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Replication and Scaling up of Programmes A key concern for UNICEF was to identify new programme ideas, test them out as pilot projects, summarise lessons learnt from country implementation, and scale up small projects to national coverage, and replicate successful projects in other countries.
We drew on the Arksey and O'Malley framework for conducting scoping review studies [ 13, 14] as well as systematic approaches to identifying empirical and theoretical gaps within ethical discussions pertaining to population-level intervention implementation and scale up [ 15].
Thus, questions have emerged as to whether or not the evidence base warrants the implementation and scale up of TasP within epidemics that are not defined by vaginal-penile transmission [ 36].
The establishment of the Nodal Institute in the EMR is a promising initiative to support the conduct and the use of HPSR in policy and programme planning, implementation, and scale up.
We drew on the Arksey and O'Malley framework for conducting scoping review studies as well as systematic approaches to identifying empirical and theoretical gaps within ethical discussions pertaining to population-level intervention implementation and scale up.
Based on the results of this scoping review, we identify several areas that hold promise for informing the ethical implementation and scale up of TasP and that could benefit from new research (see Table 3 for an abbreviated list of key recommendations from these findings).
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Invention is the creation of an idea; innovation is its development, implementation and scaling up.
However, issues about implementation and scaling up have emerged.
This strategy requires a comprehensive and systematic synthesis of the key ethical issues and concerns related to the implementation and scaling up TasP as expressed by both scientists and community stakeholders.
The four case studies (below) illustrate some of the key contributions the NGDOs made to the development of what became "community directed treatment with ivermectin" (CDTI)- in particular the implementation and scaling –up of ivermectin distribution programmes.
Despite the evidence showing the promise of HIV treatment as prevention (TasP) in reducing HIV incidence, a variety of ethical questions surrounding the implementation and "scaling up" of TasP have been articulated by a variety of stakeholders including scientists, community activists and government officials.
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