Provision of antiretroviral therapy in resource-limited settings
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A review of experience up to August 2003
Authors: Kathy Attawell and Jackie Mundy
WHO and the UKs Department for International Development
This paper was developed by HSRC on behalf of DFID and in col-
laboration with the World Health Organization (WHO). This back-
ground paper aims to increase understanding of the requirements
for introducing and scaling up provision of antiretroviral ther-
apy (ART) as part of comprehensive HIV/AIDS programmes in re-
source-poor countries. The paper provides an overview of experi-
ence and lessons learned with regard to:
* The feasibility of ART in resource-poor settings
* The different approaches being taken to delivery of ART
* The issues to be considered in scaling up ART provision
The review is based on published and unpublished literature, in-
terviews with key informants, web searches and country informa-
tion. It also draws on a review conducted by the Health Systems
Resource Centre (HSRC) and John Snow International (JSI) for the
Government of Kenya in late 2002 (under the DFID supported HAPAC
Project managed by the Futures Group) and a review of the impact
of HIV on health systems conducted by HSRC and JSI in early
2003.
Source: WHO
Download PDF file in English (111 pages, 310 kb) at:
http://www.who.int/3by5/publications/documents/en/ARTpaper_DFID_WHO.pdf
WHO has also published draft technical and operational recommen-
dations for achieving its 3 x 5 goals the delivery of antiret-
roviral therapy to 3 million people in resource-limited settings
by the end of 2005.
The recommendations emphasise the need to devolve care as
quickly as possible to the primary health care level within the
health care system, and to involve community organizations, peo-
ple with HIV and community health care workers in the delivery
of treatment and its ongoing monitoring.
Drawn up by an expert meeting that took place in Zambia in No-
vember 2003, the recommendations draw in experience from exist-
ing treatment programmes, and provide guidance on the actions to
be prioritized during the first stage of treatment scale-up.
Source:
http://www.who.int/3by5/publications/documents/zambia/en/
To download the recommendations got to:
http://www.who.int/3by5/publications/documents/en/zambia_doc_final.pdf