251621 Cotrimoxazole: Positioning and encouraging “new” and “essential” use

Tuesday, November 1, 2011: 9:42 AM

Melissa Sharer, MPH, MSW , AIDSTAR-One project, JSI Research and Training Institute, Arlington, VA
Andrew Fullem, MSPH , JSI, Boston, MA
Paula Nersesian, RN, MPH , John Snow, Inc., Arlington, VA
Issue: With the scale up of HIV treatment programs, substantial funding has been committed to guarantee an uninterrupted supply of cotrimoxazole for persons living with HIV as cotrimoxazole is a well-tolerated, inexpensive antibiotic that has been shown to reduce the risk of pneumonia, diarrhea, malaria, and other opportunistic infections among persons with HIV. It is effective across a wide range of CD4 cell counts. With the scale up of HIV treatment programs, substantial funding has been committed to guarantee an uninterrupted supply of cotrimoxazole but access to this key intervention remains inconsistent. Key barriers to cotrimoxazole access/administration are related to the supply chain and limited awareness of the benefits of cotrimoxazole use among health care providers and service recipients. Currently, AIDSTAR-One has finalized 15 systematic country reviews of the global and country level supply chain issues that provide a situation analysis, document promising practices, and make recommendations to strengthen systems. Complementing this work, AIDSTAR-One is also developing provider and patient tools to increase both use of and access to cotrimoxazole for opportunistic infections.

Lessons learned: Findings revealed through the 15 country desk reviews, include many supply chain challenges posing obstacles to ensure cotrimoxazole availability for all uses. And conversely, there are many innovative approaches that validate successful supply chains that require technical expertise, resources, and policymakers' commitment.

Recommendations are collapsed under five topics to consider when working toward improving availability of health commodities. These include access, quality, efficiency, financing, and collaboration in low-resource countries.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
Outline the common cotrimoxazole access barriers from 15 countries Highlight generic educational tools that target different tiers of health professionals and their clients to increase the use of cotrimoxazole Describe practical steps for improving access to and use of cotrimoxazole

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the research for this presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.