Creating Policies, Plans and Budgets

For PrEP to have impact, programs need to be well designed and resourced. The first step involves answering questions such as: who is at highest risk for HIV acquisition and to whom will PrEP be targeted? How much will this cost? Where will resources for prevention investments come from? This information can shape national guidelines and policies on PrEP.

Policies: WHO Guidelines

The Consolidated HIV Guidelines for Prevention, Treatment, Service delivery, and Monitoring (July 2021) include clinical and programmatic recommendations across different ages, populations and settings, bringing together all relevant WHO guidance on HIV produced since 2016
The Differentiated and Simplified Pre-exposure Prophylaxis for HIV Prevention technical brief (July 2022) supplements and updates the consolidated guidelines above, and aims to support trends towards services becoming demedicalized, simplified, differentiated, digitalized, and integrated to increase uptake and effective use of PrEP
The Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention, Diagnosis, Treatment and Care for Key Populations (July 2022) present and discuss recommendations on a public health response for five key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings)
The Guidelines on Long-acting Injectable Cabotegravir for HIV Prevention (July 2022) provide implementation considerations to support WHO Member States, programme managers, policy makers, researchers, health workers, communities, and other stakeholders in the implementation of projects and programmes for CAB for PrEP, and outlines critical research gaps
The Guidelines for HIV Post-Exposure Prophylaxis (PEP) (July 2024) prioritises broader access to PEP, including community-based delivery and task sharing to mitigate barriers such as stigma and to ensure timely access post exposure
Guidelines for lenacapavir (LEN) for PrEP are currently in development and expected in Q3 2025

Policies: Local Guidelines Development

These adaptable template guidelines (also available in French and Spanish) can support the development and adoption of national guidelines that align with WHO PrEP recommendations and guidance, including those for tenofovir disoproxil fumarate (TDF)-based daily and event-driven oral PrEP, the dapivirine vaginal ring, and injectable CAB for PrEP
The Key Considerations in Developing Policy Guidance for Differentiated PrEP Service Delivery toolkit (July 2022) from the International AIDS Society can support countries to develop and include differentiated PrEP service delivery in their national HIV operational guidance, and includes an editable template and example policies
The Synthesis of PEP Policies brief summarizes the PEP policy landscape, policy and implementation barriers, and recommends ways to increase uptake of PEP in eight African countries and can be used by ministries of health, implementing partners, providers, and potential PEP users alike to inform and expand access to PEP
This template for terms of reference for a technical working group (TWG) can aid in setting up a TWG to develop national PrEP guidelines in your country
This brief outlines key recommendations for integration of HIV pre-exposure prophylaxis (PrEP) for pregnant and breastfeeding people (PBFP) in national prevention of vertical transmission policies. Countries aiming to update their policies can refer to these considerations to help advance integration of WHO-recommended actions into their nationally endorsed prevention of vertical transmission strategies.

Planning: Modelling, Target-Setting, and Implementation Plan Development

PrEP-it is a web-based tool that helps users set targets, estimate costs and impact associated with targets, identify priority areas for PrEP for adolescent girls and young women, and forecast needed commodities
This deep dive review of modelling long-acting PrEP provides an overview of models looking at impact, cost, and cost-effectiveness of long-acting PrEP, including cabotegravir (CAB) for PrEP
The PrEP Implementation Plan template can be utilized by national governments, their ministries, and relevant stakeholders involved in rolling out new pre-exposure prophylaxis, and contains vital components of the value chain and outlines considerations for countries wishing to layer on these new PrEP products in existing PrEP programs

Planning: Value Chain Situation Analyses

These value chain situation analyses tools can be used by policymakers or others supporting policy development for new PrEP methods to conduct an analysis to assess the existing situation for the introduction of the new product

Budgets: Costing

PrEP-it is a web-based tool that helps users set targets, estimate costs and impact associated with targets, identify priority areas for PrEP for adolescent girls and young women, and forecast needed commodities
These Oral PrEP Costing Guidelines provide a framework for estimating the cost of delivering oral PrEP

Budgets: Financing

USAID’s report Greater Than the Sum of its Parts: Blended finance roadmap for global health (2019) presents a blended finance roadmap as a practical resource to help partners identify blended finance opportunities to achieve health goals; identifies different types of blended finance instruments; and features country deep dives and illustrative blended finance instruments in India and Tanzania