Implementation Science Coalition

Fogarty International Center

Investigators

Abstract

Implementation Science Coalition: While Sub-Saharan Africa (SSA) is home to only 12% of the global population, it accounts for 71% of the global burden of HIV infection.[i] Over the past few decades, there have been exciting advances in preventing and treating HIV, including anti-retroviral, PrEP, and self-testing among many others, that have reduced new infections in SSA by 43% and nearly halved AIDS-related deaths.[ii] Despite this progress, WHO predicts that SSA is unlikely to achieve the 2030 global development goal of ending AIDS.[iii] The benefits of proven interventions have not been fully realized because of enduring barriers to uptake, replication and scale-up including a complex array of interpersonal, social, structural and systems-level obstacles. Implementation science offers a scientific strategy that takes a holistic approach to address these barriers.[iv] Implementation science addresses the social, behavioral, and management bottlenecks that impede effective implementation, tests novel approaches to advance health programming, and identifies the effect of implementation strategies on the causal relationship between the intervention and its impact to enable proven intervention to be taken to scale. As the WHO 2021 country scorecards demonstrate, progress towards reducing and eliminating HIV is country specific with some African countries meeting one or two of the UNAIDS 95-95-95 targets for ending the AIDS epidemic.3 Each SSA country has specific research needs related to implementation of HIV prevention and treatment strategies calling for a local implementation science response. More broadly, at the 2021 PEPFAR Scientific Advisory Board (SAB), OGAC highlighted the need to promote implementation science methods and approaches across the continent. To leverage the utility and extend the reach of implementation science most effectively, there is clear need to identify the research gaps and needs particular to each country and developing a common research roadmap for Africa as a whole. To this end and to leverage expertise and synergies between NIH and OGAC, NIH has submitted two proposals for HOP funding that would support implementation research and research capacity building related to HIV prevention and treatment.