Use of Epidemiology Surge Support to Enhance Robustness and Expand Capacity of SARS-CoV-2 Pandemic Response, South Africa.

As COVID-19 cases increased during the first weeks of the pandemic in South Africa, the National Institute of Communicable Diseases requested assistance with epidemiologic and surveillance expertise from the US Centers for Disease Control and Prevention South Africa. By leveraging its existing relationship with the National Institute of Communicable Diseases for >2 months, the US Centers for Disease Control and Prevention South Africa supported data capture and file organization, data quality reviews, data analytics, laboratory strengthening, and the development and review of COVID-19 guidance This case study provides an account of the resources and the technical, logistical, and organizational capacity leveraged to support a rapid response to the COVID-19 pandemic in South Africa.

Scaling Up Testing for Human Immunodeficiency Virus Infection Among Contacts of Index Patients - 20 Countries, 2016-2018.

In 2017, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that worldwide, 36.9 million persons were living with human immunodeficiency virus (HIV) infection, the virus infection that causes acquired immunodeficiency syndrome (AIDS). Among persons with HIV infection, approximately 75% were aware of their HIV status, leaving 9.4 million persons with undiagnosed infection (1). Index testing, also known as partner notification or contact tracing, is an effective case-finding strategy that targets the exposed contacts of HIV-positive persons for HIV testing services. This report summarizes data from HIV tests using index testing in 20 countries supported by CDC through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) during October 1, 2016-March 31, 2018. During this 18-month period, 1,700,998 HIV tests with 99,201 (5.8%) positive results were reported using index testing. The positivity rate for index testing was 9.8% among persons aged ≥15 years and 1.5% among persons aged <15 years. During the reporting period, HIV positivity increased 64% among persons aged ≥15 years (from 7.6% to 12.5%) and 67% among persons aged <15 years (from 1.2% to 2.0%). Expanding index testing services could help increase the number of persons with HIV infection who know their status, are initiated onto antiretroviral treatment, and consequently reduce the number of persons who can transmit the virus.

Lessons learned from the first year of implementation of the Centers for Disease Control and Prevention's standardized evaluation system for HIV prevention programs.

In December 1999 the Centers for Disease Control and Prevention's (CDC's) Division of HIV/AIDS Prevention initiated a standardized evaluation system for CDC-funded health department HIV prevention programs. This health department evaluation guidance asks health departments to develop comprehensive evaluation plans and to submit aggregated data on such activities as intervention planning, process monitoring, and outcome evaluation. During the first year of this system, of 65 health departments, 62 submitted evaluation plans, 37 submitted intervention plan data, and 20 submitted process monitoring data. Major issues affecting implementation of a national evaluation system include varying levels of evaluation capacity among health departments, differences between the CDC's taxonomy for national data collection and local definitions, and limitations regarding use of 1st-year data. The CDC has learned that implementation of a standardized evaluation system takes considerable time and that stakeholder involvement and technical assistance and capacity building support are essential.

The value of engaging stakeholders in planning and implementing evaluations.

Stakeholder participation in evaluation has surfaced as a major factor contributing to the effectiveness of HIV prevention programs. In recognition of the multiple benefits, the Centers for Disease Control and Prevention (CDC), has used a framework to involve stakeholders in the evaluation of its programs. This article describes the framework used by the CDC and provides examples of four studies that involved various stakeholders from health departments, community-based organizations, and community planning groups to national and regional organizations in designing and implementing evaluations that yielded results useful for program improvement. The participatory process involved stakeholders in each of the four phases of the framework: evaluation planning, implementation, development of action plans, and dissemination. Lessons learned include the importance of having a facilitator to coordinate activities and ongoing communication with those involved in the evaluation. Stakeholders shared that using the evaluation results for action planning was beneficial for improving their programs. Despite many challenges faced in the stakeholder evaluation process, most stakeholders agreed that many benefits grew out of the multiple perspectives presented and understanding of the service agencies.

Building evaluation capacity for HIV prevention programs.

HIV prevention programs, even those using science-based interventions, need to conduct evaluation to support the implementation and transfer of effective interventions, account for services, demonstrate effectiveness, and improve programs. The Program Evaluation Research Branch of the Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, assists health department grantees and other CDC grantees by providing evaluation guidance, technical assistance (TA), and training in order to build their HIV prevention program evaluation capacity. Together, these evaluation resources assist grantees with overall implementation of evaluation and identify specific types of evaluation appropriate to each stage of intervention development. This paper describes the evaluation developmental process for different types of evaluation activities, provides a framework for building evaluation capacity, discusses the evaluation resources provided by CDC and gives examples of how evaluation TA and training support the overall technology transfer goals.