 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Stephen Gloyd, MD, MPH, Health Services/International Health, University of Washington, 1959 NE Pacific Street, H-660 P.O. Box 357660, Seattle, WA 98195-7660, (206) 543 6714, gloyd@u.washington.edu
In poor countries, 45 million more people will die of AIDS in the next decade unless our approach to HIV care is changed. In the past two years, prices for antiretroviral medicines have plummeted and the UN Global Fund has been set up to provide resources for initiating and scaling up treatment. However, many donors have been reluctant to initiate ARV treatment programs. Their concerns include adequacy of infrastructure for treatment and monitoring, adherence to medications, drug resistance, adverse behavior change, potential diversion of attention and resources from preventive efforts, and sustainability.
Experiences will be presented from in Brazil, Haiti, and Botswana that suggest that HIV treatment programs work and that treatment enhances many prevention and support strategies, including voluntary testing and counseling, prevention of mother to child transmission of HIV, STI treatment, condom use, and orphan care. In addition, preliminary experience will be presented from a national HIV care initiative by Mozambique Ministry of Health designed to provide universal access to effective AIDS triple therapy. The plan integrates treatment with preventive programs and includes strengthening and expansion of the health infrastructure, provision of drugs and essential supplies, and approaches to encourage maximal adherence to medications. Although national scale up is well within the capacity of donor support, the plan requires a new paradigm for international donor support and sustainability, including rethinking the concept of recurrent expenditure support.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.