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The essentials of antiretroviral therapy for health care and program managers

HOPE, Ruth
ISRAEL, Ellen
April 2007

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This book provides health care workers and mangers with information and practical guidance relating to antiretroviral therapies (ART). It also considers wider care and treatment issues such as; opportunistic infections, the integration of ART with antenatal and midwifery services, the particular needs of children and young people, support relating to nutrition, spiritual needs, psycho-social and economic issues. In addition, the need for community level support to help with adherence to treatment and address stigma and discrimination are also considered, as is end-of-life care for people whose disease does not respond to treatment

Expanding access to HIV treatment through community-based organisations

SIDACTION
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
WORLD HEALTH ORGANIZATION (WHO)
July 2005

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This UNAIDS Best Practice Collection document aims to highlight and advocate for the work of civil society, community based organisations in particular, in responding to the AIDS epidemic in Africa. The paper describes a ground breaking survey by Sidaction, a Paris based treatment rights group, which supports community responses to AIDS in low and middle income countries. In 2004, Sidaction, in cooperation with the UNAIDS secretariat and WHO mapped treatment and care efforts by community based organisations in Africa. Many community based organisations are already dispensing ARVs on a significant scale. The survey confirmed that community efforts to provide treatment represent an important opportunity to enrol more people in antiretroviral therapy. To seize this opportunity, national governments and the international community need to quickly provide support to expand the coverage and impact of community based treatment. The aim is for CBOs to work closely with the public sector so that each reinforces the efforts of the other

Antiretroviral therapy in primary health care : experience of the Chiradzulu programme in Malawi. Case study

MEDECINS SANS FRONTIERES (MSF) MALAWI
July 2004

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The Chiradzulu programme is one of MSF's largest. MSF currently provides HAART to more than 13,000 patients in 56 projects spread across 25 countries. These programmes provide a continuum of care, including prevention efforts (health education, prevention of mother-to-child transmission of HIV), voluntary counselling and testing, prevention and treatment of opportunistic infections, HAART and nutritional and psychosocial support. Although the Chiradzulu project is still evolving, and treatment systems and point of care continue to be modified, the project has already shown that when treatment is adapted to local conditions and is supported by human and financial resources, rural health systems can effectively provide comprehensive HIV/AIDS care

The Senegalese antiretroviral drug access initiative : an economic, social, behavioural and biomedical analysis

DESCLAUX, Alice
et al
April 2004

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This very thorough analysis of the Senegalese Antiretroviral Drug Access Initiative (ISAARV) presents preliminary results from the initiative's first three years. The analysis explores four aspects of the programme: treatment access, adherence, therapeutic efficacy, and the impact of this treatment programme on the Senegalese health care system

World health report 2004 : changing history

WORLD HEALTH ORGANIZATION (WHO)
2004

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This report argues that a comprehensive HIV/AIDS strategy linking prevention, treatment, care and support for people living with the virus could save the lives of millions of people in poor and middle-income countries. At present, almost six million people in developing countries need treatment, but only about 400 000 of them received it in 2003. The World Health Report 2004 argues that a treatment gap of such dimensions is indefensible and that narrowing it is both an ethical obligation and a public health necessity. In September 2003 WHO, UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria and their partners launched an effort to provide three million people in developing countries with antiretroviral therapy (ART) by end 2005 - the 3 by 5 initiative. This World Health Report shows how a partnership linking international organizations, national governments, the private sector and communities is working simultaneously to expand access to HIV/AIDS treatment, reinforce HIV prevention and strengthen health systems in some of the countries where they are currently weakest

Palliative care in Sub-Saharan Africa : an appraisal

HARDING, Richard
HIGGINSON, Irene
2004

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This report was written from the belief that palliative care is, and will be for the forseeable future, an essential component in the continuum of managing HIV/AIDS in sub-Saharan Africa. There is now a wealth of experience in sub-Saharan Africa about the ways in which palliative care can be delivered both affordably and effectively. However, there remains a lack of properly documented evidence and research to demonstrate the importance of this work and promote its development. This report provides a review of existing evaluations of palliative care projects in sub-Saharan Africa with an emphasis on isolating the factors that lead to sustainability, local ownership and scaling up; the role of palliative care in the management of HIV/AIDS and how to integrate palliative care and Anti-Retroviral Therapy (ART); primary health based care projects in two countries, Kenya and Malawi, that could provide lessons for the implementation of palliative care; lessons from other parallel programmes which mirror palliative care delivery, for example, tuberculosis programmes, and primary care programmes with good links to local clinics and hospitals, and community mobilization and empowerment projects linked to health facilities. In this way it contributes to the effort of providing an evidence base to demonstrate the importance of palliative care and provides a source of reference for policy makers, practitioners, donors and researchers

Interim policy on collaborative TB/HIV issues

WORLD HEALTH ORGANIZATION (WHO). Stop TB Department and Department of HIV/AIDS
2004

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This policy responds to a demand from countries for immediate guidance on which collaborative TB/HIV activities to implement and under what circumstances. It is complementary to and in synergy with the established core activities of tuberculosis and HIV/AIDS prevention and control programmes. Implementing the DOTS strategy is the core activity for tuberculosis control. Similarly, infection and disease prevention and health promotion activities and the provision of treatment and care form the basis for HIV/AIDS control. This policy does not call for the institution of a new specialist or independent disease control programme. It rather promotes enhanced collaboration between tuberculosis and HIV/AIDS programmes in the provision of a continuum of quality care at service-delivery level for people with, or at risk of tuberculosis and people living with HIV/AIDS

Handbook on paediatric AIDS in Africa

TINDYEBWA, Denis
et al
2004

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This handbook intends to provide users in resource-poor countries with a tool that can be adapted to their needs. It follows the four principles of the United Nations Convention on the Rights of the Child and aims to provide a simple, accessible and practical handbook for health workers involved in preventing infection and caring for children infected and affected by HIV. It includes substantial chapters on caring for HIV-exposed and HIV-infected children, infants and orphans; diagnosis and the clinical stages of HIV infection; clinical conditions associated with HIV (diarrhoea, malnutrition, neurological manifestations, skin manifestations and more); pulmonary conditions; anti-retroviral therapy for children; youth issues, long-term and terminal care planning; psychosocial support. The primary targets are medical students and their lecturers, nurses, clinicians, community health workers and other service providers in resource poor settings where there is a significant HIV and AIDS burden

Women's stories, women's lives : experiences with cervical cancer screening and treatment

BOYD, Anne R
BURNS, Michele
Eds
2004

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This publication is a collection of stories based on interviews with women in developing countries who participated in ACCP programmes. These women's stories illustrate the unnecessary suffering cervical cancer can cause women and their families and how prevention programs can save women's lives. ACCP projects have focused on regions in which cervical cancer incidence and mortality are highest: sub-Saharan Africa, Latin America and South Asia, and have also focused on reaching women in their 30s and 40s

Stepping back from the edge : the pursuit of antiretroviral therapy in Botswana, South Africa and Uganda

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
2004

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This report looks at what is being done to challenge the pace of progress on access to antiretroviral medicines in three very different African countries - Botswana, South Africa and Uganda. It describes who is driving these initiatives at grass-roots level and how. It offers insights and draws on lessons from firsthand experiences that can help those already working towards better access to antiretrovirals, and encourages others to embark on similar initiatives. It is intended for all those with an interest in this issue, from policy- and decision-makers with the power to create a favourable environment for antiretroviral treatment, to those working on the front line in health services, NGOs and AIDS service organizations, as well as those living with HIV, whose role in the battle for wider access is vital

Ethiopian strategic plan for intensifying multi-sectorial HIV/AIDS response 2004-2008

NATIONAL HIV/AIDS PREVENTION AND CONTROL OFFICE (HAPCO)
FEDERAL MINISTRY OF HEALTH (FMOH)
2004

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This document sets out the strategic issues facing Ethiopia as it plans its response to the HIV and AIDS epidemic. Issues include capacity, community mobilisation, mainstreaming HIV in health programmes, coordination and networking, and targetting vulnerable groups. This document lists objectives under each of these headings, and strategies that will be used to achieve them. Each strategy is then listed with corresponding 'major activities' (milestones), indicators, verification method, and responsible bodies (mostly regional health bureaux, Ministry of Health, HAPCO and other stakeholders). The report includes a statement about budget requirements and allocations, governance, monitoring and evaluation, the roles of the different stakeholders, and a list of relevant documentation (manuals, guidelines, policy documents)

National monitoring and evaluation framework for the multi-sectoral response to HIV/AIDS in Ethiopia

HIV/AIDS PREVENTION AND CONTROL OFFICE (HAPCO)
December 2003

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In 1998 the Ethiopian government scaled up the response to HIV/AIDS by forging a multi-sectoral and multi-level partnership with various stakeholders. A national policy on HIV/AIDS was enacted in August 1998. This resulted in a Strategic Framework for the National Response to HIV/AIDS in Ethiopia for 2001-2005. This monitoring and evaluation framework was developed to strengthen the multi-sectoral response to HIV/AIDS, to systematically track progress and evaluate the effects of the national response, and to meet the international reporting requirements for funds secured to fight HIV/AIDS in the country. It covers basic monitoring and evaluation concepts, an implementation strategy, national level indicators and resource requirements

Mae Chan workshop on integrated community mobilization towards effective multisectoral HIV/AIDS prevention and care

HOLLERTZ, Victoria
2000

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Report of the proceedings of a workshop aiming to build the capacities of health and social workers, and community leaders to mobilise their communities towards HIV prevention and care. The participants were selected from rural communities with the potential for a community-based approach. The workshop examined the community response model, and enabled participants to learn from the experinces of the participating countries and develop follow-up actions

HIV, health and your community : a guide for action

GRANICH, Reuben
MERMIN, Jonathan
1999

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Designed as a manual for people confronting the HIV epidemic in their communities, this book has been written to be easily accessible to those without medical or technical knowledge and without prior training in the prevention of HIV and the care of those with AIDS. Topics range from the biology of the virus to designing prevention programs, from the epidemiology of the disease to writing grant proposals. The authors discuss explicitly the risk factors for infection and suggest helpful methods for explaining them and assisting people to change their behaviour. An appendix aimed at readers with medical training discusses common HIV-related illnesses and their treatment

Human rights and HIV/AIDS

LAZZARINI, Zita
June 1998

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HIV/AIDS prevention and care programmes engage the full range of human rights. International human rights instruments recognise that only non-derogable rights are absolute; other rights may be limited under certain circumstances. However the power to restrict such rights is narrwoly proscribed. To prevent the further spread of HIV/AIDS, while simultaneously protecting the rights of those infected with HIV and those who are not, HIV/AIDS policymakers must review the legality of HIV/AIDS policies, evaluate their public health goals, assess whether the policies can achieve those goals, and weigh whether the benefits outweigh the financial and human rights burden

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