Background

Scoring

Adoption score
Definition:
Progress toward implementation of policies is scored based on adoption of each policy, as ‘Not adopted’, ‘Partial’, or ‘Adopted’.
NOT ADOPTED
PARTIAL
ADOPTED
Overall and policy category score
Definition:
For each policy category and overall, adoption scores are combined and scored for progression by quintile: ‘Very few’, ‘Few’, ‘Some’, ‘Many’, and ‘Most’.
VERY FEW
FEW
SOME
MANY
MOST

Policy scoring

Clinical and treatment

CT1 Treatment Initiation
Question:
Are all people living with HIV, regardless of CD4 count, eligible to start HIV treatment in national policy?
Possible values:
Definition of value:
Adopted
All people living with HIV, regardless of CD4 count, are eligible to start HIV treatment according to national guidelines
Not adopted
According to national guidelines, only people whose CD4 count falls below a certain threshold are eligible to start ART
Policy recommendation:
WHO, Guideline on When to Start ART and PrEP, 2015; WHO, Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection, 2016.
CT2 Same-day treatment start
Question:
Is the option to start treatment the same day as HIV diagnosis included in national policy?
Possible values:
Definition of value:
Adopted
National guidelines explicitly allow for same day start
Not adopted
National guidelines do not explicitly allow for same day start
Policy recommendation:
WHO, Guidelines for Managing Advanced HIV Disease and Rapid Initiation of ART, 2017.
CT3 Treatment regimen
Question:
Are up-to-date first-line ARV regimens aligned with international recommendations included in national HIV policy?
Possible values:
Definition of value:
Adopted
The first-line ARV regimen included in national HIV treatment guidelines aligns with international recommendations
Not adopted
The first-line ARV regimen included in national HIV treatment guidelines does not align with international recommendations
Policy recommendation:
WHO, Update of Recommendations on First- and Second-Line ARVs, 2019; WHO, Updated Recommendations on First-Line & Second-Line ARVs and PEP and Recommendations on Early Infant Diagnosis of HIV, 2018; WHO, Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection, 2016.
CT4 Differentiated service delivery
Question:
Do national HIV treatment policies identify those who are stable and include multiple options for differentiated HIV treatment services (e.g. 6-month dispensing, community ART distribution, reduced clinic visits)?
Possible values:
Definition of value:
Adopted
National guidelines allow for multiple differentiated service delivery options, including at least 6 month ARV dispensing for stable patients
Partially adopted
National guidelines define "stable patients" eligible for differentiated service delivery and provide at least one form of differentiated service delivery (e.g. community ART distribution, 3-month dispensing, reduced clinic visits)
Not adopted
National guidelines do not define "stable patients" or provide differentiated service delivery
Policy recommendation:
WHO, CDC, PEPFAR, USAID & IAS, Key Considerations for Differentiated ART Delivery for Specific Populations, 2017; WHO, Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection, 2016.
CT5 Viral load testing
Question:
Is viral load monitoring at least once per year provided for in national policy?
Possible values:
Definition of value:
Adopted
National policy provides for viral load monitoring at least once per year
Not adopted
National policy does not provide for viral load monitoring at least once per year
Policy recommendation:
WHO, What's New in Treatment Monitoring: Viral Load & CD4 Testing, 2017; WHO, Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection, 2016.
CT6 Pediatric diagnosis & treatment
Question:
Are national pediatric testing and treatment policies aligned with international recommendations?
Possible values:
Definition of value:
Adopted
National guidelines for pediatric testing and treatment align with international recommendations
Not adopted
National guidelines for pediatric testing and/or treatment do not align with international recommendations
Policy recommendation:
WHO, Updated Recommendations on First-Line & Second-Line ARVs and PEP and Recommendations on Early Infant Diagnosis of HIV, 2018; WHO & IATT, 2018 Optimal Formulary and Limited-Use List for Paediatric ARVs, 2018; WHO, Novel Point-of-Care Tools for Early Infant Diagnosis of HIV, 2017; WHO, What's New in Infant Diagnosis, 2015.
i Peds- Diagnosis
Question:
Does early infant diagnosis policy align with WHO recommendations?
Possible values:
Definition of value:
Adopted
National policy on early infant diagnosis aligns with WHO recommendations
Not adopted
National policy on early infant diagnosis does not align with WHO recommendations
ii Peds- Treatment
Question:
Does the first-line ARV regimen for infants and children included in national guidelines align with WHO recommendations?
Possible values:
Definition of value:
Adopted
The first-line pediatric ARV regimen included in national HIV treatment guidelines aligns with WHO recommendations
Not adopted
The first-line pediatric ARV regimen included in national HIV treatment guidelines does not align with WHO recommendations
CT7 Migrants access to healthcare
Question:
Are HIV services and primary healthcare available to all migrants under the same conditions as citizens under national policy?
Possible values:
Definition of value:
Adopted
National (or subnational) laws/policy makes primary healthcare and HIV services accessible to all migrants under the same conditions as citizens
Partially adopted
National (or subnational) policy makes either primary healthcare or HIV services accessible to all migrants under the same conditions as citizens
Not adopted
National (or subnational) policy restricts access to primary healthcare and HIV services for some or all migrants
Policy recommendation:
Global Commission on HIV and the Law, Risks, Rights & Health Supplement, 2018; United Nations General Assembly, New York Declaration for Refugees and Migrants, 2016; Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
i Migrants-Primary health care
Question:
Is primary healthcare available to all migrants under the same conditions as citizens under national policy?
Possible values:
Definition of value:
Adopted
National (or subnational) laws/policy makes primary healthcare accessible to all migrants under the same conditions as citizens
Not adopted
National (or subnational) policy restricts access to primary healthcare for some or all migrants
ii Migrants-HIV services
Question:
Are HIV services available to all migrants under the same conditions as citizens under national policy?
Possible values:
Definition of value:
Adopted
National (or subnational) laws/policy makes HIV services accessible to all migrants under the same conditions as citizens
Not adopted
National (or subnational) policy restricts access to HIV services for some or all migrants
CT8 TB diagnostics
Question:
Are rapid diagnostic tests (e.g. rapid molecular diagnostics, TB LAM) aligned with WHO recommendations used as the initial diagnostic test for TB in PLHIV under national policy?
Possible values:
Definition of value:
Adopted
National policy includes the use of WHO-approved rapid diagnostic tests (e.g. rapid molecular diagnostics, TB LAM) as the initial diagnostic test for TB in PLHIV
Not adopted
National policy does not include the use of WHO-approved rapid diagnostic tests (e.g. rapid molecular diagnostic, TB LAM) as the initial diagnostic test for TB in PLHIV
Policy recommendation:
WHO, Consolidated Guidelines on Tuberculosis-Rapid Diagnostics for TB Detection, 2020; WHO, Lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis of active tuberculosis in people living with HIV, 2019; WHO, Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children, 2013.

Testing and prevention

TP1 Self-testing
Question:
Is self-testing approved in national policy?
Possible values:
Definition of value:
Adopted
Self-testing is approved in national policy
Not adopted
Self-testing is not approved in national policy
Policy recommendation:
WHO, Guidelines on HIV Self-Testing and Partner Notification, 2016.
TP2 Partner notification/Index testing
Question:
Is index testing/partner notification, with robust protections for patient confidentiality, provided for in national policy?
Possible values:
Definition of value:
Adopted
National guidelines incorporate index testing/partner notification while prioritizing robust protections for patient confidentiality
Not adopted
National guidelines do not include index testing/partner notification or does not include robust protections against disclosure of HIV status without patients' consent
Policy recommendation:
UNAIDS, Fast-Track and Human Rights, 2017; WHO, Guidelines on HIV Self-Testing and Partner Notification, 2016.
i Index testing
Question:
Is index testing/partner notification provided for in national guidelines?
Possible values:
Definition of value:
Adopted
National guidelines include index testing/partner notification strategy
Not adopted
National guidelines do not include index testing/partner notification strategy
ii Confidentiality in index testing
Question:
Do partner notification guidelines include confidentiality and robust protections against disclosure of HIV status without patients consent?
Possible values:
Definition of value:
Adopted
National guidelines prioritize robust protections for patient confidentiality in partner notification process
Not adopted
National guidelines do not prioritize robust protections for patient confidentiality in partner notification process
TP3 Compulsory testing
Question:
Is compulsory HIV testing prohibited under national law?
Possible values:
Definition of value:
Adopted
National law/policy prohibits compulsory HIV testing, except in cases of blood/organ donation or with a court order
Not adopted
National law/policy does not prohibit compulsory HIV testing
Policy recommendation:
WHO & UNAIDS, Statement on HIV Testing Services, 2017.
TP4 Age restrictions on testing & treatment
Question:
Can adolescents access HIV testing and treatment without parental consent under national policy?
Possible values:
Definition of value:
Adopted
National law/policy does not require adolescents (≥12 years) to obtain parental/guardian consent in order to access HIV testing and/or treatment
Not adopted
National law/policy requires adolescents to obtain parental/guardian consent in order to access HIV testing and/or treatment
Policy recommendation:
Joint United Nations statement on ending discrimination in health care settings, 2017; UNAIDS, Prevention Gap Report, 2016; UN, Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, 2016; WHO, HIV and Adolescents: Guidance for HIV Testing and Counselling and Care for Adolescents Living with HIV, 2013; Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
TP5 PrEP
Question:
Are medicines for pre-exposure prophylaxis (PrEP) approved and are all people/populations at substantial risk of HIV infection eligible for PrEP under national policy?
Possible values:
Definition of value:
Adopted
National policy makes PrEP available to people/populations at substantial risk and at least one PrEP drug has regulatory approval
Partially adopted
National policy makes PrEP is available to people/populations at substantial risk but no PrEP drugs have received regulatory approval; or at least one PrEP drug has regulatory approval but national policy on PrEP eligibility excludes some people/populations at substantial risk
Not adopted
PrEP is not available to all eligible people/populations under national policy and no PrEP drugs have received regulatory approval
Policy recommendation:
WHO, Guideline on When to Start ART and PrEP, 2015.
i PrEP-Policy
Question:
Are people/populations at substantial risk of HIV infection identified and eligible for PreP under national policy?
Possible values:
Definition of value:
Adopted
National policy identifies and makes PrEP available to all people/populations at substantial risk
Not adopted
National policy does not make PrEP available to all people/populations at substantial risk
ii PrEP-Regulatory approval
Question:
Has at least one PrEP drug received regulatory approval?
Possible values:
Definition of value:
Adopted
At least one drug has received regulatory approval
Not adopted
No PrEP drug has received regulatory approval
TP6 Harm reduction
Question:
Does national law and HIV policy incorporate key harm reduction strategies, including avoidance of criminalizing syringe possession?
Possible values:
Definition of value:
Adopted
Harm reduction services are included in national policy and service packages for people who inject drugs and syringe possession is not criminalized
Partially adopted
Either harm reduction services are included in national policy and service packages for people who inject drugs or syringe possession is not criminalized, but not both
Not adopted
Harm reduction services are not included in national policy and service packages for people who inject drugs and syringe possession is criminalized
Policy recommendation:
UNAIDS, Fast-Track and human rights, 2017; Global Commission on HIV and the Law, Risks, Rights & Health, 2012; United Nations, Political Declaration on HIV and AIDS, 2011.
i Harm reduction strategy
Question:
Is harm reduction included in national policy & service packages for people who inject drugs?
Possible values:
Definition of value:
Adopted
Harm reduction services are included in national policy and service packages for people who inject drugs
Not adopted
Harm reduction services are not included in national policy and service packages for people who inject drugs
ii Syringe non-criminalization
Question:
Does national law avoid imposing criminal penalties for possession of syringes and associated paraphernalia?
Possible values:
Definition of value:
Adopted
National law avoids criminalizing possession of syringes and associated paraphernalia
Not adopted
National law criminalizes possession of syringes and associated paraphernalia
TP7 Comprehensive sexuality education
Question:
Is comprehsenive sexuality education required in primary and secondary schools under national policy?
Possible values:
Definition of value:
Adopted
National policy requires that a comprehensive sexuality education curriculum meeting international standards be taught in primary and secondary schools
Not adopted
National policy does not require that a comprehensive sexuality education curriculum meeting international standards be taught in primary & secondary schools
Policy recommendation:
UNESCO, International Technical Guidance on Sexuality Education, 2018; UNAIDS, Fast-Track Strategy 2016-2021.
TP8 Prisoners prevention
Question:
Are both condoms/lubricants and syringe access/exchange programs available to prisoners as a matter of policy?
Possible values:
Definition of value:
Adopted
Both condoms/lubricants and syringe access/exchange programs are available to prisoners
Partially adopted
Either condoms/lubricants or syringe access/exchange programs are available to prisoners, but not both
Not adopted
Neither condoms/lubricants nor syringe access/exchange programs are available to prisoners
Policy recommendation:
Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
i Prisons- Condoms
Question:
Are condoms/lubricant available in prisons as a matter of national policy?
Possible values:
Definition of value:
Adopted
Condoms/lubricant are available in prisons as a matter of national policy
Not adopted
Condoms/lubricant are not avaiable in prisons as a matter of national policy
ii Prisons- Needle & syringe programs
Question:
Are syringe access/exhcange programs available in prisons as a matter of national policy?
Possible values:
Definition of value:
Adopted
Needle/syringe programs are available in prisons as a matter of national policy
Not adopted
Needle/syringe programs are not avaiable in prisons as a matter of national policy

Structural

S1 Same-sex sex non-criminalization
Question:
Does national law/policy refrain from criminalizing and prosecuting people for consensual same-sex sexual acts?
Possible values:
Definition of value:
Adopted
National law avoids criminalizing consensual same-sex sex acts and there are no reports of people being prosecuted for consensual same-sex sex acts in recent years
Partially adopted
National law criminalizes consensual same-sex sex acts but there are no reports of people being prosecuted in recent years; or there are reports of people being prosecuted in recent years even though consensual same-sex sex acts are not criminalized under national law
Not adopted
National law criminalizes consensual same-sex sex acts and there are reports of people being prosecuted in recent years
Policy recommendation:
UNAIDS, Fast-Track and human rights, 2017; Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
i Same-sex sex non-criminalization- Laws
Question:
Does national law refrain from criminalizing consensual same-sex sexual acts?
Possible values:
Definition of value:
Adopted
Consensual same-sex acts are not criminalized under national law
Not adopted
Consensual same-sex sexual acts are criminalized under national law
ii Same-sex sex non-criminalization- Arrests
Question:
Has law-enforcement policy avoided prosecution for consensual same-sex acts in recent years?
Possible values:
Definition of value:
Adopted
There are no reports of people being prosecuted for consensual same-sex sex acts in recent years
Not adopted
There are reports of people being prosecuted for consensual same-sex sex acts in recent years
S2 Sex work non-criminalization
Question:
Does national law avoid criminalizing sex work (buying, selling, and organizing of sex work)?
Possible values:
Definition of value:
Adopted
Buying, selling, and organizing of sex work are not crimes under national laws and country does not impose punitive regulations on sex work
Partially adopted
Buying or selling sex are not crimes under national law, however the management/organization/facilitation of sex work is a crime and in some countries is used against sex workers; or national law operates a system of ‘legalization’ which imposes punitive or overly-restrictive regulations on sex work
Not adopted
Buying or selling of sex are crimes, or other activities associated with the buying or selling of sex are crimes
Policy recommendation:
UNAIDS, Fast-Track and human rights, 2017; Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
S3 Drug use non-criminalization
Question:
Does national law refrain from criminalizing personal drug use/possession?
Possible values:
Definition of value:
Adopted
National law refrains from criminalizing drug use or possession of drugs, including opioids, for personal consumption
Partially adopted
National law refrains from criminalizing drug use or possession for personal consumption, but may still impose punitive civil sanctions
Not adopted
National law criminalizes drug use or possession of drugs for personal consumption
Policy recommendation:
UNAIDS, Fast-Track and human rights, 2017; Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
S4 HIV exposure non-criminalization
Question:
Does national law refrain from criminalizing and prosecuting people for HIV exposure/ transmission?
Possible values:
Definition of value:
Adopted
National law does not criminalize non-intentional HIV exposure/transmission and there are no reports of people being prosecuted for HIV transmission in recent years
Partially adopted
National law criminalizes non-intentional HIV exposure/transmission or there have reports of people being prosecuted for HIV transmission in recent years, even though the law does not explicitly criminalize it
Not adopted
National law criminalizes non-intentional HIV exposure/transmission and there are reports of people being prosecuted for it in recent years
Policy recommendation:
UNAIDS, Fast-Track Strategy 2016-2021; Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
i HIV exposure non-criminalization- Laws
Question:
Does national law refrain from criminalizing HIV exposure/transmission?
Possible values:
Definition of value:
Adopted
National law does not criminalize non-intentional HIV exposure/transmission
Not adopted
National law criminalizes HIV exposure/transmission, through laws that apply either to HIV specifically or to infectious or sexually transmitted diseases (including by imposing penalties if PLHIV do not disclose their status to a partner)
ii HIV exposure non-criminalization- Arrests
Question:
Has law-enforcement policy avoided prosecution for HIV tranmission/exposure in recent years?
Possible values:
Definition of value:
Adopted
There are no reports of people being prosecuted for HIV exposure/transmission in recent years
Not adopted
There are reports of people being prosecuted for HIV exposure/transmission in recent years
S5 Non-discrimination protections
Question:
Do national/laws policies include protections from discrimination on the basis of sexual orientation, gender identity, and HIV status?
Possible values:
Definition of value:
Adopted
National laws protect people from discrimination, including employment discrimination, on the basis of sexual orientation, gender identity, and HIV status
Partially adopted
National laws protect people from discrimination, including employment discrimination, on one or two of these bases (sexual orientation, gender identity, HIV status)
Not adopted
National laws do not protect people from discrimination, including employment discrimination, on the basis of sexual orientation, gender identity, or HIV status
Policy recommendation:
Joint United Nations statement on ending discrimination in health care settings, 2017; UNAIDS, Fast-Track Strategy 2016-2021; Global Commission on HIV and the Law, Risks, Rights & Health, 2012.
i Non-discrimination- Sexual orientation
Question:
Do national laws protect people from discrimination on the basis of sexual orientation?
Possible values:
Definition of value:
Adopted
National laws protect people from discrimination, including employment discrimination, on the basis of sexual orientation
Not adopted
National laws do not protect people from discrimination, including employment discrimination, on the basis of sexual orientation
ii Non-discrimination- Gender Identity
Question:
Do national laws protect people from discrimination on the basis of gender identity/diversity?
Possible values:
Definition of value:
Adopted
National laws protect people from discrimination, including employment discrimination, on the basis of gender identity/diversity
Not adopted
National laws do not protect people from discrimination, including employment discrimination, on the basis of gender identity/diversity
iii Non-discrimination- HIV Status
Question:
Do national laws protect people from discrimination on the basis of HIV status?
Possible values:
Definition of value:
Adopted
National laws protect people from discrimination, including employment discrimination, on the basis of their HIV status
Not adopted
National laws do not protect people from discrimination, including employment discrimination, on the basis of their HIV status
S6 National human rights institutions
Question:
Is there an independent national human rights institution to which violations can be reported?
Possible values:
Definition of value:
Adopted
The country has a national human rights institution that is fully compliant with the Paris principles
Partially adopted
The country has a national human rights institution that is partially compliant with Paris principles
Not adopted
The country does not have a national human rights institution to which violations can be reported in compliance with the Paris principles
Policy recommendation:
United Nations, Principles relating to the Status of National Institutions (The Paris Principles), 1993.
S7 Constitutional right to health
Question:
Is there an enforceable right to health in the national constitution?
Possible values:
Definition of value:
Adopted
National constitution includes the right to health
Not adopted
National constitution does not include the right to health
Policy recommendation:
WHO Constitution, 1948.
S8 Girls education
Question:
Is there a national policy in place to encourage secondary school retention among girls?
Possible values:
Definition of value:
Adopted
National policies strongly encourage secondary school retention among girls
Partially adopted
National policies take limited steps to encourage secondary school retention among girls
Not adopted
The country lacks policies to encourage secondary school retention among girls
Policy recommendation:
UNAIDS, Fast Track Strategy 2016-2021.
S9 Gender based violence
Question:
Does the law explicitly address domestic violence with enforceable penalties?
Possible values:
Definition of value:
Adopted
Country has domestic violence legislation with enforcable penalties
Not adopted
Country does not have domestic violence legislation with enforceable penalties
Policy recommendation:
Global Commission on HIV and the Law, Risks, Rights & Health, 2012; United Nations, Political Declaration on HIV and AIDS, 2011.
S10 Civil society
Question:
Are NGOs/CSOs able to register, seek funding and operate freely under national law and is there a social contracting policy for financing NGOs/CSO-provided services?
Possible values:
Definition of value:
Adopted
There is a social contracting policy for financing NGOs/CSO-provided services and NGOs/CSOs able to register, seek funding and operate freely under national law
Partially adopted
Either there is a social contracting policy in place or NGOs/CSOs are able to register, seek funding and operate freely under national law, but not both
Not adopted
There is no social contracting policy for financing NGOs/CSO-provided services, nor are NGOs/CSOs able to register, seek funding and operate freely under national law
Policy recommendation:
Global Fund Sustainability Transition & Co-financing Policy, 2016; United Nations, Political Declaration on HIV and AIDS, 2011.
i Civil society- Social Contracting
Question:
Does national policy provide for social contracting (or other mechanisms by which the government finances CSOs to provide health services)?
Possible values:
Definition of value:
Adopted
National policy provides for social contracting (or similar mechanisms)
Not adopted
National policy does not provide for social contracting (or similar mechanisms)
ii Civil society- Freedom
Question:
Are NGOs/CSOs able to officially register, seek funding, and operate freely under national laws and policies?
Possible values:
Definition of value:
Adopted
National law/policy fosters free operation of civil society
Not adopted
National law/policy imposes legal barriers to the free operation of NGOs/CSOs

Health systems

HS1 Task shifting
Question:
Are nurses or other non-physicians allowed to initiate HIV treatment under national policy?
Possible values:
Definition of value:
Adopted
National policy allows nurses or other non-physicians to initiate ART
Not adopted
National policy does not allow nurses or other non-physicians to initiate ART
Policy recommendation:
WHO, CDC, PEPFAR, USAID & IAS, Key Considerations for Differentiated ART Delivery for Specific Populations, 2017
HS2 Health financing
Question:
Does the national budget and fiscal policy include sufficient health spending and adequate tax revenues to meet international targets?
Possible values:
Definition of value:
Adopted
National budget and fiscal policy includes sufficient health spending and adequate tax revenues to meet international targets
Partially adopted
National budget and fiscal policy includes either sufficient health spending or adequate tax revenues to meet international targets, but not both
Not adopted
National budget and fiscal policy does not include sufficient health spending and adequate tax revenues to meet international targets
Policy recommendation:
WHO, UHC-Lessons to Guide Country Actions on Health Financing, 2019; Global Fund Sustainability Transition & Co-financing Policy, 2016.
i Health financing- Budget
Question:
Does the percent of government spending going to health align with the Global Fund co-financing targets?
Possible values:
Definition of value:
Adopted
The percent of government spending going towards health aligns with the Global Fund co-financing target
Not adopted
The percent of government spending going towards health does not align with the Global Fund co-financing target
ii Health financing- Tax Revenue
Question:
Does government collect adequate tax revenue to align with the tax:GDP ratio in the Global Fund co-financing targets?
Possible values:
Definition of value:
Adopted
Country's tax:GDP ratio meets or exceeds Global Fund co-financing target
Not adopted
Country's tax:GDP ratio does not meet Global Fund co-financing target
HS3 Universal health coverage
Question:
Does national health coverage include medications for HIV treatment & pre-exposure prophylaxis?
Possible values:
Definition of value:
Adopted
National health coverage include medications for HIV treatment & PrEP
Partially adopted
National health coverage includes either ARVs or PrEP, but not both
Not adopted
National health coverage does not include ARVs or PrEP
Policy recommendation:
United Nations, Political Declaration of the High-level Meeting on Universal Health Coverage, 2019; WHO Model List of Essential Medicines; United Nations, Political Declaration on HIV and AIDS, 2011.
i UHC- ARVs
Question:
Are ARVs covered by the national health system/scheme?
Possible values:
Definition of value:
Adopted
ARVs are covered by the national health system/scheme
Not adopted
ARVs are not covered by the national health system/scheme
ii UHC- PrEP
Question:
Is PrEP covered by the national health system/scheme?
Possible values:
Definition of value:
Adopted
PrEP is covered by the national health system/scheme
Not adopted
PrEP is not covered by the national health system/scheme
HS4 User fees
Question:
Are public primary healthcare and HIV services available without user fees at the point of service under national policy?
Possible values:
Definition of value:
Adopted
Most patients are able to access both primary healthcare and HIV services in public facilities without having to pay user fees
Partially adopted
Most patients are able to access either primary healthcare or HIV services (but not both) in public facilities without having to pay user fees
Not adopted
Most patients are required to pay user fees in order to access both primary healthcare and HIV services in public facilities
Policy recommendation:
United Nations, Political Declaration of the High-level Meeting on Universal Health Coverage, 2019; WHO, Primary Health Care on the Road to UHC, 2019; WHO, “The Practice of Charging User Fees at The Point of Service Delivery for HIV/AIDS Treatment and Care.” WHO Discussion Paper. WHO/HIV/2005.11.
i User Fees- Primary care
Question:
Are primary healthcare services in public facilities available without user fees?
Possible values:
Definition of value:
Adopted
Most patients are able to access PHC services in public facilities without having to pay user fees
Not adopted
Most patients are required to pay formal or informal user fees in order to access PHC services in public facilities
ii User Fees- HIV services
Question:
Are HIV services in public facilities available without user fees?
Possible values:
Definition of value:
Adopted
Most patients are able to access HIV services in public facilities without having to pay user fees
Not adopted
Most patients are required to pay formal or informal user fees in order to access HIV services in public facilities
HS5 Access to medicines (TRIPS)
Question:
Does national law/policy take advantage of TRIPS flexibilities for affordable medicines?
Possible values:
Definition of value:
Adopted
Country has incorporated TRIPS flexibilities into national law and has made use of those flexibilities
Partially adopted
Country has either incorporated TRIPS flexibilities into national law or has made use of those flexibilities, but not both
Not adopted
Country has neither incorporated TRIPS flexibilities into national law nor made use of those flexibilities
Policy recommendation:
United Nations, Political Declaration on HIV and AIDS, 2011; Doha Declaration on the TRIPS Agreement and Public Health, 2001.
i TRIPS- Incorporation
Question:
Are TRIPS flexibilities (including parallel importation, compulsory licensing, and LDC extension) incorporated in national law?
Possible values:
Definition of value:
Adopted
The country has incorporated TRIPS flexibilities into national law
Not adopted
The country has not incorporated TRIPS flexibilities into national law
ii TRIPS- Use
Question:
Are there documented examples of the country utilizingTRIPS flexibilities?
Possible values:
Definition of value:
Adopted
There are documented examples of use of TRIPS flexibilities by the country
Not adopted
No documented examples of use of TRIPS flexibilities could be found
HS6 Unique identifiers w/ data protections
Question:
Are unique identifiers for continuity of care across multiple facilities included in national policy along with protections for patients' privacy?
Possible values:
Definition of value:
Adopted
The country utilizes unique IDs and has legally-enforceable data privacy protections
Partially adopted
The country utilizes unique IDs or has legally-enforcable data privacy protections, but not both
Not adopted
The country neither utilizes unique IDs nor has legally-enforcable data privacy protections
Policy recommendation:
Global Commission on HIV and the Law, Risks, Rights & Health Supplement, 2018; UNAIDS, Fast-Track and Human Rights, 2017; UNAIDS, Developing Developing and Using Individual Identifiers for the Provision of Health Services including HIV, 2009.
i Unique IDs- Use
Question:
Is there a unique ID (or other method of de-duplicating data) that allows for continuity of care across multiple facilities?
Possible values:
Definition of value:
Adopted
The country utilizes unique IDs (or another method of de-duplicating data) that allows for continuity of care across multiple facilities
Not adopted
The country does not utilize unique IDs (or another method of de-duplicating data) that allows for continuity of care across multiple facilities
ii Data protections
Question:
Does national law include legally enforceable protections against disclosure of individually-identifiable health data, including HIV status?
Possible values:
Definition of value:
Adopted
National law includes legally enforceable protections against disclosure of individually-identifiable health data, including HIV status
Not adopted
National law does not include legally enforceable protections against disclosure of individually-identifiable health data
HS7 Data sharing
Question:
Is it national policy to publicly share disaggregated HIV data on a regular basis?
Possible values:
Definition of value:
Adopted
The country shares disaggregated data at least quarterly
Partially adopted
The country shares data on a quarterly basis but it is not disaggregated, or shares disaggregated data but not on a quarterly basis
Not adopted
The country does not share disaggregated data on a quarterly basis
Policy recommendation:
UNAIDS Fast-Track Strategy 2016-2021
i Data sharing- Disaggregation
Question:
Is data disaggregated by geographic region, age, and gender?
Possible values:
Definition of value:
Adopted
Shared data is disaggregated by geographic region, age, and gender (at least)
Not adopted
Shared data is not disaggregated
ii Data sharing- Frequency
Question:
Is data shared at least quarterly?
Possible values:
Definition of value:
Adopted
Data is shared quarterly (at least)
Not adopted
Data is shared less frequently or not routinely