Using Data to Measure Progress Toward 90-90-90

The PEPFAR 3.0 initiative, Controlling The Epidemic: Delivering on the Promise of an AIDS-free Generation, calls for programs to target evidence-based interventions for populations at greatest risk in areas of greatest HIV incidence, a shift referred to as the "PEPFAR pivot." The document defines progress as achieving 90-90-90 by 2020, meaning that 90 percent of people with HIV know their status, 90 percent of those diagnosed are on ART, and 90 percent of those treated are virally suppressed. Countries have an increasing need for high-quality data to identify the areas and populations that have the greatest numbers of HIV-affected people or the greatest risk for HIV transmission. MEASURE Evaluation provides tools, guidance, and capacity building to help countries reach their 90-90-90 targets and to substantiate their progress. The organization fills a need to help a ministry of health understand the consequences of the PEPFAR pivot, which may have shifted the distribution of PEPFAR funding in the country from one location to another. MEASURE Evaluation can provide technical assistance to help countries strengthen district and national information systems that support HIV programming and policy, improve or roll out DHIS 2, refine indicators to focus on fewer indicators while still accurately measuring HIV progress and impact, develop indicators of HIS sustainability in government systems, and conduct data quality assessments. MEASURE Evaluation's PLACE (Priorities for Local AIDS Control Efforts) assessment tools have been updated to help countries estimate the size of key populations more accurately and track and measure the HIV cascade of treatment among these populations more precisely. The revised PLACE manual pays more attention to the HIV treatment cascade among individual populations and offers better measures of viral load suppression. Improved methods for size estimation of key populations in HIV program populations have also been developed, with tools for comparing this information to PLACE data in order to review and revise these estimates. This approach helps programs to follow the HIV treatment cascade among their target populations, providing them with improved measures of impact and progress. MEASURE Evaluation's expertise enables countries to measure progress toward 90-90-90 in several ways. Compiled FAQs are provided to help implementers understand the rationale and the skills needed for collecting the Monitoring, Evaluation, and Reporting (MER) essential indicators to measure outcomes for orphans and vulnerable children (OVC) programs. Geography-informed data in geographic information systems is used to assess the targeting and availability of services for HIV-affected populations. Programs and interventions are evaluated to determine their capacity to test, treat, and achieve viral suppression and adherence to ART. Data systems are established to support Test and Start, through the adoption and implementation of new World Health Organization guidelines, including those related to service delivery and predicting commodities supply under Test and Start conditions.