FTCI-Fast-Track Cities Web Portal

FTCI Web Portal Update
An Interactive Advocacy Tool , Resource Repository, and
Real-Time Monitoring & Evaluation Platform
1. Fast-Track Cities Initiative
Cities bear a large share of the global HIV burden. Cities are also home to deep, and in some
places growing, inequity. In places with large HIV epidemics, the numbers of people living with
HIV (PLHIV) in urban areas are so high that effective city-level action is likely to influence national
outcomes. Even where an HIV epidemic is smaller, cities are home to large numbers of people
belonging to key populations at higher risk of HIV infection but which often receive limited
attention in HIV programs. As urban populations continue to rapidly grow, cities will contend
with growing HIV epidemics if urgent and effective action is not taken.
The Fast-Track Cities Initiative (FTCI) is a global partnership between the International Association
of Providers of AIDS Care (IAPAC), Joint United Nations Programme on HIV/AIDS (UNAIDS), United
Nations Human Settlements Programme (UN-Habitat), and the City of Paris, in collaboration with
local, national, regional, and international partners and stakeholders.
The initiative was launched on World AIDS Day 2014 in Paris, where Mayors from 26 cities around
the world convened to sign a Paris Declaration committing to accelerate and scale-up their local
AIDS responses. Additional cities have subsequently signed the Paris Declaration (e.g., Mumbai,
San Francisco), and negotiations are ongoing to recruit more Fast-Track Cities.
Focused on translating global goals, objectives, and targets into local implementation plans, the
FTCI is meant to build upon, strengthen, and leverage existing HIV-specific and -related programs
and resources to facilitate locally coordinated, city-wide responses to:
1. Attain 90-90-90 targets
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Ensure that at least 90% of PLHIV know their status
Improve access to ART for PLHIV to 90%
Increase to 90% the proportion of PLHIV on ART with undetectable viral load
2. Increase utilization of combination HIV prevention services
3. Reduce to zero the negative impact of stigma and discrimination
4. Establish a common, web-based platform to allow for real-time monitoring of progress
The FTCI’s flexible design also extends to other city efforts to build resiliency. Developing and
implementing plans to reach the 90-90-90 and zero stigma and discrimination targets will help
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prepare cities to be more resilient to other health challenges. Thus, while the initiative is primarily
oriented toward attaining HIV-specific targets, there is built in flexibility to address health
concerns such as tuberculosis (TB), viral hepatitis, and non-communicable diseases.
3. FTCI Web Portal
Designed through a partnership between IAPAC and Dure Technologies , the FTCI Web Portal will:
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provide Fast-Track Cities a repository of resources to optimize their care and prevention
continua and reducing stigma and discrimination (e.g., guidelines, policies, toolkits);
facilitate exchanges between and among cities regarding best practices as well as
challenges and opportunities via web-enabled “communities of learning”;
enable real-time monitoring of progress against the initiative’s indicators; and
communicate progress via city-specific dashboards featuring updates from city health
officials, clinician-leaders, and civil society representatives.
The web portal will be designed to incorporate real-time program, open, infrastructure, and
community crowdsourced data and to portray it in an audience-friendly format. Much of the
necessary data are already available. Additional data can be crowdsourced via short message
service (SMS) and/or retrieved from existing public domain sources. Figure 1 describes the
interconnected ecosystem that the web portal will leverage.
Figure 1. Diagram of the FTCI software design’s ability to interact and capture data from various sources
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The web portal’s software platform is advanced and has features that have been proven to be
effective in other settings. The software is also versatile and adaptable to the local context and
the software team has extensive experience working in the public health space. Figure 2
illustrates a landing page that was used as part of Thailand’s move toward cloud-based HIV
program monitoring via http://www.aidszeroportal.org/, which was designed and is maintained
by IAPAC’s partner, Dure Technologies, for the Ministry of Public Health.
Figure 2. Illustration of the iMonitor web portal designed by Dure Technologies for the Government of Thailand
The web portal’s main page will feature a global platform to track progress toward attaining the
initiative’s 90-90-90 and zero stigma and discrimination targets (Figure 3). The web portal is
meant to function as an interactive advocacy tool that allows for real-time monitoring through
dynamic mapping of key indicators, and with user-friendly visualization of maps, graphs,
counters, charts, relevant statistics and data in an easy‐to-read and user-friendly interface.
Moreover, it will allow cities to monitor the progress made and strategies deployed in other cities
and to directly link with each other via standard communications links.
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Figure 3. Illustration of FTCI Web Portal’s main page tracking and communicating progress against key indicators
Each Fast-Track City will have a dashboard featuring visualizations of local data, health facilities,
and other points of interest mapped and dynamically accessible. The dashboard will include a
real-time monitoring component to allow Fast-Track City Task Forces to geo-locate data, track
their city’s progress against key indicators, and facilitate course corrections and/or quality
improvement interventions across the HIV care continuum. Figures 4-7 illustrate the visualization
of three indicators – HIV testing, ART coverage, and epidemiological hotspots.
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Figure 4. Illustration of real-time HIV testing and coverage mapping at city-level on the FTCI Web Portal
Figure 5. Illustration of real-time city-level ART coverage mapping by facility on the FTCI Web Portal
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Figure 6. Illustration of real-time epidemiological hotspots mapping at city-level on the FTCI Web Portal
Some key indicators that the Fast-Track City dashboards and maps will track include:
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City’s (or relevant metropolitan area’s) population
Number and proportion of people estimated to be living with HIV (PLHIV)
Number and proportion of PLHIV diagnosed with HIV
Number and proportion of PLHIV on antiretroviral therapy (ART)
Number and proportion of PLHIV on ART who are virally suppressed
Number of AIDS cases
Number of AIDS‐related deaths
Number of new HIV infections
Number and proportion of estimated HIV transmission from mother to child
Based on data availability, maps and dashboards can demonstrate geographic and temporal
trends and disaggregate data by factors such as age, sex, key population, and TB.
The following table lists additional indicators that the dashboards and maps will track:
Political
Demographic
Economic
Geographic
Stigma and
Discrimination
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Administration
Population (by age, ethnicity, etc.)
Gross domestic product and per capita income
Economic disparity – below poverty line
Labor force and unemployment rate
Land area, including metropolitan areas (urban core and surrounding territories)
Facilities certified as having anti -stigma/discrimination action plans
Community groups addressing HIV human rights issues
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Health and HIV
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Legislation protecting the rights of PLHIV and affected people
Legislation protecting the rights of key populations
Health facilities providing HIV-related services
Local and/or country guidance on ART, TB, viral load monitoring, etc.
Select Fast-Track Cities will be offered a “deeper dive” software platform that will allow real-time
mapping of crowdsourced data, including commodities stock-outs and/or service delivery
quality. This information could help PLHIV to access it via the web, smart phones, and/or via SMS
push; provide feedback on service quality (e.g., stigma); and know before travelling to a clinic
whether services are available. Figure 7 illustrates the web portal’s virtuous information circle.
Figure 7. Illustration of the web portal’s virtuous information circle in select Fast-Track Cities
Figure 8 illustrates how the web portal will be used to enhance each Fast-Track City’s HIV
response through open access to actionable data, some of it crowdsourced from stakeholders,
including PLHIV, nongovernmental organizations (NGOs), and/or city health departments.
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Figure 8. Illustration of the web portal’s virtuous information circle in select Fast-Track Cities
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