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Why did the scale-up of HIV treatment work? A case example from Malawi.
- Source :
-
Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2011 Aug; Vol. 57 Suppl 2, pp. S64-7. - Publication Year :
- 2011
-
Abstract
- The national scale-up of antiretroviral therapy (ART) in Malawi is based on a public health approach, with principles and practices borrowed from the successful DOTS (directly observed treatment short course-the system used to successfully deliver antituberculosis treatment to people in some of the poorest countries of the world) tuberculosis control framework. During the first 6 years, the number of patients registered on treatment increased from 3000 to >350,000 in both the public and private sectors. The most important reasons for this success have been strong international and national leadership combined with adequate funds, a standardized approach to ART with practical guidelines, an approved national scale-up plan with clear, time-bound milestones; investment in an intensive program of training and accreditation of ART sites, quarterly supervision and monitoring of ART and operational research, rational drug forecasting and no stock-outs of drugs during the first few years, and involvement of the private sector. The looming challenges of human resources, guaranteed financial support, better but also more expensive ART regimens, use of electronic medical records to monitor response to therapy, and attention to HIV prevention need to be met head-on and solved if the momentum of the earlier years is to be maintained.
- Subjects :
- Adolescent
Adult
Anti-HIV Agents economics
Anti-HIV Agents therapeutic use
Antitubercular Agents economics
Antitubercular Agents therapeutic use
Child
Developing Countries economics
Developing Countries statistics & numerical data
Female
HIV Infections drug therapy
HIV Infections epidemiology
Health Services Needs and Demand economics
Health Services Needs and Demand statistics & numerical data
Humans
International Cooperation
Malawi epidemiology
Male
Organizational Case Studies economics
Organizational Case Studies statistics & numerical data
Public Health methods
Public Health statistics & numerical data
Tuberculosis, Pulmonary drug therapy
Tuberculosis, Pulmonary economics
HIV Infections economics
Public Health economics
Subjects
Details
- Language :
- English
- ISSN :
- 1944-7884
- Volume :
- 57 Suppl 2
- Database :
- MEDLINE
- Journal :
- Journal of acquired immune deficiency syndromes (1999)
- Publication Type :
- Academic Journal
- Accession number :
- 21857298
- Full Text :
- https://doi.org/10.1097/QAI.0b013e31821f6bab