AEGiS-15IAC: Introduction and scaling-up antiretroviral therapy (ART) at the national level in Haiti.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Introduction and scaling-up antiretroviral therapy (ART) at the national level in Haiti.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrB1280)

Pape JW, Severe PD, Leger PD, Barbot EB, Deschamps MM, Grand'Pierre RG, Noel FN, Bois GB, Fitzgerald DW, Wright PF, Johnson WD
Weill Medical College of Cornell University and Centres GHESKIO, New York and Port-au-Prince, Haiti

ISSUES: ART is particularly urgent for HIV+ patients in developing countries because of their more rapid progression to AIDS and death. However, less than 6% of AIDS patients in the developing world are actually receiving ART. For over 21 years GHESKIO has been at the forefront of HIV prevention and care including the provision of simultaneous counseling and testing for HIV, STI, TB, OI prevention and treatment, reproductive heath services, MTCT, nutritional support and home care. However, ART was seldom provided because ARV drugs were not available. This presentation describes the rapid national ART scale-up with the support of the Global Fund to fight AIDS, TB and Malaria (GFATM)

DESCRIPTION: In March 2003, the GFATM was activated. The scale-up steps consisted of the following: 1. Turn GHESKIO into a national center of excellence for ART a)Train GHESKIO personnel in ART at affiliated US universities (Cornell, Vanderbilt) b) Hire and train mobile teams consisting each of MD, nurse, lab technician c) Develop National ARV treatment and adherence guidelines. 2. Identify with the Ministry of Health 20 national sites based on specific criteria a) Hire and train personnel (MD, nurse, lab technician) at each of 20 sites b) Have each site develop a specific implementation plan to be activated after a site visit. 3. Order supplies of ARVs and HIV tests for diagnosis and evaluation.

LESSONS LEARNED: After 10 months of operation: All 20 centers are operational, over 26,000 people were counseled and tested for HIV/syphilis, >1,000 patients placed on TB therapy/prophylaxis, >3,500 treated for STIs and >1,000 placed on ART. Recommendation: The major obstacles were in the procurement and distribution of ARVs and lab tests and limited site capabiliy. The network will be extended to 37 sites in 2004 with the creation of 10 centers of excellence and over 4,000 persons placed on ART.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, Research Design, Anti-HIV Agents, HIV Seropositivity, Developing Countries, Counseling, Haiti, Humans, therapy, methods

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