treatment

 {Photo credit: Jimmy Felix/SCMS in Haiti.}“John” is a healthy 2-year-old, thanks to HIV medication for his mother.Photo credit: Jimmy Felix/SCMS in Haiti.

SCMS and MSH at the forefront of efforts to remove supply chain barriers to the scale up of HIV/AIDS treatment programs

For many of us in the developed world, it is easy to overlook the critical role that well-functioning supply chains play in effective healthcare. When supply chains are operating as they should, we take for granted that the medicines we need will be in stock and available. Yet throughout the developing world, most patients’ access to critical health commodities is much more tenuous; linking medicines to the health professionals that provide treatment and the people who receive care remains a central challenge facing national health systems.

Ensuring that supply chains are sustainable and can tap into high-quality, low-cost medicines, presents an even greater challenge.

Mukabaha Ntakwigere (at right) at the General Reference Hospital in Nyangezi, DRC. {Photo credit: MSH staff.}Photo credit: MSH staff.

Tuberculosis (TB) is a leading cause of death in Democratic Republic of the Congo (DRC), partly due to a low case detection rate within the health system, compounded by little knowledge or awareness among patients of the disease’s symptoms. In the province of Sud Kivu, where people have relied on traditional healers for generations, those who were suffering from the persistent, painful coughing that is one symptom of TB were advised by traditional healers that they had been poisoned, and they were not referred to health centers.

In Sud Kivu province, in the health zone of Nyangezi, with a population of roughly 129,000 people, case detection was below 12%, which is the minimum "acceptable" threshold for TB detection.

Medical professionals in Nyangezi realized that they were never going to identify and treat those suffering from TB until they could educate the community about the symptoms and the treatment methods.

Marie Madelaine Thomas receives antiretroviral therapy through an SDSH-supported clinic. Since August 2012, SDSH has provided ART to more than 3,665 individuals.

Mildred Akinyi sitting by a family planning unit in Masafu sub-county, Uganda. Photo: MSH.

 

Post updated February 2, 2012.

Mildred Akinyi had abdominal pain for some time before she attended a reproductive health workshop for HIV positive couples at Masafu Hospital in Uganda in July 2011.

“I always felt pain in my abdomen, and would take a lot of panadols to ease the pain. I did not know what was wrong with me," Akinyi said. "When I heard from the case manager at Masafu hospital that STAR-E had organized for women living with HIV and their partners to be screened for cervical cancer and sexually transmitted infections (STIs), I could not wait to use that chance to get checked.”

Yesterday the results of HIV Prevention Trials Network (HPTN) 052, a clinical trial funded by the National Institutes for Health, offered definitive proof of what we have long suspected---that treating HIV infected persons substantially reduces the risk of transmitting HIV to uninfected persons.

This is FANTASTIC news and offers very convincing evidence that, at least for heterosexual discordant couples (the study was not able to enroll significant numbers of gay men), if the infected person is on ART, the uninfected partner is protected. And more broadly, it offers significant evidence that treatment is indeed highly effective in preventing transmission of HIV. This can reasonably be described as a “game changer” with respect to how we think about HIV prevention, care, and treatment. We used to talk about “treatment as prevention,” but now we can say “treatment IS prevention.”

Read the UNAIDS report here.

This blog post originally appeared on the US Agency for International Development's IMPACT blog.

Yodit Assefa (center) and procurement colleagues from PEPFAR’s Supply Chain Management System (SCMS). Photo credit: SCMS

As a procurement specialist with PEPFAR’s SCMS (the Supply Chain Management System) project, I am one of a growing number of women working in supply chain management in Ethiopia. I manage procurements of HIV/AIDS commodities---including the complex procurement of specialized medical equipment used to treat HIV/AIDS---as well as the vehicles that distribute those commodities.

Well planned, strategic procurement is a smart investment. Our team helps save money by minimizing costly unplanned and emergency procurements and buying low-value and bulky products locally.

As Haitians continue to struggle against many obstacles in improving and developing their country, cholera and sanitation remain challenges to many development efforts.

Since the cholera epidemic started in October, there have been a total of 252,640 confirmed cases. MSH integrated its response, where appropriate, with the national response that was coordinated by the Ministry of Health. Following the earthquake, MSH’s USAID-funded Santé pour le Développement et la Stabilité d’Haíïti (SDSH) Project found that provision of basic health care through mobile kiosks in the settlement camp tents were an effective way to provide services and messages. Educational messages and oral rehydration solution (ORS) therapy are now being delivered via these kiosks. In addition, SDSH distributed cots, buckets, bleach, bottled water, and ORS to combat the disease.

Every day people are dying in the developing world because they cannot access affordable, quality medicines. Modern pharmaceuticals have revolutionized health care, but weak health systems prevent many people from accessing basic life-saving medicines. The health of men, women, and children can be dramatically improved throughout the world by enhancing access to and improving the use of essential medicines and other health care technologies.

Gaps in the management and availability of essential medicines and health commodities have been a constant weakness for developing countries. These gaps hamper the ability to access and distribute the pharmaceutical and medical supplies needed to treat infectious diseases. We have seen particular success in addressing pharmaceutical management challenges when interventions include: increasing access to products and services, improving the use of those products and services, promoting rational pharmaceutical use, developing public-private partnerships, providing thorough assessments and trainings, and improving procurement processes.

Annie Likhutu, shown right, receiving volunteer HIV counseling and testing services from Word Alive’s HTC volunteer, Charles Sapala.

Three months ago, Annie Likhutu, a mother of six, came to Migowi Health Center in Phalombe, Malawi to receive voluntary HIV counseling and testing (VCT); now, she is back at the health center and ready to be tested for a second time.“It is very important to know your status, it is no good waiting until you get sick,” she said.

Annie initially learned of the importance of testing through a radio advertisement from Word Alive Ministries International (WAMI), which is aired regularly and encourages listeners to go to health centers for VCT.

Although Annie takes pride in knowing her status and encourages others in her village to do so, her husband refuses to go for testing. This motivates Annie to continue returning to confirm her negative status.

On this World AIDS Day, we reflect yet again on progress made toward global commitments to fight the HIV epidemic. According to UNAIDS, new infections have decreased this past year from 2.7 million to 2.6 million, but, 30 years into the epidemic, only 5.2 million people out of the estimated 15 million who need drugs have access to treatment. Stigma, discrimination and human rights violations against persons living with HIV still exist, even in countries with generalized epidemics.

Integrated HIV programming across the entire health system can minimize many of these barriers to HIV prevention, care and, treatment.

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