Progress Report on Pepfar Minimum Program Requirements (MPR) and Sustainability Index Dashboard (SID) Sustainable HIV Response in Central America Project

Central America is the sub-region most affected by the HIV/AIDS epidemic in the Latin American and Caribbean region, with four of the six countries with the highest prevalence rates of HIV infection located in the region. The project focuses on implementing PEPFAR's minimum program requirements, which include the adoption and implementation of Test and Start, rapid optimization of Antiretroviral Therapy (ART), adoption and implementation of differentiated service delivery models, completion of Diagnostic Network Optimization activities, and scale-up of index testing and self-testing. The project also aims to eliminate all formal and informal user fees for public sector access to HIV services and medications, and to ensure that all eligible people living with HIV (PLHIV) complete Tuberculosis (TB) preventive treatment and receive cotrimoxazole, where indicated. The project has made significant progress in implementing the minimum program requirements in Guatemala, El Salvador, Honduras, and Panama. In Guatemala, the project has supported the implementation of Test and Start, with demonstrable access across all ages, sex, and risk groups. In El Salvador, the project has focused on rapid optimization of ART, with a significant increase in the number of PLHIV receiving Treatment as Prevention (TasP). In Honduras, the project has implemented differentiated service delivery models, including six-month multi-month dispensing (MMD) and decentralized drug distribution (DDD). The project has also made progress in scaling up index testing and self-testing, with a significant increase in the number of people tested for HIV. In addition, the project has eliminated all formal and informal user fees for public sector access to HIV services and medications in all four countries. The project has also supported the completion of Diagnostic Network Optimization activities, including the optimization of Viral Load (VL) and Early Infant Diagnosis (EID) testing. The project's progress has been monitored and reported through the Sustainability Index Dashboard (SID), which provides a comprehensive overview of the project's progress in implementing the minimum program requirements. The SID has been used to track progress in all four countries, and has provided valuable insights into the challenges and opportunities facing the project. The project's success has been attributed to the strong partnership between USAID, PEPFAR, and local partners, including FANCAP, which has been institutionally strengthened to become a local partner and executor of the project. The project's progress has also been supported by the commitment of the host governments, including the Ministry of Health and National AIDS councils, to assume responsibility for the HIV response in their countries. Overall, the Sustainable HIV Response in Central America Project has made significant progress in implementing PEPFAR's minimum program requirements and strengthening national policies to contain the HIV epidemic in the region. The project's success has been attributed to the strong partnership between USAID, PEPFAR, and local partners, as well as the commitment of the host governments to assume responsibility for the HIV response in their countries.