USAID SHIFT YEAR1 Technical Strategies and Priority TA Dr. Nguyen To Nhu, MD, PhD Technical Director, USAID SHIFT Email: tonhu@fhi360.org

5 KEY TA PRIORITIES Promoting local entities to the use TA Marketplace, TA demand creation Priority 1: Support health system consolidation and social health insurance (SHI) implementation at site and provincial levels Site level: all 46 HIV treatment facilities (HTFs) supported by USAID SHIFT Intensive support to sites in maintenance provinces, focus on sites in HCMC, Hanoi and 9 sites to be transitioned in Y1 Intensive support to sites located at one function preventive medicine center Provincial level: Nghe An, Dien Bien, Lao Cai, Bac Giang, other TA requests from provinces Priority 2: Support interventions to retain people living with HIV (PLHIV) on antiretroviral therapy (ART) Sites/provinces supported by USAID SHIFT Support Ministry of Health (MOH) to achieve retention in different provinces/sites through TA/interventions Attrition rate goal: <5%/year; <1.25%/quarter

5 KEY TA PRIORITIES Promoting local entities to the use TA Marketplace, TA demand creation Priority 3: Help increase # of PLHIV starting ART Support 3 priority provinces (NA, DB, HCMC) Support MOH review and provide TA to increase # of PLHIV starting ART Mechanism: New case finding, old case finding using information system, Hospital provider-initiated HIV testing and counseling (PITC) and linkages to care and treatment (C&T), mobile reach-test-start (mRTS) approaches Priority 4: Reduce stigma and discrimination (S&D), create enabling environment for key populations (KPs) to access HIV testing and counseling (HTC) and treatment, treatment retention, and increase HI card coverage amongst PLHIV Strategic partners Campaign Priority 5: Advocacy Financing for ARVs and methadone maintenance therapy (MMT) drugs Technical guidelines, HIV Law revision

90% of PLHIV know their status Aligning 5 key TA priorities with 90-90-90 Goals Priority 1: Support health system consolidation and SHI implementation at site and provincial levels Priority 3: Increase # of PLHIV in treatment Priority 2: Retain PLHIV in treatment 90% of PLHIV know their status 90% of PLHIV who know their status are on ART 90% of those on ART have suppressed viral load Priority 4: Reduce S&D, create enabling environment for KPs to access HTC and treatment, treatment retention, and increase HI card coverage amongst PLHIV Priority 5: Advocacy

EXAMPLES OF PRIORITY TA Health system strengthening and transition TA for HIV treatment facility (HTF) consolidation at provincial and site levels to gain eligibility for SHI reimbursement TA to increase coverage of SHI cards amongst PLHIV Advocacy and support to increase financial resources for ARV drug demand given donor funding reductions

EXAMPLES OF PRIORITY TA Monitoring, evaluation and strategic information National HIV cascade and provincial HIV cascade tracking toward 90- 90-90 Identify HIV program gaps to inform provincial program action via HIV cascade analysis, HIV Info and ARV treatment database Help integrate facility electronic health information system (eHIS) to support SHI reimbursement, reporting and case management for HIV C&T services beyond 46 USAID SHIFT-supported HTFs EPP and KP size estimation in selected provinces Provincial and National guidelines on M&E system strengthening (C03 and C09) NA and DB C03 strengthening

EXAMPLES OF PRIORITY TA Outreach, prevention, and HIV testing and counseling Innovations and TA for active case finding Old case finding New case finding Linking and engaging LTFU cases back to care and treatment Reduce stigma and discrimination toward PLHIV and KPs to remove barriers to access and retain in HIV C&T TA to assist local CSOs to develop capacity building action plans

EXAMPLES OF PRIORITY TA HIV care and treatment and MMT HIV retention guidelines and TA support Help revise Circular #32 detailing HIV treatment SOPs, protocols and tools, harmonizing with Law on Medical Examination and SHI reimbursement requirements Case management and tracking to minimize patient loss during and after transition to SHI TA support to train and certify HIV clinicians per SHI eligibility requirements TA for mRTS in remote mountainous areas Revise national MMT guidelines, MethQual package TA to build cadre of national trainers and mentors for MMT and HIV care and treatment TA support for TB-HIV integration and coordination

FINAL THOUGHTS Not all TA requests will necessarily obtain USAID approval and funding Chance for USAID approval increased if the TA request aligns with PEPFAR and USAID priorities Priorities will evolve over time Current hot topics: Transitioning SHI eHIS ART patient retention

Thank you for your attention!