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MSF at the International AIDS Conference in Washington, DC (22-27 July 2012)
The International AIDS Conference is being held this week on US soil for the first time in over 20 years. It is happening at a time when scientific advances have shown that treatment is prevention, giving even more of an imperative to scale-up, while at the same time some donors are reducing their support.
Médecins Sans Frontières/Doctors Without Borders (MSF) began providing antiretroviral therapy (ART) for HIV/AIDS in 2000 in Thailand, Cameroon and South Africa, to a limited number of people in urgent need of treatment. Today, MSF treats 220,000 people in 23 countries, and some projects have been able to reach and maintain ‘universal access’ to treatment—defined as reaching 80 percent of the people in need for ART—in their districts.
A first-of-its-kind study released today by MSF maps progress across 23 countries on HIV treatment strategies, tools and policies needed to increase treatment scale-up. The results show that governments have made improvements to get better antiretroviral treatment (ART) to more people, but implementation of innovative community-based strategies is lagging in some countries. The study, a collaboration with UNAIDS, looked at 25 indicators in each country. This is the first ever study of HIV treatment policies in 23 countries.
“What we’re seeing is that governments are working to get better HIV medicines to their people, and to provide treatment closer to home so that more people can benefit,” said Sharonann Lynch, HIV Policy Advisor for MSF’s Access Campaign. “But there’s still a long way to go. More countries need to shift policies to allow nurses to start people on treatment, and other health workers to monitor patients’ treatment so treatment can be available in every clinic, in every village, in every country struggling with HIV.”
Main findings of the Speed Up Scale-Up study include:
- Eleven of 23 countries have reached ART coverage of 60% or more, while six are still reaching only one third of people in need.
- Six countries have prevention of mother-to-child transmission (PMTCT) coverage rates over 80%, while eight are still below 50%, with five of these below 30%.
- Only eight of the 20 countries for which data was available provide ART in 30% or more of their health facilities, while in countries like Lesotho, Malawi and South Africa where over 60% of health facilities offer ART, treatment coverage is greater, at over 50%.
- Of the 18 sub-Saharan African countries in the study, 11 allow nurses to start patients on ART, with Kenya, South Africa, Swaziland, Uganda, Zambia and Zimbabwe having changed their policies just in the last two years to allow this. Mozambique is the country with the highest HIV prevalence of the countries in the study to still not allow basic nurses to initiate and manage ART.
“One of the biggest questions being posed at this conference is whether it will be feasible to reach the number of people in need of treatment in order to start reversing the epidemic,” said Dr. Tom Decroo of MSF in Mozambique. “There's a lot of talk about efficiencies at this conference, but we have to make sure the patient doesn’t get lost in this discussion. Moving treatment down to the community level means the interest of patients and health systems overlap. We’re showing that we can take HIV care out of hospitals and keep people healthy while making life easier for patients and easing the strain on the health system. We’re starting to move toward a model of patient care similar to that of chronic disease management in developed countries.”
“I am one of eight million people living with HIV who have access to life-saving treatment,” said Charles Sako, who works in MSF’s clinic outside of Nairobi, Kenya. “But for every person like me, there is one more person who doesn’t have the medicines they need to stay alive. We must not tire in pushing governments to implement the best strategies, tools and policies to get treatment to as many people as possible, as fast as possible. And we must appeal to all donors to keep supporting this vital global effort.”
For more information and reports from the International AIDS Conference please see http://aids2012.msf.org/