HIV/AIDS Twinning Center Program

(2004 – 2019)


AIHA, through the Twinning Center Program, made vital contributions to the HIV/AIDS approach both through traditional twinning partnerships and, in the period of performance, through direct implementation of multiple programs. Over the course of the 15.5-year TCP, with a focus on the last 5.5 years, AIHA has learned valuable lessons, particularly in its core areas of improving human resources for health (HRH) in low- and middle-income countries and in health system strengthening.

Since the inception of the TCP, AIHA and partners have provided pre- and in-service training to over 27,000 health care professionals, including physicians, nurses, biomedical engineers and technicians, laboratory technicians, para social workers, and other allied health care workers. These trainings on topics ranging on topics from adolescent disclosure to incorporation of continuous quality improvement and far beyond have provided important skills critical to reducing the burden of HIV/AIDS in nearly 20 countries across Africa, Europe, and Asia.

The peer-to-peer twinning model has led to a strong sense of country ownership, as local experts have graduated from being the recipient partner to providing South-to-South twinning leadership and building in-country capacity. While this report outlines the most direct results of AIHA’s work through the TCP, the follow-on impacts will be felt for decades to come as shared best practices continue to take root and spread.

AIHA twinning programs maximized voluntary contributions of professional expertise, equipment, and materials, to leverage donor resources effectively. This included more than $112 million in USG funds through the TCP, leveraged by over $41 million in in-kind contributions of professional time, equipment, supplies, and other material support from our U.S. partners involved in the program.  

To read the final report, click here.

Project Countries

AIHA utilized a wide range of evidence-based, cost-effective approaches for health systems strengthening (HSS), developing human resources for health (HRH), and other needed capacity building.

In accordance with the PEPFAR Blueprint for Creating an AIDS-free Generation, AIHA’s TCP activities focused on:

  • Making strategic and scientifically sound investments to maximize impact and efficiencies; working with partner countries, civil society, faith-based organizations (FBOs), and the private sector;
  • Supporting activities that minimize stigma and discrimination with attention to gender equality; and
  • Proactively monitoring and improving HIV outcomes and seeking

AIHA’s Multi-pillar Approach to HSS/HRH

HSS Multi-pillar GraphicUsing a multi-pillar approach for HRH strengthening, AIHA increased the number and quality of trained physicians, nurses, mid-level health professionals, managers, biomedical technicians, pharmacists, and other allied health staff, who were then integrated into national and local health systems where they provide quality HIV/AIDS-related services.

Depending on the needs of the recipient country, this multi-pillar approach included:

  • Strengthening educational institutions in recruitment, teaching methods, and curricula;
  • Training of trainers to build capacity through pre- and in-service training programs;
  • Collaborating with national authorities to support human resource mapping, planning, task-shifting, and retention;
  • Collaborating with service providers to ensure their needs are being appropriately met by educational institutions; and
  • Engaging and supporting regulatory bodies and professional associations for certification, accreditation, and licensing of graduates.

With PEPFAR support, AIHA’s twinning programs strengthened health systems in a number of key areas, including: increasing the capacity of healthcare workers; introducing new cadres; accrediting pre- and in-service curricula; professional health and allied workforce strengthening; building the capacity of professional associations; creating new models of care; and – from 2006 through 2017 – through the long-term placement of skilled professionals via the Volunteer Healthcare Corps (VHC).

AIHA built successful, mutually-supportive relationships with host country stakeholders at multiple levels of the health sector, from national ministries and schools of the health professions to hospitals, clinics, and grassroots service organizations. Our proven ability to collaborate with all stakeholders helped to ensure that twinning projects promoted local ownership and created synergy with host country goals from day one, thus ensuring they were sustainable.


Snapshot of AIHA TCP Accomplishments: 2004-2019

  • Established more than 60 twinning partnerships and other capacity building initiatives in 16 countries in Africa, Asia, Eurasia, and the Caribbean, leveraging $112 million in U.S. Government funds with $41 million in in-kind contributions from US partners.
  • Provided in-service training for more than 10,000 health and allied care providers and graduated more than 15,000 individuals from pre-service programs at partner institutions worldwide.
  • Placed 105 highly skilled professionals in long-term assignments in five African countries through the Volunteer Healthcare Corps (VHC); these volunteers collectively contributed more than 23,545 professional days to strengthen health system capacity in host countries.
  • Supported development and/or strengthening of a number of mid-level cadres, including clinical associates, nurses, pharmacy technicians, lab technicians, biomedical technicians, para social workers, and social welfare assistants.
  • Established 27 Learning Resource Centers in eight countries to build institutional and individual capacity to access and utilize evidence‐based knowledge resources, promote evidence‐based practice and use of point‐of‐care applications for professional decision making, and promote the use of information and communication technologies to improve health services and systems.

Sampling of Key Accomplishments at the Partnership Level

  • AIHA’s DREAMS Initiative project in Western Kenya trained more than 53,000 community members in gender norms, provided mentoring through Safe Space activities to some 35,000 girls, provided access to  between the ages of 10-14, and referred nearly 9,000 girls for medical care, including HIV counseling and testing. 35,000+ Girls reached through Social Asset Building activities, HIV counseling & testing to more than 39,700 girls, and provided education subsidies and support to some 25,100 girls.
  • Debre Berhan Hospital partnered with Elmhurst Hospital Center from 2007-2014 to build institutional and human resource capacity to improve medical and psychosocial care services, particularly for PLHIV. Thanks to twinning, Debre Berhan has become one of Ethiopia’s leading tertiary care facilities and has become a model for positive change in nursing, hospital administration, and the provision of quality ART, among other things. The hospital was honored as a top performer by the Ministry of Health in 2014, 2015, and 2016.
  • Catholic University of Mozambique and the University of Pittsburgh partnered to improve access to ART and other healthcare services in Sofala Province. In 2009, they opened São Lucas Health Center in Beira. Since then, clinic staff have provided primary medical care to more than 50,000 patients, including managing ART for 1,367 patients living with HIV. The clinic also serves as a rotation site, training students in HIV-related treatment and care.
  • Addis Ababa University, in partnership with the University of Wisconsin – Madison, has pioneered emergency medicine in Ethiopia, training more than 6,000 healthcare workers and medical and nursing students in both adult and pediatric emergency medicine since February 2010. They’ve also launched an Emergency Medicine Fellowship Program and designed an emergency medicine subspecialty training program at Addis Ababa University, graduating the first cohort of four residents in October 2013. These physicians are first subspecialists in emergency medicine on the continent to graduate outside of South Africa.
  • The Kenya Conference of Catholic Bishops and their partners at DePaul University developed a school-based prevention program that has reached more than 770,000 children in 1,611 schools across the country. 
  • Working with the University of Kentucky, the Zambia Institute of Mass Communication Educational Trust (ZAMCOM) has trained 463 health workers, media professionals, and policymakers to elevate HIV-related reporting and raise public awareness of HIV and has secured funding from the Zambian Government to support its HIV-related programs.

Partnering to Build Sustainable HSS/HRH Capacity

AIHA’s TCP partnerships and projects have provided in-service training for more than 25,000 health and allied care providers, graduating more than 15,000 individuals from pre-service programs at partner institutions worldwide. We also placed 105 highly skilled professionals in long-term assignments in five African countries through the TCP’s Volunteer Healthcare Corps; these highly skilled professionals collectively contributed more than 23,545 professional days to strengthen health system capacity in host countries.

Click here for a PDF of the infographic.