HIV and infant feeding in emergencies operational guidance

In 2016 the World Health Organization (WHO) and UNICF published the guideline Updates on HIV and infant feeding¹, where the relevance of these recommendations in emergencies was recognised. The purpose of a recently launched guidance document is to provide operational guidance on HIV and infant feeding in emergencies. It is intended to be used to complement emergency and sectoral guidelines on health, nutrition and HIV, including specifically infant feeding, prevention of mother-to-mother transmission of HIV and paediatric antiretroviral treatment. The envisaged target audience consists of decision-makers, policy-makers, national and sub-national government managers and planners, managers for refugee camps and similar settlements for displaced persons, and managers and planners in United Nations (UN) agencies, non-governmental organisations (NGOs) and other groups responding to humanitarian situations.

This operational guidance is based on a consultation convened by WHO, UNICEF and ENN in Geneva in September 2016, which brought together a cross-section of senior participants from UN agencies, government, NGOs, academia and other agencies working in nutrition and HIV in emergencies. The document sets out basic principles related to HIV and infant feeding in emergency settings and the actions that government and other stakeholders can take to prepare for emergencies.

Specific actions are set out according to three scenarios: (i) national policy is breastfeeding plus antiretroviral drugs; (ii) national policy is replacement feeding; and (iii) HIV and infant feeding policy is unclear or not up to date. Countries are encouraged to hold key stakeholder discussions to inform decision-making on the use and introduction of the guidance into national programmes before an actual emergency situation.