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HIV / AIDS
using technology to dam the cascade
                                                    Presentation by InSTEDD:
                                                       Caricia Catalani, DrPH, MPH
                Innovative Support to Emergencies
                Diseases and Disasters
                                                                       Brooke Estin
the issues | global




                      the scale
the issues | global




                      the scale
the context
the context | HIV around the world




regional adult HIV prevalence
                                15 - 50   5 - 15   1-5   0.5 - 1.0   0.1 - 0.5   0.0 - 0.1   no data
          (2009) (%)
the context | HIV around the world




         33.2 million
the context | HIV around the world




            33.2 million
            Middle East &   Eastern Europe    Latin       North America &              Sub-Saharan
Caribbean   North Africa    & Central Asia   America   Western/Central Europe   Asia      Africa
240,000      460,000           1.4m          1.4m             2.3m              4.9m    22.5m
17 million   2.5 million
  women        children
30 million   have lost parents
 children      to HIV/AIDS
the context | HIV around the world



           Number of people on antiretroviral therapy (millions)




8

6

4

2

0
    2001    2002   2003   2004   2005   2006   2007   2008   2009   2010
the context | HIV around the world




 regional adult HIV treatment
                                81 - 100   61 - 80   41 - 60   21 - 40   1 - 20   no data
          (2009) (%)
the context | HIV around the world




              5 million
@ONE Campaign




33.2 million   5 million
  infected     in treatment
the problem
the problem | the cascade




   Tested       Enrolled    CD4       Eligible   Short-term   Long-term
 HIV positive    in care   tested   begin ARTs   adherence    adherence
the problem | the cascade




                           why?
   Tested       Enrolled    CD4       Eligible   Short-term   Long-term
 HIV positive    in care   tested   begin ARTs   adherence    adherence
the problem | the cascade

                            POLICY


                      CLINICS/ORG




                      INDIVIDUAL
the issues | the cascade


         so what helps?
the approach | where to look?




     the field                   the literature
        local                      global
the approach | where to look?




    the social                  the technical
      people                        tools
the approach | where to look?




       online                   offline
     resources                  resources
the approach | where to look?




 engage with                    understand
   people in                    global best
 their context                   practices
the approach | social + technical
mission

   Our mission is to improve global health, safety and sustainable development through 4 areas:




                                                             Creating Collaboration Technologies




                                                                                                                               Ensuring Usefulness and Impact
                                                                                                   Collaborating with People
Building Capacity
within communities to foster a local culture of innovation
mission

Our Our mission is to improve global health, safety and sustainable development through:
    mission is to improve global health, safety and sustainable development through 4 areas:




                                                                                                    Ensuring Usefulness and Impact
                                                                        Collaborating with People
 Building Capacity




                     Creating Collaboration Technologies
                     for social good
mission

Our Our mission is to improve global health, safety and sustainable development through:
    mission is to improve global health, safety and sustainable development through 4 areas:

                     Creating Collaboration Technologies




                                                                                                                Ensuring Usefulness and Impact
 Building Capacity




                                                           Collaborating with People
                                                           through a bottom up design and development process
mission

Our Our mission is to improve global health, safety and sustainable development through:
    mission is to improve global health, safety and sustainable development through 4 areas:

                     Creating Collaboration Technologies




                                                           Collaborating with People
 Building Capacity




                                                                                          Ensuring Usefulness and Impact
                                                                                          through research and evaluation
Muddy Boot Doctors
Out of the Office Engineers
Community Based Researchers
Domain Experts
Creative Communicators
Resourceful Business Managers
Local Leadership
projects
Our approach facilitates collective    Argentina    Haiti       Mexico       Thailand
  action by local partners, and is     Bangladesh   Indonesia   Mozambique   USA
       being successfully applied      Cambodia     Kenya       Rwanda       Vietnam
                                       China        Laos        Ghana        Zimbabwe
                         globally.
tools platform

KEY Our mission FEATURES
    BENEFITS & is to improve global health, safety and sustainable development through:



   free and open source

   customizable

   use independently or together

   realtime alerts

   data synchronization

   works on any phone

   works with low signal

   most don’t require internet

   many don’t require literacy

   cheap, fast & easy
tools




   Verboice is a
   customizable
 application that
empowers users
    to build their
 own interactive
 voice response
        systems.
tools




   Verboice is a
   customizable
 application that
empowers users
    to build their
 own interactive
 voice response
        systems.
tools




        Baby Monitor is an
unconventional approach
  to service delivery along
     the birth continuum in
       remote locations by
    creating an interactive
             voice response
     application for mobile
   phones that is designed
for mothers as end‑users.
tools




  Resource Mapping
      helps people to
 collaboratively track
their work, resources
           and results
  geographically and
        through SMS.
tools




  Resource Mapping
      helps people to
 collaboratively track
their work, resources
           and results
  geographically and
        through SMS.
tools




Remindem allows you to
      set up a list of tips,
   reminders and advice
         that people can
     subscribe to via text
     messages. You can
 schedule the messages
    based on a schedule
              you define.
tools




Remindem allows you to
      set up a list of tips,
   reminders and advice
         that people can
     subscribe to via text
     messages. You can
 schedule the messages
    based on a schedule
              you define.
Cool tools.
but what really

works?
the opportunity | win-win




     systematic review of the literature
the opportunity | win-win




                  find the gold in the rubble
the opportunity | win-win




      select few invited to apply for fellowship
the opportunity | win-win




                            intellectual community
Innovative Support to Emergencies
                  Diseases and Disasters




www.instedd.org

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Using Technology to Dam the HIV/AIDS Treatment Cascade

  • 1. HIV / AIDS using technology to dam the cascade Presentation by InSTEDD: Caricia Catalani, DrPH, MPH Innovative Support to Emergencies Diseases and Disasters Brooke Estin
  • 2.
  • 3. the issues | global the scale
  • 4. the issues | global the scale
  • 6. the context | HIV around the world regional adult HIV prevalence 15 - 50 5 - 15 1-5 0.5 - 1.0 0.1 - 0.5 0.0 - 0.1 no data (2009) (%)
  • 7. the context | HIV around the world 33.2 million
  • 8. the context | HIV around the world 33.2 million Middle East & Eastern Europe Latin North America & Sub-Saharan Caribbean North Africa & Central Asia America Western/Central Europe Asia Africa 240,000 460,000 1.4m 1.4m 2.3m 4.9m 22.5m
  • 9. 17 million 2.5 million women children
  • 10. 30 million have lost parents children to HIV/AIDS
  • 11. the context | HIV around the world Number of people on antiretroviral therapy (millions) 8 6 4 2 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
  • 12. the context | HIV around the world regional adult HIV treatment 81 - 100 61 - 80 41 - 60 21 - 40 1 - 20 no data (2009) (%)
  • 13. the context | HIV around the world 5 million
  • 14. @ONE Campaign 33.2 million 5 million infected in treatment
  • 16. the problem | the cascade Tested Enrolled CD4 Eligible Short-term Long-term HIV positive in care tested begin ARTs adherence adherence
  • 17. the problem | the cascade why? Tested Enrolled CD4 Eligible Short-term Long-term HIV positive in care tested begin ARTs adherence adherence
  • 18. the problem | the cascade POLICY CLINICS/ORG INDIVIDUAL
  • 19. the issues | the cascade so what helps?
  • 20. the approach | where to look? the field the literature local global
  • 21. the approach | where to look? the social the technical people tools
  • 22. the approach | where to look? online offline resources resources
  • 23. the approach | where to look? engage with understand people in global best their context practices
  • 24. the approach | social + technical
  • 25. mission Our mission is to improve global health, safety and sustainable development through 4 areas: Creating Collaboration Technologies Ensuring Usefulness and Impact Collaborating with People Building Capacity within communities to foster a local culture of innovation
  • 26. mission Our Our mission is to improve global health, safety and sustainable development through: mission is to improve global health, safety and sustainable development through 4 areas: Ensuring Usefulness and Impact Collaborating with People Building Capacity Creating Collaboration Technologies for social good
  • 27. mission Our Our mission is to improve global health, safety and sustainable development through: mission is to improve global health, safety and sustainable development through 4 areas: Creating Collaboration Technologies Ensuring Usefulness and Impact Building Capacity Collaborating with People through a bottom up design and development process
  • 28. mission Our Our mission is to improve global health, safety and sustainable development through: mission is to improve global health, safety and sustainable development through 4 areas: Creating Collaboration Technologies Collaborating with People Building Capacity Ensuring Usefulness and Impact through research and evaluation
  • 30. Out of the Office Engineers
  • 36. projects Our approach facilitates collective Argentina Haiti Mexico Thailand action by local partners, and is Bangladesh Indonesia Mozambique USA being successfully applied Cambodia Kenya Rwanda Vietnam China Laos Ghana Zimbabwe globally.
  • 37. tools platform KEY Our mission FEATURES BENEFITS & is to improve global health, safety and sustainable development through: free and open source customizable use independently or together realtime alerts data synchronization works on any phone works with low signal most don’t require internet many don’t require literacy cheap, fast & easy
  • 38. tools Verboice is a customizable application that empowers users to build their own interactive voice response systems.
  • 39. tools Verboice is a customizable application that empowers users to build their own interactive voice response systems.
  • 40. tools Baby Monitor is an unconventional approach to service delivery along the birth continuum in remote locations by creating an interactive voice response application for mobile phones that is designed for mothers as end‑users.
  • 41. tools Resource Mapping helps people to collaboratively track their work, resources and results geographically and through SMS.
  • 42. tools Resource Mapping helps people to collaboratively track their work, resources and results geographically and through SMS.
  • 43. tools Remindem allows you to set up a list of tips, reminders and advice that people can subscribe to via text messages. You can schedule the messages based on a schedule you define.
  • 44. tools Remindem allows you to set up a list of tips, reminders and advice that people can subscribe to via text messages. You can schedule the messages based on a schedule you define.
  • 47. the opportunity | win-win systematic review of the literature
  • 48. the opportunity | win-win find the gold in the rubble
  • 49. the opportunity | win-win select few invited to apply for fellowship
  • 50. the opportunity | win-win intellectual community
  • 51. Innovative Support to Emergencies Diseases and Disasters www.instedd.org