The News

5th Annual National Pediatric Conference on Children Infected and Affected by HIV/AIDS 2009 – “Count Down to 2015 for Children and HIV – Achieving Millenium Development Goal (MDG 6)”
Kigali, Rwanda, 16th – 18th November, 2009

Pediatric Care and Treatment Technical Working Group - Concept Note

Theme: Quality HIV testing, care and treatment for Children towards MDG 6 by 2015

Context

Rwanda is one of the leaders in sub-Saharan Africa in terms of reaching HIV-infected children in need of treatment. As of 30th July, 2009, 6,065 children are receiving antiretroviral therapy, representing roughly 66% of estimated need.  Furthermore, the scale up of pediatric care and treatment occurred rapidly, increasing from just 880 children on treatment a mere four years earlier in June of 2005.  While the National Pediatric Care and Treatment Scale-Up Plan goal of providing comprehensive HIV care and treatment services to at least 80% of children in need by 2011 is well within reach and universal access appears on the horizon, quality of care is becoming an increasing area of focus.

Rationale for Theme

Rwanda has been very successful at rapidly scaling-up pediatric HIV care and treatment. The theme of the care and treatment working group provides an opportunity to reflect upon this success but also to look ahead at how Rwanda can continue to energize all stakeholders including funders, health care workers and communities to meet the many challenges which remain.

Challenges

While Rwanda is reaching a significant number of children in need of treatment, universal access is not yet a reality. The 34% of children who remain untreated will likely be much harder to find and new strategies including community mobilization will be necessary. For whatever reason, some children have clearly escaped existing points of entry to HIV testing even the whole process of testing ,from bone-marrow samples to the result the system is not till now well organized in order to have results in a reasonable time; all  these gaps must be addressed. In addition, there is concern that all children who are enrolled in care may not be placed on treatment in a timely manner. Clinicians’ lack of knowledge or comfort with complicated pediatric cases as well as for dealing with emerging problems such as care for the HIV infected adolescent, treatment failure, families’ psychosocial support, etc.

Methodology

The session on Pediatric HIV Care and Treatment will include both oral presentations and posters. Oral presentations will be chosen based on general quality, timeliness, relevance to the theme and relevance to the current state of affairs in Rwanda. The oral presentations will include a mix of national and international speakers and efforts will be made to ensure that a variety of partners and perspectives are represented.

Discussion Orientation

Moving away from a focus primarily on numbers of children on treatment as in the past, this year’s discussion will be oriented toward improving quality of care over the long term for all children enrolled. Presentations will emphasize strategies for children early testing and enrolment of those in need for long term follow up to meet the ongoing challenges of assuring quality care and treatment for all pediatric patients.

Expected Results

•    Reflection on past successes and lessons learned.
•    Presentation and discussion of new ideas for both high quality care and treatment and accelerating the achievement of universal access.
•    Commitment of partners to continually re-evaluate funding and programmatic priorities to align with national needs.