and in 2006 in Mozambique. This eight-year project, funded through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Centers for Disease Control and Prevention (CDC), saw dramatic results. In 2010, one out of every 10 PEPFAR-supported ART patients in sub-Saharan Africa received their treatment through Project HEART. By early 2012, more than one million men, women, and children received HIV care and support; more than 2.5 million pregnant women received HIV counseling and testing; more than 66,500 pediatric HIV infections were prevented; and more than half a million people started lifesaving antiretroviral therapy (ART). Working with a network of more than 215 international and local partners, Project HEART dramatically improved delivery of HIV/AIDS services and ultimately strengthened national health systems by:

• Supporting HIV prevention, care, and treatment services at more than 510 ART sites and 1,053 prevention of mother-to-child transmission of HIV (PMTCT) sites throughout five countries;
• Building the clinical, managerial, financial, and administrative capacity of local health providers and partners to more effectively provide HIV services;
• Strengthening program and data quality;
• Improving the technological and physical infrastructure of health facilities;
• Providing sub-awards to local partners and Ministries of Health at the district and provincial/regional levels, in coordination with capacity building

Project HEART’s innovative practices – most notably using a decentralized district approach, scaling up performance-based financing, and piloting new, easy-to-use technology – have served as best practices that have been authorized and disseminated by Ministries of Health and other implementing partners.

In Côte d’Ivoire, EGPAF coordinated with the Ministry of Health to expand PMTCT services and integrate those services with access to ART for pregnant mothers, partner and family testing, and screening for tuberculosis. In its role as an innovator and national leader in PMTCT services, EGPAF began the first opt-out voluntary counseling and testing program. The subsequent introduction of provided-initiated counseling and testing to reflect changes in international guidelines has increased HIV testing uptake. EGPAF supported TB/HIV integration and infection prevention activities at 56 EGPAF-supported TB sites and at 70 ART sites, and expanded TB/HIV services to 18 additional TB centers.
EGPAF/Côte d’Ivoire supported 412 PMTCT and care and treatment sites over the life of the project, and achieved the following:

• Provided over 790,000 women with access to services to prevent transmission of HIV to their babies;
• More than 180,000 individuals, including more than 12,600 children, have been enrolled into our care and support programs;
• 671,213 pregnant women have been tested for HIV through EGPAF-supported programs;
• Supported services at 476 ART sites and 2,231 PMTCT sites.