ICAP: Empowering Health for 15 Years

icapcolumbiau

This booklet celebrates ICAP's 15th anniversary with beautiful images and major milestones in the organization's history.

EMPOWERING

HEALTH FOR

15 YEARS



This is an organization of

tireless warriors who never

give up, endlessly striving for

better ways to solve problems,

more creative means to answer

questions, new approaches to

save lives.

Wafaa El-Sadr, MD, MPH, MPA

Founder and Global Director

ICAP at Columbia University


Empowering

In the mountains of Lesotho, ICAP gives support to nurses

who reach patients in remote areas on horseback.

Health

Since 2003, ICAP at Columbia

University has been dedicated

to improving the health of

families and communities around

the world. Together with its

partners—ministries of health, nongovernmental

and community-based

organizations, academic centers, the

private sector, civil society groups

and communities—ICAP applies

sustainable solutions to the world’s

most pressing health threats.

From its origins as a bold initiative

established to confront a raging

epidemic, ICAP has grown into

a global health leader bringing

innovative, effective, and ethical

research and programs to the most

challenging, resource-limited settings

across the globe.

Through its unparalleled experience

in strengthening health systems, its

deep investment in the power of

collaboration to effect change, and

its unwavering belief that every

person has the right to reach their

fullest potential, ICAP strives for

a world where every human being

has the means to live a healthy and

productive life.


The early years of the HIV

epidemic were marked by

relentless human loss. In the four

years between 1993 and 1997,

the number of people living with

HIV more than doubled, from 14

million to 30 million.

By the year 2000, an estimated 15

million people had lost their lives to

AIDS. Funerals became an everyday

part of life and the ranks of orphans

swelled. The HIV epidemic was

tearing at the fabric of communities

around the world.

HIV from a death sentence into a

manageable chronic disease. People

living with HIV who were fortunate

enough to get their hands on these

medicines were now able to live long

and productive lives.

In short order, death rates from

AIDS began to plummet in the U.S.,

but the suffering continued unabated

in Africa. By the year 2000, deaths in

the U.S. had decreased by 60 percent,

while in Africa an estimated 2.4

million people continued to die each

year from the epidemic.

As the global epidemic grew, the

scientific community responded. In

1987, the first antiretroviral drug for

treating HIV became available. Eight

years later, a remarkable combination

of HIV medicines transformed

As a global crisis

unfolded...

Clinic for prevention of mother

to child transmission of HIV.

Namicopo, Mozambique

HIV positive mother with her

HIV negative baby. Côte d’Ivoire


...A vision of

hope emerged

Inspired by the availability of

these miraculous treatment

options, a group of visionary

doctors in Harlem committed

themselves to bringing these

lifesaving treatments to their

disenfranchised patients.

Dr. Wafaa El-Sadr, then chief of the

Division of Infectious Diseases at

Harlem Hospital in New York City,

pioneered an integrated model of care

to address the medical, psychosocial,

and other needs of her stigmatized

patients and demonstrated the

success of a novel family-focused

approach. Meanwhile, her colleague,

Dr. Elaine Abrams, a pediatrician

who cared for some of the first

HIV-infected infants at Harlem

Hospital, was pioneering approaches

to prevent transmission of the HIV

virus from mother to child.

Based on their success in Harlem,

they became convinced that

treatment could be—and must be—

made a reality for those living in

resource-limited settings. Together,

and joining forces with Dr. Allan

Rosenfield, then dean of Columbia’s

Mailman School of Public Health

and longtime global champion for the

health of women, they challenged the

prevailing thinking. Countering the

many naysayers who believed it to be

impossible and inadvisable to bring

treatment to Africa, they brought

a revolutionary new paradigm to a

crisis that was causing incalculable

suffering.

In 2002 came the historic

announcement that they would lead

the world’s first-ever, multi-country

HIV treatment program.

With the goal of demonstrating

to a disbelieving world that quality

HIV care and treatment could be

provided in resource-limited settings,

the MTCT-Plus Initiative began

enrolling pregnant women living

with HIV at 13 demonstration sites

in eight countries.

The family-focused model that had

proven so successful in Harlem made

services to prevent mother-to-child

transmission of HIV the entry point

to lifelong HIV care and treatment

for women and their families. Within

four years, more than 14,000 women

and their family members were

accessing HIV care and treatment

at these sites, establishing a shining

precedent for the world and ushering

in a new era of response to HIV.


Scaling up

Bozi rural health center.

Côte d’Ivoire

From proof of concept

to global health leader

In 2003, under the leadership of

Dr. El-Sadr, ICAP was founded as

a center in the Columbia Mailman

School of Public Health to build

on the groundbreaking MTCT-Plus

model and work toward a vision of

a world where quality health care

is available to all families

and communities.

Contemporaneously, the launch of

the Global Fund in 2002 and the

U.S. President’s Emergency Plan

for AIDS Relief (PEPFAR) in 2003

signaled a new global commitment to

confronting the HIV epidemic. With

its already significant experience in

addressing the epidemic in numerous

countries around the world, ICAP

was well-positioned to contribute

to the effort to rapidly scale up

access to HIV treatment across sub-

Saharan Africa and quickly assumed

the mantle as one of PEPFAR’s key

implementing partners.

From its earliest days, ICAP engaged

the global HIV epidemic with

vigor and with a commitment to

an innovative model that combined

service, research, training, and

impact measurement to achieve

steadily improving outcomes.

ICAP’s unique model

achieves maximum impact


A worker in the testing lab at

a clinic. Kigali, Rwanda

A health care worker

examines a child. Cameroon

Staff workers test blood samples

at the laboratory at Muranga

District Hospital. Kenya

As the global response to the HIV

epidemic gathered steam, ICAP

launched major multi-year initiatives

to support government partners in a

dozen of countries as they wrestled

with the complex challenges of

scaling up specialized, ongoing care

and treatment services across health

facilities ranging from large hospitals

to remote health centers.

During this period, ICAP worked

with in-country partners in sub-

Saharan Africa to bring familyfocused

HIV care and treatment to

settings as diverse as the Tanzanian

coast and Lesotho highlands. For

the first time, pregnant women were

able to access HIV testing, care, and

treatment services for themselves

and their families under a single roof.

For the first time, children could be

born HIV-free. For the first time,

men and women with HIV could

regain their health and provide for

their families.

ICAP worked diligently to make

its ambitious vision a reality. It

engaged partners to renovate

facilities and laboratories, train

health workers, strengthen

monitoring and evaluation, put in

place supply management systems

for consistent supply of medicines,

launch peer education programs, and

better integrate community-based

organizations into the HIV response.

And ICAP provided technical

assistance to ministries of health

to develop national HIV clinical

guidelines, launch national training

programs, establish model centers for

clinical training and programmatic

innovation, conduct evaluations

to improve service quality—all in

support of building an effective HIV

response suited to the populations in

need.

By 2006, ICAP’s large-scale,

collaborative efforts had achieved

what had seemed impossible only

a few years before: 100,000 people

living with HIV had initiated

lifesaving treatment through ICAPsupported

programs.

By 2010, that number had jumped to

more than half a million.

And today it stands at nearly 1.5

million.


33,000,000

People tested for HIV

at ICAP-supported

facilities

2018


6,000

ICAP-supported

health facilities

2018

4,600,000

HIV patients screened for

TB at ICAP-supported

health facilities

1,500,000

People treated at

ICAP-supported

facilities

2018

2018

ICAP has provided HIV testing to over

8,000,000 pregnant women and initiated

640,000 on antiretroviral therapy (ART).

ICAP has supported more than 2,150

laboratories around the world, enabling

quality testing and rapid return of results.

All figures current as of September 2018


World-class, relevant

research adds up

to lives saved

It all begins with a question.

Research is a pillar of ICAP’s

dynamic approach to improving

the health of vulnerable

populations.

From the halls of its headquarters at

Columbia University to communitybased

research centers in Harlem and

the Bronx and out to the furthest

regions of the world, ICAP teams

passionately pursue an ethos of

inquiry.

To date, ICAP has conducted

more than 90 research studies in

25 countries. From drug trials to

implementation science to data

analyses, ICAP’s teams are always

asking questions and seeking

solutions. As they tackle one pressing

health challenge after another, the

questions they ask derive directly

from first-hand experience in the

field, caring for individuals, families

and communities impacted by HIV

and other health threats. The answers

they reach guide their own work and

inform the work of others.

In five countries severely affected

by the HIV epidemic—Ethiopia,

Kenya, Mozambique, Rwanda and

Tanzania—ICAP’s Optimal Models

Study enabled the analysis of

program data from health facilities

to measure patient outcomes and

identify what it takes to achieve

those.

In a pioneering study conducted in

Eswatini (formerly Swaziland), ICAP

researchers looked at key challenges

to integrating screening for risk of

heart disease into HIV clinic visits.

In Kyrgystan, where injection drug

use accounts for nearly 60 percent

of HIV infections, ICAP conducted

one of the first assessments of the

barriers and facilitators that affect

individuals’ participation in harm

reduction programs.

In Mozambique, a study explores

using a combination of interventions—

including peer support and new

digital communications technologies

—to connect adolescents with HIV

to care and keep them on treatment.

Through many more studies like

these, ICAP is asking powerful

questions that will point the way to a

healthier world.


Everyone at ICAP is consistently asking:

“Why?” “Who?” “What?” “Where?” “When?”

No matter what an individual’s role or focus,

all seek to understand how things work, why

they don’t work, and how to make them work

better.

A laboratorian examines a

specimen at Adama Hospital.

Ethiopia

Elaine Abrams, MD

Senior Research Director

ICAP at Columbia University


Seeking

answers

Support group for youth living

with HIV. Zambézia, Mozambique

A health care worker performs a blood

test in the Nicoadala district mobile

clinic. Mozambique

A technician tests samples at the

Bishkek City AIDS Center. Kyrgyzstan


Investing

in people

ICAP is building capacity

on the front lines of health

Nurses provide 90% of health care

in countries where ICAP works,

often serving as a person’s only

point of contact with the health

care system. Yet, until recently,

nurses have not been at the center

of investment in health globally.

ICAP is working to change this

and to demonstrate the profound

return on investment from focusing

on nurses and midwives—enabling

them to do what they know how to

do best and elevating the profession

by securing a seat at the table for

nurse leaders to influence policy.

ICAP has supported nearly 5,000

nursing school faculty, mentors, and

administrators to revamp nursing

school curricula in line with modern

practice and updated technology.

As a result, more than 13,000 new

nurses and midwives have graduated

into the workforce across sub-

Saharan Africa, more equipped and

knowledgeable than ever before.

But learning doesn’t stop at

graduation. Professional networks

and ongoing growth opportunities

are critical to support and retain

nurses where they are most needed.

To this end, ICAP has enabled

more than 5,500 working nurses and

midwives to improve their skills via

professional development courses

offered through innovative on-thejob

training programs as well as

online learning.


Our work has ensured that skilled nurses

are there where they are most needed, and

that the nursing profession’s unique patientcentered

approach is front and center in

shaping health services.

Susan Michaels-Strasser, PhD, MPH, RN, FAAN

Senior Implementation Director and

Associate Director for Nursing Programs

ICAP at Columbia University

Students studying e-learning modules at

the Roma School of Nursing. Lesotho


Students in auditorium, Lusaka School of Nursing. Zambia

Students practice inserting intravenous line on simulation

mannequin at Mzuzu University Nursing Facility. Malawi


ICAP’s collaboration with the Ministry of

Enabling front-line program managers,

policy makers and health workers

Health in building the capacity of health

to ask questions from their day-today

experiences and seek answers

professionals to implement and utilize

research will drive progress toward

through research is fundamental.

evidence-based clinical and public

ICAP’s Health Research Training

health programs in the country.

Program in Eswatini is investing

in the future of public health by

training professionals from diverse

Harriet Nuwagaba-Biribonwoha, MD, PhD

backgrounds in research methods

Research Director

ICAP in Eswatini

and enabling them to use data at

their fingertips to answer critically

important questions. The insights

from their research can drive policy,

programs, and resource allocation

within the country.


ICAP tackles tuberculosis, malaria,

non-communicable diseases, and

emerging threats

Tuberculosis is the number one

infectious disease killer globally

and the number one killer of

people living with HIV.

Malaria continues to threaten the

lives of people around the world,

particularly pregnant women and

young children. At the same time,

non-communicable diseases—like

heart disease, diabetes, cancer, and

mental illness—are the number

one cause of death globally and a

looming threat for low- and middleincome

countries.

ICAP’s work spans all these

conditions, investing in health

systems strengthening to position

countries to respond to a broad

array of issues. ICAP leaders have

highlighted how lessons learned

from the HIV response can go a

long way in addressing other chronic

conditions.

Across the countries where it works,

ICAP has screened nearly 4.6

million people living with HIV for

tuberculosis, in order to enable rapid

diagnosis and prompt initiation of

HIV treatment, thus preventing

unnecessary deaths.

In Ethiopia, ICAP works to improve

the quality of malaria diagnosis

and management throughout the

country.

In Lesotho, ICAP supports health

facilities that serve migrant miners

and their families to provide

integrated services for both HIV

and tuberculosis.

In Eswatini, ICAP supports cervical

cancer screening for women living

with HIV, enabling them to access

prevention and early treatment

services for this leading cancer killer

of women in Africa.

Over the past 15 years, ICAP

has supported more than 2,150

laboratories to provide essential

testing services. These laboratories

are able to accurately diagnose

multiple conditions, thus facilitating

access to necessary care.

In 2015, ICAP responded to the

unprecedented Ebola epidemic in

West Africa by sending a response

team to Sierra Leone. The team

conducted a three-week, rapid

assessment of Ebola community

care centers, a new model of care

that aimed to break the cycle of

household transmission of the

Ebola virus.

Ebola facility.

Sierra Leone


The care center is better because it’s in the

community. Many people died from Ebola before

the community care centers were established.

Now people are using these as a safe haven

where they can get the care they need.

Ebola Survivor

Sierra Leone

Malaria testing. Ethiopia


ICAP has a rare “big picture” view of the health

threats facing the communities that it serves.

As our knowledge and practice expand, we are

ever more able to work with our partners to

address these challenges.

Andrea Howard, MD, MS

Director, Clinical and Training Unit

ICAP at Columbia University


Going

beyond

HIV

A boy with malaria gets treatment at the

Fresco General Hospital. Côte d’Ivoire

Patient being treated for HIV, syphilis, malaria,

general fatigue, and coughing. Côte d’Ivoire


A nurse counsels a woman living with

HIV in Dushanbe, Tajikistan.



ICAP began as bold experiment

that changed the course of the HIV

epidemic response. From there it

has grown into an expansive and

powerful force for public health. In

15 years of transformative work,

ICAP has brought health and hope

to millions across the globe.

Lee Goldman, MD, MPH

Executive Vice President and Dean of the Faculties of

Health Sciences & Medicine, and Chief Executive

Columbia University Irving Medical Center


ICAP’s Portfolio

Expanding Depth

and Breadth

Since 2003, ICAP has steadily enhanced

its capabilities and added to its expertise

as it has forged its place among leading

providers of global health solutions

Human resources

for health

Key populations

Migrant health

Guidelines and tools

Distance learning

Strategic information

systems

Infection prevention

and control

Emerging infections

Non-communicable

diseases

Health management

and economics

Impact assessment

Quality improvement

Differentiated service delivery

Treatment optimization

Program optimization

Lab systems

HIV prevention

Tuberculosis

Malaria

PMTCT

Scale-up of HIV

treatment

Health systems

strengthening


ICAP’s Presence

Growing over

the years

ICAP Headquarters

(New York City)

ICAP is active worldwide, with more

than 1,800 staff in over 30 countries

2003

2004

2005

2010

2011

2012

2014

2015

2016

2017

Cameroon

Côte d’Ivoire

Rwanda

South Africa

Thailand

Uganda

Zambia

Kenya

Mozambique

Tanzania

Eswatini

Ethiopia

Lesotho

Nigeria

D.R. Congo

Kazakhstan

Kyrgyzstan

Tajikistan

Malawi

Mali

Uzbekistan

South Sudan

Burma

(Myanmar)

China

Sierra Leone

Angola

Jordan

Lebanon

Zimbabwe

Brazil

Guatemala

Ukraine

Georgia

Haiti

Namibia


Charting

progress

Gathering the data that

drive policy and programs

The scale-up of access to

treatment for people living with

HIV is a historic global health

achievement.

In order to make further progress,

countries and funders need to

understand how well they are faring

in responding to their national

epidemics and how best to focus

future resources and efforts.

Thanks to the Population-based HIV

Impact Assessment (PHIA) Project,

implemented by ICAP with funding

from the President’s Emergency

Plan for AIDS Relief (PEPFAR) and

in partnership with the U.S. Centers

for Disease Control and Prevention

(CDC) and ministries of health,

14 countries confronting the HIV

crisis will have access to a breadth

of population-level HIV data that

provide the most accurate measures

of the HIV epidemic to date.

The PHIA surveys involve

hundreds of trained staff who

conduct high-quality, householdbased

HIV counseling and testing

for all members of the household,

return the results, and refer HIVpositive

survey participants for care.

They also obtain blood samples

to determine HIV infection, how

well HIV is controlled, and also to

evaluate for other priority diseases

based on country priorities. To

date, more than 300,000 people

have participated in these nationally

representative surveys.

The surveys have been enormously

successful and are providing an

unprecedented understanding of

where countries stand in terms of

the HIV epidemic—yielding critical

information on HIV prevalence,

incidence, who is on treatment, and

how they are doing on treatment.

This information spotlights national

HIV program successes and points

to the gaps that remain.

Impressive declines in the rate of

new HIV infections have been

shown in countries such as Namibia

and Eswatini. At the same time,

the results provide a roadmap for

the future—recharging efforts to

confront the epidemic and guiding

adjustment of strategies.

Côte d’Ivoire Population-based HIV Impact Assessment

(CIPHIA) survey staff prepare for a day in the field. Staff

form clusters and use electronic tablets and printed materials

to identify survey households, check supplies, and coordinate

logistics.


Together with its remarkable partners, ICAP

brings ingenuity, expertise, and dedication

to these ambitious surveys. The findings will

continue to offer valuable insights for years

to come.

Jessica Justman, MD

PHIA Project Principal Investigator

and Senior Technical Director

ICAP at Columbia University


A KenPHIA survey team

on its way to conduct

interviews in rural Kenya.


Delivering

and using

data

A nurse scans patient records at the

East-Kazakhstan Oblast AIDS Center.

Ust-Kamenogorsk, Kazakhstan


Link4Health health care worker coming from Mankayane

Government Hospital to visit rural patients. Once the patients

are located, their addresses are entered into GPS systems so that

they can be easily located. Eswatini

Rural outreach teams test people for HIV in their homes and

counsel them on how to live healthy lives. Patients are registered

on computers and data about them is collected by the teams.

Tanzania

Patient information is recorded.

Democratic Republic of the Congo

Reliable information

makes the difference

Delivering quality services is the

ultimate goal guiding ICAP’s work.

Whether a health worker is making

a decision about a patient’s care, a

district health manager is deciding

which clinics need extra support, or

a policymaker is struggling to define

programmatic direction, having

readily accessible and accurate data

on which to base decisions is a must.

ICAP’s skilled staff around the world

are at the forefront of building the

systems needed to track progress and

measure outcomes.

ICAP provides the technical expertise

to build strong data systems, as well

as the on-the-ground training and

mentorship of the managers and

health workers who need to use the

systems confidently.

In Lesotho, ICAP spearheaded the

transition from an outdated and

cumbersome paper-based system to

one that is electronic, and used by

health managers across the country

to monitor all health programs.

In Kazakhstan, Kyrgyzstan, and

Tajikistan, ICAP helped reshape

national surveillance systems to enable

pinpointing which populations are at

increased risk for HIV and where

new infections are occurring.

In Tanzania, ICAP is developing data

systems that can reliably track HIV

services being delivered right in the

communities where people live.


ICAP believes in the value of data and, most

importantly, in using data to inform action.

Our goal is to put in place state-of-the-art

data systems and make this information

available to those who need to use it day-in

and day-out.

Tiffany G. Harris, PhD, MS

Director of Strategic Information

ICAP at Columbia University

In Cameroon, ICAP supported

the Ministry of Health to overhaul

its system for tracking data on the

prevention of mother-to-child

transmission of HIV and to assure

the quality of these data.


Making health

systems work

better

When quality improves,

lives are saved

Ensuring increased coverage

and enhanced quality of health

services for all people who need

them is essential.

Services need to be available and

accessible—but if they are not also

of high quality, impact will be limited

and resources wasted.

That is why ICAP is dedicated to

quality improvement, a systematic

approach that uses the scientific

method to analyze and improve

health system performance.

ICAP’s evidence-based, flexible

quality improvement approach has

helped improve turnaround time of

tests that determine whether a baby

has HIV infection in Cameroon,

increased coverage of HIV testing of

children in Tanzania, and improved

infection prevention and control in

Sierra Leone following the Ebola

epidemic.

Another strategy to enhance both

patient satisfaction and streamline

health services is the use of

differentiated service delivery, an

approach that adapts the services

to patient needs. Based on the

health status of the patient, clinic

visit frequency is adjusted and

services are relocated to be closer to

where patients reside. Moving the

services to the community also helps

unburden crowded health facilities

and overwhelmed health workers.

A leader of a monthly community ART refill

group (CARG) distributes life saving medication

to members. Outskirts of Harare, Zimbabwe


A physician training session at Muranga

District Hospital. Muranga, Kenya

ICAP works with ministries of

health from 11 African countries to

support the scale-up of these tailored

models of care. Through a learning

network that includes representatives

from various groups from these

countries, lessons can be shared on

how to implement and scale up these

tailored models of care.

living with HIV, assisted Zambia

in developing its scale-up plan for

differentiated service delivery, and

revealed complexities related to

connecting men to HIV services in

Zimbabwe.

A health care worker cares

for a patient. Cameroon

This network has helped the

Eswatini ministry of health revamp

its teen-club model for adolescents


We’re at a seminal moment in the global HIV

response. As more and more people access

services, ensuring quality is more important

than ever for achieving impact.

New technology

helps track patient data.

Quelimane, Mozambique

Miriam Rabkin, MD, MPH

Director, Health Systems Strategies

ICAP at Columbia University


Generating

new leaders

Empowering the next

generation of global

health champions

Global public health is constantly

presenting new challenges. But

the next wave of public health

champions are being well trained

to tackle them.

Through its Next Generation

program, ICAP provides a training

ground for the rising stars of global

public health.

Students from diverse backgrounds

and disciplines are welcomed at ICAP,

where they work on projects ranging

from research in HIV prevention at

ICAP’s centers in Harlem and the

Bronx to quality improvement of

laboratory systems in Eswatini.



This program was life-changing for

me, it pushed me to think beyond

what I thought were my limits.

Javier Cattle

ICAP Training Fellow

Contributing to the bigger picture

of global public health is a unique

educational experience for trainees—

nearly 200 to date—giving them a

foundation and direction for future

career growth.

ICAP researchers are unique. They

work on real-world problems and

the application of public health

theory, and that matches well with

my experiences and where I want

to take my career next,” said Jorge

Soler, PhD, MPH, an ICAP Trainee.

“This training is one-of-a-kind,”

said Chioma Onuoha, who worked

on ICAP’s survey of men who have

sex with men in Zimbabwe. “The

ICAP team prepares you to make a

meaningful contribution to the work

in the field, so when you leave you

see that what you did is part of a

bigger picture. I really appreciated

that.”


ICAP’s commitment to

prevention is paying off

A community mobilizer encourages men

to get a voluntary medical circumcision,

which can help prevent HIV transmission.

Mocuba, Mozambique

HIV-positive or negative?

The moment a person tests

for HIV is a pivotal one.

For those who test HIV-positive—

whether they reside in sprawling

Nairobi or rural Mozambique—

ICAP supports stronger health care

systems to ensure that all have access

to quality, lifelong HIV care and

treatment. For those who test HIVnegative,

ICAP works diligently to

ensure that health care providers

can equip them with the most upto-date

information and prevention

methods to help them stay negative.

ICAP works at the cutting edge

of HIV prevention, conducting

research, small-scale pilots, and

evaluations, and supporting the

scale-up of prevention tools that

have been shown to work.

ICAP has been a leader in seeking

an end to HIV infection among

children around the world. Whether

establishing the first peer support

groups for pregnant women

living with HIV in Côte d’Ivoire,

conducting pioneering research

to evaluate a new combination

prevention approach in Eswatini,

or revamping Cameroon’s national

evaluation system for preventing

mother-to-child transmission of

HIV, ICAP’s teams are doing the

hard work needed to achieve an

HIV-free generation.

With definitive studies demonstrating

that medical circumcision helps

prevent HIV among men, ICAP

works to expand access to safe male

circumcision in Africa. In Tanzania,

Kenya, and Mozambique, ICAP

launched campaigns, trained health

workers, and equipped mobile

teams to offer the service, resulting

in more than 450,000 men and boys

benefiting from this prevention

method.

Most recently, ICAP has turned

its attention to pre-exposure

prophylaxis (PrEP)—the use of

HIV drugs to prevent individuals

from acquiring HIV. ICAP is

conducting research to understand

how to best use PrEP among young

sex workers in Kenya and wives of

migrant miners in Mozambique.

ICAP is also evaluating new and

exciting, long-acting drugs for PrEP

among men who have sex with men

in Harlem and the Bronx, as well as

among women at risk for HIV in

Eswatini.

An HIV support group counselor

conducts a condom demonstration.

Bouafle, Côte d’Ivoire


Whether pursuing a new prevention

approach or designing a novel way to

reach a forgotten group at risk for HIV,

ICAP brings a tradition of innovation and

ingenuity combined with sensitivity to the

contexts and settings where it works.

Community sensitization and drama groups help get

the word out about male circumcision. Tanzania

Mark Fussell, MPA

Deputy Director and Chief Operating Officer

ICAP at Columbia University


Stemming

the tide

Clinicians perfrom medical male circumcision in mobile

tent clinics near the Kagera Sugar Company. Tanzania

Patient counseling at ICAP’s Harlem

Prevention Center. New York City


Needle exchange program. Kyrgyzstan

A recovering user of opioids, who is now a peer counselor for

people who inject drugs and people living with HIV, takes a

dose of methadone. Dushanbe, Tajikistan


Finding the

Counseling session at ICAP’s

Harlem Prevention Center.

New York City

A speaker talks to the crowd about HIV testing and prevention

as part of a project known locally as “FIKIA,” which means “to

reach” in Swahili. Geita, Tanzania.

keys to the

puzzle

Bringing the needs of key

and vulnerable populations

to the forefront


HIV isn’t spoken about in the community. It’s

something that people would rather ignore

than face. I am known in this community

and it means a lot that I can contribute to an

environment where it’s okay to talk openly

about HIV.

Robert Gamboa

Peer Health Educator

ICAP’s Harlem Prevention Center

While the unprecedented global

effort to confront the HIV

epidemic has begun turning

the tide, it is clear that certain

population groups have been

left behind. Vulnerable and often

disenfranchised populations

are not fully benefitting from

advances in HIV prevention and

treatment.

Around the world, ICAP’s teams

work tirelessly to design, implement,

and evaluate approaches to meet

the complex needs of vulnerable

populations.

At its two research centers in New

York City—Harlem Prevention

Center and Bronx Prevention

Center—ICAP has spent the last

decade examining how to improve

services for those most deeply

impacted by HIV in the U.S. ICAP

conducts research on how to better

prevent HIV among men and

women of color and is evaluating

cutting-edge new prevention drugs.

In South Africa, ICAP trained a large

cohort of courageous peer outreach

workers to bring HIV testing and

prevention services to other men

who have sex with men in their

communities.

In Central Asia, where most new

HIV infections occur among

persons who inject drugs, ICAP has

worked with ministries of health and

partners in Kazakhstan, Kyrgyzstan,

and Tajikistan to support a holistic

approach to treat people who are

affected by the opioid crisis and to

expand access to integrated HIV and

TB services.

In Tanzania, ICAP is leading

ambitious efforts to provide vulnerable

groups—such as adolescent girls

and young women, men who have

sex with men, female sex workers,

and people who inject drugs—with

tailored HIV testing, prevention, and

treatment services right in their own

communities.


Envisioning

a healthier

tomorrow

Poised to meet the global health

challenges of the future

For 15 years, ICAP has addressed

some of the world’s most urgent

health challenges through a

commitment to advancing

research, training, health service

delivery, and impact measurement,

using a collaborative approach

that brings together diverse

partners.

Over this time, ICAP has grown

from a bold initiative into an

expansive and trusted global health

leader with a portfolio of projects

that have improved millions of lives

in dozens of countries.

Through the trajectory of this

growth, ICAP has gained invaluable

experience, forged deep connections

around the world, and positioned

itself to confront current and

future health challenges with

knowledge, expertise, experience,

and determination.

Today, the world is changing ever

more rapidly, provoking dramatic

new challenges to the health of

individuals, communities, and

nations. Economic development and

changing lifestyles are fueling the

risk of chronic non-communicable

diseases. The breakneck growth

in urbanization is creating new

health challenges stemming from

environmental pressures and

disconnection from cultural norms

as people leave traditional rural

homesteads for large cities. Concerns

have been raised for young people

who may be engaging in riskier

behaviors as a result of new digital

communications tools. Ease of travel

and encroachment of populations

on natural animal habitats make

the threat of emerging infections a

looming reality. Even as we cope with

these new and unknown health perils,

the world must continue to battle the

big killers: HIV, tuberculosis, and

malaria.

Against this volatile and uncertain

backdrop, ICAP is at the ready to

engage with the challenges that will

define the global health landscape

in the coming years. As it has done

for 15 years, ICAP is poised to face

the toughest challenges unflinchingly

and remains firmly committed to the

belief that a healthier world is within

reach.

Babies receiving care at

Bishoftu Hospital. Ethiopia



Through visionary commitment to a

healthier world, ICAP has empowered

communities to overcome whatever

stands between them and a brighter

future. Today, 15 years into its

remarkable journey, no organization

is better positioned to meet the

global health challenges of tomorrow

than ICAP.

Linda P. Fried, MD, MPH

Dean, Columbia Mailman School of Public Health

ICAP’s work during its

first 15 years has been

made possible by the

following funders

The President’s Emergency

Plan for AIDS Relief (PEPFAR)

The President’s Malaria

Initiative (PMI)

Centers for Disease Control

and Prevention (CDC)

Health Resources and Services

Administration (HRSA)

National Institutes

of Health (NIH)

United States Agency for

International Development

(USAID)

UK Department for International

Development (DFID)

The Global Fund to Fight AIDS,

TB and Malaria (GFATM)

World Health Organization

UNICEF

The World Bank

Bill & Melinda Gates Foundation

Open Society Foundations

Children’s Investment Fund

Foundation (CIFF)

The William and Flora

Hewlett Foundation

The Robert Wood

Johnson Foundation

The Henry J. Kaiser

Family Foundation

The John D. and Catherine T.

MacArthur Foundation

The David and Lucile

Packard Foundation

The Rockefeller Foundation

The Starr Foundation

Medtronic Foundation

Gilead Sciences

Janssen Pharmaceuticals

Merck

Columbia University


Support ICAP

Visit our website and click our

donation button to make a gift that

will help us empower health around

the world.

Stay Connected

Keep up with us through our monthly

newsletter or follow us on social media

as we continue to improve the health

of families and communities.

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@icapcolumbia

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@icap-at-columbia-university