Nutrition/HIV – new developments
• Increased Evidence Base – e.g. micronutrient supplements, RUTF
• High Profile Meetings – Durban, Blantyre. Others planned in Africa
• Updates on Infant Feeding Advice – evidence and policies
• UN Reform - Collaboration
• Public/Private Partnerships
SCN WG on Nutrition and HIV
• UN reform/PPPs for Nutrition/HIV – Andrew Tomkins
• The impact of the Nutrition Cluster – Bruce Cogill
• Operationalising Food/Nutrition links - Stuart Gillespie
• Recent joint achievements in the UN - Randa Saadeh
• HIV and mortality in SAM – Pamela Fergusson
• CTC/RUTF for SAM in HIV – Bahwere Paluku
• Discussion and Conclusions on Priority Actions
Nutrition and HIV/AIDS WGAndrew Tomkins
Institute of Child Health, London
2 key issues for our WG
Part 1 - Working together more effectively
Part 2 - Public/Private Initiatives
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Coordination for
Nutrition and HIV
Whose responsibility?
8 Nutritional Interventions for HIV within National Aids
Committees (NACs)
1. Convincing NAC professionals of the impact of Nutrition on HIV
2. Getting Nutrition into NAC policies and funded programmes
3. Obtain and Deliver Resources for Targeted Nutrition/HIV Interventions – 4S’ - strategy, supplies, staff, skills
4. Ensure linkages between different cadres of staff working in HIV/AIDS
5. Set up M&E systems for assessing coverage and impact
6. Assist those applying to Global Fund
7 Incorporate Nutrition Training within NAC programmes
8 Document examples of Good Practice
Nutritional Care for Mothers and Children – in NAC policy
Infant FeedingAdvice
RUTF for HIV infected malnourished
Management of metabolic syndrome
in children
Screening health/nutritional
status of children of HIV infected
mothers
Health/Nutrition of HIV infected
mothers
NutritionalManagement of
HIV infected adolescents
Unknown Issues in Mothers and Children
• Value of Multiple Micronutrients in HIV infected pregnancy
• Value of food supplements for HIV infected mothers
• Optimal dose and stage at which ARVs should be used in SAM
Nutritional Care for Adults in NAC policy
Dietary Advice re ARVs for HIV Infectedwith appetite
Dietary provision for HIV infected who are unemployedor stigmatised
RUTF for HIV infected
who are anorectic
Management of
metabolic syndrome
ImprovingHFS by increasingProduction and/or
Provision
Unknown Issues in Adults
• Role of Multiple Micronutrients in preventing progression – with and without HIV
• Role of Dietary Supplements/RUTF on Diseases Progression
Summary
• We know enough to merit establishing a HIV/Nutrition Support Unit within each NAC
• Different cadres of HIV/Nutrition Staff need to have Job Plans developed for linking with different government sectors
• We need leadership/advocacy for such Units by the international agencies to get their value recognised by the predominantly infectious disease trained staff in NACs
• A few countries (Malawi and Kenya) have started – let others become more active
Pfizer – drugs for filariasis donated to LDC
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“Melinda and I believe that innovative financing initiatives, such as the Advanced Market Commitment for pneumococcal vaccine, can harness the expertise of private industry and help close this research gap so that one day, those born in the developing world will have the same chance for good health as those born in America and Britain.”Bill GatesBill & Melinda Gates Foundation
Letter to Economist Feb 24th 2007
Included money from 6 European donors
Health NutritionProduct Development
ARVs RUTF
Opportunities for Public Private Sector Action in Nutrition and HIV
Health NutritionProduct Development
ARVs RUTF
Research ARV for PMTCT
ARV dose in
SAM
Health NutritionProduct Development
ARVs RUTF
Research ARV for PMTCT
ARV dose in
SAM
Improving Access
HIV Testing HFS
Health NutritionProduct Development
ARVs RUTF
Research ARV for PMTCT
ARV dose in
SAM
Improving Access
HIV Testing HFS
Service Strengthening
ARV staff Nutrition Professionals
Health NutritionProduct Development
ARVs RUTF
Research ARV for PMTCT ARV dose in
SAM
Improving Access
HIV Testing HFS
Service Strengthening
ARV staff Nutritionists
Advocacy and Education
Behaviour Change – understood by all
Infant Feeding knowledge –understood by all
Health NutritionProduct Development
ARVs RUTF
Research ARV for PMTCT ARV dose in
SAM
Improving Access
HIV Testing HFS
Service Strengthening
ARV staff Nutritionists
Advocacy and Education
Behaviour Change – understood by all
Infant Feeding knowledge – understood by all
Quality Control
Generic ARVs Generic RUTF
Summary
• Many opportunities for Private Sector to contribute to improved management of Nutrition and HIV
• Need to understand what is stopping PPP developments in Nutrition whereas they are successful in Health
• Need careful monitoring of all Public Private Partnerships to ensure that the malnourished and poor benefit
How much can PPP help me?
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Thank you for listening