Second-generation HIV surveillance: better data for decision-making.

This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second-generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance - HIV, AIDS, sexually transmitted infections (STIs) - and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated - which might differ depending on the stage and type of the epidemic - and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women and linking HIV surveillance and behavioural data collection. In addition, a strategic partnership between second-generation surveillance and AIDS programme evaluation is proposed that stresses the complementary roles of these data collection activities in determining the effectiveness of prevention and care programmes and explaining the epidemiological trend data collected by sentinel serosurveillance systems. In conclusion, second-generation HIV surveillance systems provide a comprehensive, cost-effective and appropriate response to the information needs of AIDS control programmes. The implementation of such systems, including a better use of the data generated by the system, will ensure that national programmes are in the best possible position to respond to the challenges of the epidemic

Proceedings of the first African Health Forum: effective partnerships and intersectoral collaborations are critical for attainment of Universal Health Coverage in Africa

Abstract Background Universal Health Coverage (UHC)is central to the health Sustainable Development Goals(SDG). Working towards UHC is a powerful mechanism for achieving the right to health and promoting human development which is a priority area of focus for the World Health Organization WHO. As a result, the WHO Regional Office for Africa convened the first-ever Africa Health Forum, co- hosted by the government of Rwanda in Kigali in June 2017 with the theme “Putting People First: The Road to Universal Health Coverage in Africa”. The Forum aimed to strengthen and forge new partnerships, align priorities and galvanize commitment to advance the health agenda in Africa in order to attain UHC and the SDGs. This paper reports the proceedings and conclusions of the forum. Methods The forum was attended by over 800 participants. It employed moderated panel and public discussions, and side events with political leaders, policy makers and technicians from ministries of health and finance, United Nations agencies, the private sector, the academia, philanthropic foundations, youth, women and non-governmental organizations drawn from within and outside the Region. Conclusions The commitment to achieve UHC was a collective expression of the belief that all people should have access to the health services they need without risk of financial hardship. The attainment of UHC will require a significant paradigm shift, including development of new partnerships especially public-private partnerships in selected areas with limited government resources, intersectoral collaboration to engage in interventions that affect health but are outside the purview of the ministries in charge of health and identification of public health issues where knowledge gaps exist as research priorities. The deliberations of the Forum culminated into a “Call-to-Action” – Putting People First: The Road to Universal Health Coverage in Africa, which pledged a renewed determination for Member States, in partnership with the private Sector, WHO, other UN Agencies and partners to support the attainment of the SDGs and UHC. There was agreement that immediate action was required to implement the call-to-action, and that the African Regional Office of WHO should develop a plan to rapidly operationalize the outcomes of the meeting