Ghana

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Ghanas HIV Response

• The Ghana Team
• Richard N. Amenyah
• Matilda Owusu-Ansah
• Evelyn Awittor
• Lord Dartey
• Mercy Bannerman

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Background

• 1985
• National Advisory Council on AIDS (NACA)
• National Technical Committee on AIDS (NTCA)
• 1986
• First AIDS Case diagnosed in Ghana
• 1987
• National AIDS/STD Control Programme (NACP)
• Sept 2000
• Ghana AIDS Commission

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Goals of the National Response

• To achieve Universal Access, the goals of the
  National Response as outlined in the NSF II are
•  Reducing new infections among vulnerable groups
  and the general population
• Mitigating the impact of the epidemic on the
  health and socio-economic systems as well as
  infected and affected persons and
• Promoting healthy life-styles, especially in the
  area of sexual and reproductive health.

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Thematic areas

• Within the framework of Universal Access to
  prevention, treatment, care and support by 2010,
  the NSF II is programmed around 7 thematic areas
• Policy, Advocacy and Enabling Environment
• Coordination and Management of the Decentralized
  Response
• Mitigating the Economic, Socio-cultural and Legal
  Impacts
• Prevention and Behavioral Change Communication
• Treatment, Care and Support
• Research, Surveillance, Monitoring and Evaluation
• Mobilization of Resources and Funding Arrangement

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National HIV Prevalence
Source NACP-Ghana
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Ghanas gains

• Strategic planning NSF I (2001-2005) and NSF
  II-(2006-2010), JPR (2004, 2007), 5-POW, APOW
• Policy formulation (National HIV Policy-2004)
• Decentralized implementation of the National
  response
• Prevention programmes (Near Universal awareness)
• Treatment and care and support (5th year of ART)
• Human rights issues (anti-stigma campaigns)
• Monitoring and evaluation (ME Plans for all
  Levels)
• Increased participation of CSOs and GIPA
  (Partnership Forum, TWG etc)
• Impact mitigation (OVCs, NHIS for PLHIVs, IGAs)

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UNIVERSAL ACCESS NATIONAL TARGETS FOR GHANA
Programmatic area Indicator Data Sources Baseline (year) 2008 2010 Data Collection Type
Impact target National HIV prevalence among people aged 15-49 GHS 2.20 (2003) 2.10 1.90 NACP Technical Report (HSS/GDHS/Programme Data)
Impact target HIV prevalence among young people aged 15-24 GHS 1.9 (2005) 1.4 1.0 HSS
Prevention Prevention Prevention Prevention Prevention Prevention Prevention
Impact target of HIV-infected infants born to HIV infected mothers GHS 30 (2004) 22 151 Routine data collection system
Process target of centers providing PMTCT services GHS 135 (2005) 190 238 Routine reporting system
Impact target of people aged 15-49 who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about HIV transmission GSS GHS F-38 M-44 (2003) F-46 M-54 F-50 M-60 GDHS(2008) BSS(2006) MICS(2006)
Treatment Treatment Treatment Treatment Treatment Treatment Treatment
Impact target of women, men and children with advanced HIV infection who are receiving antiretroviral combination therapy GHS 6.5 (2005) 42 66 Routine reporting system
Process target of centers providing ART services GHS 5 (2005) 50 138 Routine reporting system
Process target of centers providing VCT services GHS 145 (2005) 190 238 Routine reporting system
Process target of clients tested for HIV at VCT sites and receiving their serostatus results in the past 12 months GHS 42,206 (2005) 200,000 300,000 Routine reporting system
Impact target of HIV positive pregnant women who receive a complete course of antiretroviral therapy to prevent mother to child transmission in the last 12 months. GHS 0.45 (2005) 24.8 47.6 Routine reporting system
Process target of centers providing PMTCT services GHS 135 (2005) 190 238 Routine reporting system
Care and support Care and support Care and support Care and support Care and support Care and support Care and support
Impact target Ratio of current school attendance among orphans to that among non-orphans, aged 10-14 GSS 0.79 (2003) 0.9 0.95 GDHS MICS
National commitment National commitment National commitment National commitment National commitment National commitment National commitment
Impact target Amount of national funds disbursed by government on HIV/AIDS MoFEP Cedi 97 billion (2003) TBD TBD NASA2

1 Impact target UNAIDS estimated 50 reduction
of the proportion of infants infected with HIV.
2 National AIDS Spending Assessment
(NASA). Abbreviations GHS Ghana Health Service
, GSS Ghana Statistical Service, TBD- To be
determined, MoFEP- Ministry of Finance and
Economic Planning , MICS Multiple Cluster
Study, BSS-Behaviour Surveillance Survey, HSS-HIV
Sentinel Survey, NACP- National AIDS Control
Programme, GDHS-Ghana Demographic Health Survey
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Key issues in HIV response

• Prevention
• An increasing trend in HIV new infections
• Slow rate of behavior change
• Low risk perception
• Low uptake of prevention services
• High levels of stigma
• Weak link between community and health services
• Weak integration of HIV programs into sexual
  reproductive health programs
• Low priority for workplace HIV prevention
  programs
• Inadequate Operational research on prevention
  services

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• Treatment care and support
• 16 of adults who need HAART are on therapy
• 10 of HIV infected children lt15 years in need
  of HAART are on HAART
• 10 of HIV infected pregnant women have received
  antiretrovirals to reduce the risk of mother to
  child transmission (past 12 months)
• New combination ARV prophylaxis introduced
• Weak Home Based care programs
• Inadequate human resource to support services

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• Coordination/Management
• Weak Coordination of the multi-sectoral response
• Weak M E particularly on Prevention activities

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