Even with increased commitment, funding, and coordination, U.S. AIDS treatment efforts will fall far short of what is needed to provide ARV treatment to those suffering from AIDS today, according to a document from the Centre for Health and Gender Equity. Given limited resources, choices will inevitably be made about who will be treated and when, raising the issues of equity in access to treatment for sub-groups of those infected. In turn, these considerations dramatically underscore the need to ensure that specific efforts be made to ensure that treatment programs reach those groups that already face a disproportionately higher risk of infection.
Equity and HIV/AIDS
Gender, AIDS, and ARV Therapies: Equitable access for women
South Africa’s antiretroviral rollout stalled
Delays in the drug procurement process and lack of training for doctors are postponing the rollout of antiretroviral therapy (ART) in South Africa, the country’s government has admitted. Except for the Western Cape Province (which has set aside its own funds to buy antiretroviral drugs), the celebrated South African HIV care and treatment programme has yet to treat a single patient. Activists are beginning to question the government’s resolve to put the operational plan into action, citing statements made over the last week by Health Minister Manto Tshabalala-Msimang and President Thabo Mbeki.
The forgotten people: care for people dying of AIDS in sub-Saharan Africa
What care do sufferers of AIDS receive in sub-Saharan Africa (SSA)? If their lives cannot be saved, are their last days made as comfortable as possible? As more funding is made available for the care of terminally-ill AIDS patients, it is important to look at the level of care currently available. King’s College London, together with the US Office of National AIDS Policy, conducted a survey across 14 SSA countries to discover the end-of-life care AIDS patients are currently receiving. As hospitals cannot cope with the sheer numbers of patients, care must take place in the community. Nevertheless, while home-based care seems the only possible solution due to the scale of the epidemic, communities can be overwhelmed by the burden placed on them.
Wealthy nations neglecting need, says AIDS envoy
With pointed jabs at the United States, a U.N. special envoy told a gathering of leading AIDS scientists that wealthy nations must make up for a "decade of financial abstinence'' to battle the global epidemic. Stephen Lewis, a Canadian diplomat who has been the United Nations' special representative for AIDS in Africa, made his case on Sunday for a dramatic increase in spending to fight the disease at the opening session of the 11th Conference on Retroviruses and Opportunistic Infections, held in San Francisco.
Access to antiretroviral treatment in Africa
Rene Loewenson and David McCoy, Equinet
The demand for people living with HIV and AIDS in Africa to access treatment cannot be ignored. At the same time the challenges to meeting this demand are many. They include the shortfalls in health services and lack of knowledge about treatment, making decisions about newer regimens, and the risk of resistance to antiretrovirals. The challenges also include ensuring uninterrupted drug supplies, laboratory capacities for CD4 monitoring, accessible voluntary counselling and testing, trained healthcare workers, and effective monitoring of resistance to antiretroviral drugs. A series of papers produced in 2003 through the southern African regional network on equity in health raised further concerns about measures to ensure fairness in the rationing of scarce treatment resources and the diversion of scarce resources from strained public health services into vertical treatment programmes.
Equity in health care responses to HIV/AIDS in Malawi
In Malawi, HIV/AIDS has created an increasing demand for healthcare, exacerbated by population pressure, chronic poverty and food insecurity. This demand is set against a reduced capacity to supply healthcare. With funding from the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), Malawi is now in a position to commence a programme of provision of anti-retroviral therapy (ART) using a public health approach, within an integrated programme of prevention, care and support. This technical paper, produced by Equinet in cooperation with Oxfam GB, analyses the equity issues in HIV/AIDS health sector responses in Malawi, including access to ART.
Frustration As SA Government Slashes AIDS Budget by Two Thirds
AIDS activists from the advocacy group, AIDS Therapeutic Treatment Now, South Africa (ATTN SA) expressed outrage and frustration over the move by the South African government to cut by two-thirds its AIDS budget. According to the Financial Times (UK) newspaper (2/2/04), "The initial budget of R296m (pounds Sterling 22m, $42m, euro 34m) for the first phase of the roll-out of treatment, up to the end of next month, has been cut to R90m by the Treasury, without explanation."
Poor drug supply causing treatment problems in South Africa, Nigeria
Problems with drug supply of antiretrovirals have come to the surface in both Nigeria and South Africa in the past few weeks as the realities of implementing large-scale treatment access begin to hit home. In South Africa the Treatment Action Campaign (TAC) has issued a warning that supplies of the paediatric formulation of efavirenz (Stocrin) are running out, with no stock guaranteed to be brought into the country by the drug’s manufacturer, Merck Sharp and Dohme (MSD), before January 28. TAC claims that one patient has already had to interrupt treatment as a result of the drug `stock out`, and highlights the risk of resistance that may arise if efavirenz treatment is interrupted without planning.
Providing ARV's in resource-limited settings
A paper developed by the Health Systems Resource Centre on behalf of the Department for International Development (DFID) and in collaboration with the World Health Organisation (WHO) aims to increase understanding of the requirements for introducing and scaling up provision of antiretroviral therapy (ART) as part of comprehensive HIV/AIDS programmes in resource-poor countries. The paper provides an overview of experience and lessons learned with regard to: The feasibility of ART in resource-poor settings; The different approaches being taken to delivery of ART; and The issues to be considered in scaling up ART provision. The review is based on published and unpublished literature, interviews with key informants, web searches and country information.