Neftaly Initiative: Expanding ART Coverage to 90% of Diagnosed PLHIV by 2021
Goal
To ensure that at least 90% of all People Living with HIV (PLHIV) who are aware of their HIV-positive status are enrolled in and receiving life-saving antiretroviral therapy (ART) by the end of 2021.
This goal aligns with the UNAIDS 90-90-90 targets, aiming to curb the HIV epidemic through widespread testing, treatment access, and viral suppression.
Rationale
Access to antiretroviral therapy (ART) is critical for:
- Prolonging and improving the quality of life for PLHIV.
- Preventing onward transmission of HIV (treatment as prevention).
- Reducing HIV-related morbidity and mortality.
- Strengthening the overall health system response to HIV/AIDS.
Despite global progress, significant gaps remain—particularly in low-resource and high-stigma environments. Neftaly aimed to bridge this gap through targeted, inclusive, and community-centered strategies.
Strategic Interventions
1. Strengthening the HIV Care Continuum
- Developed local referral pathways from testing sites to ART centers.
- Reduced delays between diagnosis and treatment initiation.
- Monitored patient retention and adherence through digital and community tools.
2. Decentralizing ART Services
- Expanded ART delivery to rural clinics and community-based health posts.
- Trained local health workers and peer navigators to initiate and manage ART.
- Integrated ART distribution into maternal, TB, and outpatient services to normalize care.
3. Removing Barriers to Access
- Implemented mobile ART clinics for remote and underserved populations.
- Provided transport stipends, nutritional support, and psychosocial counseling.
- Advocated for stigma-free environments in health facilities and communities.
4. Empowering PLHIV Networks
- Partnered with PLHIV groups to improve community outreach and treatment literacy.
- Supported peer-led follow-up and adherence support programs.
- Promoted patient voices in local health governance and monitoring efforts.
5. Data-Driven Monitoring
- Introduced real-time data systems to track ART initiation and retention rates.
- Disaggregated data by age, gender, and key population to identify gaps.
- Used data for rapid response interventions in low-performing areas.
Achievements by 2021
- 92% of diagnosed PLHIV enrolled on ART in Neftaly-supported regions.
- Treatment dropout reduced by over 40% due to peer follow-up mechanisms.
- Enhanced ART literacy among PLHIV, with over 20,000 individuals reached through community education.
- Strengthened collaboration with national HIV programs and integrated Neftaly data into country reporting systems.
Challenges Faced
- COVID-19 disruptions temporarily limited ART access in early 2020.
- Persistent stigma in some communities continued to hinder service uptake.
- Drug stockouts and supply chain delays affected continuity in certain regions.
Conclusion
By the end of 2021, Neftaly successfully contributed to global HIV response targets by ensuring that over 90% of PLHIV who knew their status were on ART, marking a critical milestone in the journey toward epidemic control. The program’s emphasis on equity, accessibility, and sustainability ensured long-term impact and resilience, even in challenging settings.