AEGiS-15IAC: Experiences with HIV treatment and care programs in nine resource-poor settings: Common success factors and lessons learned.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Experiences with HIV treatment and care programs in nine resource-poor settings: Common success factors and lessons learned.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrB1316)

Studdert LJ, Reid EA
Australian National University, Canberra, Australia

ISSUES: As the epidemic progresses, HIV care, support and treatment join prevention as priority areas. In mid-2002, WHO announced it would lead efforts to significantly increase access to antiretroviral therapy by 2005. However, the delivery of HIV treatments and care in resource-poor settings presents new challenges to policy-makers, managers, health care workers, community groups, families and PLWHA. Experience shows that treatment can be successfully delivered in resource-poor settings. The factors that underlie success in current programs need to be considered if goals are to be achieved.

DESCRIPTION: Multidisciplinary teams from 11 resource-poor countries participated in the International Roundtable on Increasing Access to HIV Treatments in Resource-Poor Settings, at the Australian National University, Canberra in September 2002. Using reflective learning processes, the teams analysed case studies from Burundi, Botswana, India, Thailand, Malaysia, Indonesia, Papua New Guinea, Haiti and Brazil. Presentations addressed living with treatment, the role of day care centres in an integrated care system, health system capacity, the role of civil society and enterprise-based access as well as contextual factors such as trade and intellectual property issues, social justice, social research, governance and public-private partnerships.

LESSONS LEARNED: Delivery scenarios are complex but this should not preclude action. Successful programs are often initiated by committed individuals or organizations, in local settings, with scarce and uncertain resources. Sustainability and lifelong access is a goal but not a pre-requisite for many who want treatment and are willing to start treatment programs with less than such guaranteed. Community supported programs can achieve effective adherence. Local responses can be scaled-up and expanded into a national program. System readiness is an iterative process and there is no ideal state for which action should wait.

RECOMMENDATIONS: Lessons from existing efforts can guide new programs and scaling up.

Keywords: AEGIS, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Poverty, Health Resources, HIV Infections, Anti-HIV Agents, Organizations, Health Planning Guidelines, Health Services Needs and Demand, Health Services, Thailand, Botswana, Burundi, Indonesia, Malaysia, Papua New Guinea, Brazil, Haiti, India, therapy

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WeOrB1316