National hiv/aids and sti policy

Objectives

Ghana’s National HIV/AIDS and sexually transmitted infections policy provides a rights-based, multisectoral framework to reduce HIV transmission, improve prevention, treatment, care and support, and address the epidemic’s health, social, demographic and economic consequences. It seeks to create an enabling environment in which people living with HIV/AIDS can retain dignity, access services, exercise their rights and remain productive for as long as possible.[1][2][3][4][5]

• Protect human rights, confidentiality, dignity and equitable access to healthcare, while reducing stigma, discrimination, exclusion and harmful practices affecting people living with HIV/AIDS and other sexually transmitted infections.[2][4][6]
• Prevent HIV and sexually transmitted infections through advocacy, behaviour-change communication, information and education, safer-sex promotion, condom access, blood safety, voluntary counselling and testing, sexually transmitted infection control and prevention of mother-to-child transmission.[4][7][8][9][10]
• Expand comprehensive, affordable and cost-effective clinical, nursing, counselling, nutritional, palliative, community and home-based care, including support for treatment choices and antiretroviral access.[11][12][9]
• Reduce vulnerability among women, children, young people, commercial sex workers, orphans and vulnerable children, and people affected by gender inequality, sexual abuse or domestic violence.[4][13][14][15]
• Promote healthy lifestyles, strong family values, responsible sexual and reproductive decision-making, men’s participation, women’s empowerment and poverty-alleviation measures linked to HIV/AIDS reduction.[4][7][13][14]
• Strengthen research, evidence use, workforce development and national capacity, including access to relevant research findings and equitable access to any vaccine, treatment or cure developed through research.[14][6][16]

The policy is grounded in social justice, equity, people-oriented development and the recognition of healthcare as an inalienable right. It is aligned with Ghana’s 1992 Constitution, national poverty-reduction and population policies, the Millennium Development Goals, and relevant international human-rights instruments.[2][17]

Implementation

Implementation is designed as a decentralised, complementary and multisectoral national response led by the Ghana AIDS Commission, rather than a response confined to the health sector. The Commission coordinates joint planning, advocacy, resource mobilisation, fund management, monitoring and supervision through its Secretariat, with Regional and District AIDS Committees supporting local implementation under decentralisation arrangements.[18][4][19][16]

• Coordinate action among government ministries, departments and agencies, the Ministry of Health, Ghana Health Service, District Assemblies, civil society, communities, people living with HIV/AIDS, faith-based organisations, traditional authorities, educational institutions, employers, the private sector and development partners.[1][2][4][20]
• Assign the Ministry of Health and Ghana Health Service technical leadership for medical prevention and care, including counselling and testing, antiretroviral therapy, prevention of mother-to-child transmission, condom promotion, facility-based care and home-based support.[20]
• Develop sector-specific workplace, prevention, care and support programmes, with employers expected to protect workers’ rights, provide education and training, support condom distribution and maintain employment for HIV-positive workers who remain able to work.[6][20][5]
• Integrate HIV/AIDS and sexually transmitted infection education into formal and non-formal education, beginning at primary level, while engaging parents, schools, youth groups, religious bodies and media organisations in prevention and behaviour-change efforts.[7][13][15]
• Deliver voluntary, confidential HIV counselling and testing in non-stigmatising settings, including through antenatal and family-planning services, while prohibiting routine testing without knowledge except in specified clinical and donated-blood circumstances.[7][8][13]
• Strengthen blood safety through regional and district transfusion services, national screening protocols, licensing of screening kits and reagents, laboratory regulation, quality assurance and periodic review of transfusion and organ-transplant guidance.[8]
• Provide prevention and care through hospitals, clinics, primary healthcare, outreach, communities and homes, supported by trained health workers, counsellors, volunteers, families, traditional practitioners and faith-based providers.[11][12][9]
• Support safer sexual practices through abstinence, mutual fidelity and correct, consistent condom use, alongside condom quality control, social marketing, distribution and support for domestic manufacture and importation.[9][10]
• Mobilise human, financial and material resources through government inputs, sectoral budget lines, District Assembly support, donor contributions, multilateral and bilateral assistance, corporate foundations and domestic and international links for medicines, laboratory supplies and testing commodities.[4][21][12][16][20]

Monitoring combines epidemiological and behavioural surveillance, mandatory notification and reporting, quality assurance, research, and institutional supervision. HIV-testing facilities are to report through district health authorities using standard Ministry of Health surveillance forms; the Ghana AIDS Commission monitors resource allocation, utilisation and ongoing activities; and regional, district, ministerial and private-sector bodies monitor their respective programmes.[11][19][16][20]

The policy provides for periodic review of strategies, protocols, guidelines and policies in response to scientific knowledge, implementation experience, changing needs, behaviours and culture. However, the supplied material does not specify a consolidated national indicator set, quantified targets, reporting timetable, evaluation methodology, total implementation budget or funding gap.[1][4][8][11][16]

Monitoring & Evaluation

Monitoring and evaluation combine epidemiological and behavioural surveillance, programme monitoring, quality assurance, reporting through health-system structures, and decentralised supervision by national, regional and district bodies. The Ghana AIDS Commission leads joint planning, monitoring, evaluation, advocacy and oversight of resource allocation and utilisation, supported by its Secretariat and sub-national AIDS Committees.[19]

• Maintain HIV and AIDS epidemiological surveillance, with the Ministry of Health and Ghana Health Service monitoring the epidemic and publishing new information as available.[2][17]
• Use reported AIDS cases, sentinel surveillance, antenatal-clinic data and demographic analysis to describe epidemic trends, geographical variation and populations affected. By September 2003, 72,541 AIDS cases had been reported and the estimated actual number was approximately 370,000.[22]
• Conduct unlinked anonymous screening at selected sites among sentinel groups under periodically updated Ministry of Health protocols, and undertake behavioural surveillance periodically to assess intervention effects and guide policy and programme modifications.[11]
• Require HIV-testing facilities to report through district health authorities to the national authority using the standard Ministry of Health AIDS Surveillance form, and make notification of sexually transmitted infections, including HIV, obligatory for contact tracing, treatment and national data compilation.[11]
• Record actual HIV-related causes of death rather than only secondary or opportunistic infections, in line with the Registration of Births and Deaths Act, 1965.[11]
• Coordinate, monitor and evaluate information, education and communication programmes delivered by government, non-governmental organisations, private-sector bodies and international agencies.[7]
• Apply quality assurance to blood safety through periodic testing of reagent lots or batches, discard reactive donated blood, regulate diagnostic laboratories, and apply sanctions for non-compliance where necessary.[8]
• Strengthen quality control through accurate reporting of sexually transmitted infection cases, scientific validation of claimed HIV/AIDS cures before marketing, and continuous condom-quality checks by the Ghana Standards Board.[9][10]
• Assign Regional and District AIDS Committees, District Assemblies, ministries, departments, agencies and private-sector organisations responsibilities for coordinating, supervising, monitoring and evaluating activities within their respective areas.[19][16][20]

The source identifies epidemiological measures and selected indicators, including transmission patterns, tuberculosis-related impacts, awareness, prevalence, adult mortality, orphanhood and life expectancy. However, it does not provide a consolidated indicator framework, indicator definitions, reporting timetable, evaluation methodology, performance targets or a distinct system of accountability sanctions.[2][18][4][20]

Costing & Financing

Financing is framed primarily as resource mobilisation for a multisectoral HIV/AIDS and sexually transmitted infection response, rather than through a quantified costed implementation plan. The Ghana AIDS Commission is responsible for mobilising, controlling and managing resources and for monitoring their allocation and use.[19]

• Mobilise human, financial and material resources to support national ownership, implementation, research, monitoring and evaluation.[4][21]
• Advocate budget allocations and other financial provisions at all levels, including support for advocacy materials and training, laboratory rehabilitation, equipment, supplies, diagnostic and surveillance reagents, and voluntary HIV-testing services.[21]
• Secure Government of Ghana inputs alongside broad donor funding for the expanded multisectoral response, with sector ministries establishing budget lines for HIV/AIDS activities and District Assemblies supporting district-level work.[16]
• Coordinate donor and other financial contributions through the Ministry of Finance, while seeking assistance from multilateral and bilateral partners, international organisations and corporate foundations.[16][20]
• Explore domestic and international donor links to improve the availability and affordability of antiretroviral drugs, and use a cost-effective HIV/AIDS and sexually transmitted infections drug list within the Essential Drug List and National Formulary.[12]
• Mobilise internal and external resources, including donor links, for HIV screening kits and reagents.[8]
• Provide resources for the Women and Juvenile Unit and community-based women’s organisations, and ensure that HIV/AIDS and sexually transmitted infection research programmes are properly funded.[14]
• Support insurance access and cover prevention and management of opportunistic infections for people living with HIV/AIDS through the National Health Insurance Scheme.[19]
• Recognise policy-development support from the United States Agency for International Development through the POLICY Project, Ghana, with personnel and technical resource materials contributed by the World Health Organization and the Joint United Nations Programme on HIV/AIDS.[22]

No total budget, programme cost, monetary allocation, financing proportion, funding-gap estimate, costing methodology or economic assumption is specified in the supplied material.[4][12][16]