BPS MODEL
The Blantyre Prevention Strategy (BPS) launched in May 2020 as a “business unusual,” systems-based approach to HIV prevention. BPS is an adaptable model for a more economical, effective, and sustainable sub-national HIV response.
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BPS Core Aim 1: Support the establishment of a district-based system that will enhance deployment and uptake of novel and existing HIV prevention interventions and products.
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With BPS support, key functions have been embedded within local structures at the district level in Blantyre. Key elements of the BPS model include governance and technical leadership, data access and use, targeting of interventions, risk surveillance and response, community engagement and insights gathering, health promotion, expanded quality delivery, addressing structural risks, and partnership across sectors. As illustrated in the graphic below, the BPS model is not just a series of individual program elements, but rather an approach to building an integrated system, under the governance and technical leadership of the district and city health teams, that leverages various functions and components for a holistic approach to HIV prevention.
The result of bringing these governance, technical capability, and engagement elements together is a system capable of using data to identify areas of risk and target HIV prevention services effectively, gather community insights and generate demand for services, deliver quality and accessible HIV prevention services, and support those utilizing the services to sustain use through periods of risk. The system is multi-sectoral in nature – leveraging the collective core competencies and resources of the government, donor-funded implementing partners, civil society organizations and CBOs, private health facilities, and the corporate sector. BPS complements, and strengthens the coordination of, existing investments by government, PEPFAR, the Global Fund, and Gates Foundation in Malawi.
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BPS Core Aim 2: Institutionalize HIV prevention as a cohesive, effective, and sustainable country-led response with coordinated external support, creating a replicable model for districts across Malawi and beyond
BPS is supporting the Government of Malawi to institutionalize Blantyre’s HIV prevention system fostered through BPS support, adopt the BPS model into national policy and guidelines, and explore expansion of the approach in other districts. A district-agnostic toolkit to support other districts to adapt the model is under development.
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The first district to adapt the BPS model outside of Blantyre is Lilongwe, Malawi, in support of the PathToScale Injectable PrEP Initiative. Launched on 1st September 2023, PathToScale leverages BPS and Malawi’s HIV prevention clinical and implementation capacity, to test the delivery of long-acting injectable cabotegravir (CAB-LA) to prevent HIV as PrEP. The initiative, with implementation funding from The Gates Foundation and CAB-LA product through PEPFAR, will enroll 9,900 Malawians in an implementation science study in 36 public and private clinics and key population-focused drop-in centers across the two districts. The lead-in phase started in March 2024. The initiative includes a focus on foundational systems and addressing policy and other barriers to full implementation of CAB-LA, creating a path to scale through the life of the initiative.
