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

Picture removed

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

Picture removed

“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?

Picture removed

Thank you for listening