HIV & AIDS

 {Photo credit: Julius Kasujja}Team of doctors and nurses at the Joint Clinical Research Centre in Uganda Photo credit: Julius Kasujja

What it takes for health systems to provide lifelong antiretrovirals

Soon after her husband’s death in 1991, Bahati Shellinah tested positive for HIV, but antiretroviral drugs (ARVs) were not yet available. In 2004 she fell ill, but, luckily, this time ARVs were available. Bahati visited the Joint Clinical Research Centre (JCRC) outside of Kampala, Uganda, and she began taking ARVs for the first time

Thankfully for Bahati, a local service provider was able to start her on treatment, but that is not the case for many people living with HIV, who often find themselves facing long waiting times, overwhelmed staff, medicine stock outs, stigma, and discrimination. No organization is immune to these challenges, and although JCRC was prepared when Bahati returned, they, too, grappled with organizational challenges as they scaled up services between 2003 and 2010. The gaps in management systems put JCRC's eligibility for donor funding at risk, which would mean patients like Bahati would lose access to their essential medicines. 

 {Photo Credit: Gwenn Dubourthournieu}HIV education is a crucial aspect of family planning services.Photo Credit: Gwenn Dubourthournieu

This year’s World Population Day coincides with the Family Planning Summit—a global moment where intentions and commitments to the right to health for all are revitalized. An essential component of HIV prevention and treatment, family planning must be prioritized in global and national agendas. Here are four reasons why: 

  1. Family planning is essential to maintaining progress on HIV goals: Meeting the needs of young people, particularly in developing countries, is critical to maintaining progress and momentum in controlling the HIV and AIDS epidemic. In Sub-Saharan Africa, where the youth population has nearly doubled since the beginning of the epidemic, millions more young people are entering a stage in life where they may be at increased risk of exposure to HIV. With the world’s highest fertility rates and the lowest use of modern contraception, family planning services are urgently needed to help young people protect themselves and prevent new infections.

 {Photo Credit: Warren Zelman}A hospital in Mwene Ditu, DRCPhoto Credit: Warren Zelman

Before the civil war in the late 1990s, the Democratic Republic of Congo (DRC) had a large network of clinics and health facilities. But decades of conflict weakened a fragile health system and robbed this resource-rich country of its potential to become one of sub-Saharan Africa’s wealthiest nations. By 2010, 70 to 80 percent of Congolese people had little or no access to healthcare, and the country suffered from a lack of basic security, communication systems, power, clean water, and transportation. Exacerbated by a dearth of health providers, essential medicines and nutritious foods, the country’s maternal, infant, and child mortality rates rose to some of the highest in the world.

I’m in the U.S. this week to share my experiences working side-by-side with the Congolese government and partners on the Integrated Health Project (IHP), funded by USAID and implemented by Management Sciences for Health (MSH) and its partners, International Rescue Committee and Overseas Strategic Consulting, Inc. . The aim of IHP was to rebuild and strengthen the health system and improve health across 78 health zones in the country. In five years, IHP improved health services for more than 13 million people – 17 percent of the Congolese population.

Photo Credit: Mark Tuschman

For the fifth year in a row as part of MSH's annual storytelling contest, we invited staff to submit stories on how health systems are saving lives and improving the health of people around the world. MSH staff submitted dozens of stories from 16 projects in 12 countries.

In these 12 winning stories, meet health workers, community leaders, pharmacy managers, and patients working together toward healthier communities. These stories demonstrate the power of effective partnerships to help save lives.

Ethiopia: Changing Systems to Change Lives: Aster's Story

By Tsion Issayas

Happy holidays and health on earth!

Envision a 2017 where everyone has the opportunity for a healthy life. Working together for stronger health systems around the world in 2017. Best wishes for the new year!

Like and share this ecard on Facebook:

 

Photo Credit: Gwenn DubourthournieuPhoto Credit: Gwenn Dubourthournieu

On this World AIDS Day, we reflect on our global successes in scaling up HIV prevention and treatment efforts and averting new infections.

The “treat all” recommendation issued by the World Health Organization in 2015 was a critical milestone in the HIV response. Also known as “test and treat,” the recommendation expands antiretroviral therapy (ART) eligibility to include all people living with HIV, regardless of CD4 count, and recommends universal lifelong treatment.

This approach ensures that HIV-positive pregnant and breastfeeding women identified in antenatal care, during labor, or while breastfeeding, can benefit from the use of lifelong ART — also known as Option B+ — rather than starting and stopping treatment if they are ineligible upon cessation of breastfeeding, which is known as Option B.

The Option B+ approach simplifies treatment guidelines and prioritizes the health of pregnant women and mothers, and it has proven effective. According to UNAIDS, the number of new HIV infections among children has decreased by 56 percent globally since 2010.

Alime, a patient featured in MSH's Medicine Movers

by Devex's Noa Gutterman and Management Sciences for Health

This summer, Devex partnered with Management Sciences for Health (MSH) to host Access to Medicines (), a conversation that has analyzed and amplified the discussion on global access to medicines.

Over the last three weeks,  has examined major questions including: 

 Cynthia (left) cares for her grandson, Alime, orphaned to AIDS and living with HIV, in East London, South Africa.

This post is an excerpt from "Medicine Movers," written by Daphne Northrop, and videos by Emily Judem

EAST LONDON, South Africa -- Nine-month-old Alime and his grandmother Cynthia sit at a table piled with pill bottles, cardboard cartons, and syringes. There are 19 items in all. 

The squiggly Alime, who traveled that morning on his grandmother’s back to the hospital, happily munches on a cookie while the pharmacist counsels his grandmother on when he should take each of his medicines and how much to give him. It’s hard to believe such a tiny boy needs so many pills to survive.

Alime has been HIV-positive since birth. His treatment seems to be working. His weight has doubled, and as he smiles and gurgles quietly in Cynthia’s arms, he looks like a healthy toddler. He rarely takes his eyes off his grandmother, and he reaches out to touch her face as she talks.

Medicine Movers: South Africa from Management Sciences for Health on Vimeo.

{Photo credit: Michael Paydos/MSH}Photo credit: Michael Paydos/MSH

This week, Devex and Management Sciences for Health (MSH) are discussing innovations for access to medicines in low- and middle-income countries. Public-private partnerships are key to ensuring innovations help medicines affordably reach the people who need them most.

From communities to global policy: Innovations to access to medicines underway

Devex reporter Andrew Green writes:

In Tanzania in 2002, MSH realized the medicines needed for basic treatment are in the government system, but not available to patients -- either because health facilities ran out of stock or were too far away.

Instead, patients turn to private dispensaries in high numbers. MSH reports that 82 percent of people in sub-Saharan Africa seek health care and medicines from retail drug shops -- even though the people staffing them often have little knowledge or training.

In Tanzania, MSH decided to try to change that, conceptualizing a program in 2002 to set government standards for the accredited drug dispensing outlets, or ADDOs, and upping the knowledge of the people running them. ...

Saving lives and improving health continues long after diagnosing disease or delivering medicines.

(Watch Faith tell her story)

Faith had been ill for months. She was 31 and had two daughters. She didn’t know what was wrong. A friend urged her to get an HIV test; it came back positive.

Faith started on antiretroviral treatment.

But, in 2013, one of her antiretroviral medicines started to work against her, causing misshapen fat deposits to develop on her body.

When she finally mustered the courage to speak up one year later, her doctor knew just what to do and shifted her to a different medicine.

(Medicine Movers: Kenya from Management Sciences for Health on Vimeo)

Faith didn’t know it, but her report to the doctor became part of a nationwide database that tracks adverse drug reactions, and poor quality or expired medicines.

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