The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 19: Palliative Care in Resource-Poor Settingsneed for symptom control and supportive therapies to improve their quality of life. Figure 19-1illustrates existing and ideal distribution of resources between active disease-specific therapiesand palliative services for people with HIV/AIDS along the trajectory of their illness. 626 picasFigure 19-1: Models for Allocation of Curative and Palliative Care ResourcesModel 1: Former Allocation of Healthcare ResourcesIn this model of care, all available resources are used exclusively for active disease-specifictreatment, regardless of efficacy or concurrent needs, limiting patients’ access to palliativetherapy to the last days of life.Model 2: Proposed Allocation of Healthcare Resources in Developed CountriesIn this model of care, a portion of healthcare resources is devoted to pain relief and palliativecare beginning at initial diagnosis. The proportion of resources for palliative care increasesas disease progresses and/or as needed.XIXModel 3: Proposed Allocation of Healthcare Resources in Developing CountriesIn this model of care, a greater proportion of healthcare resources is devoted to palliativecare as patients typically present with advanced disease and disease-specific therapies areoften not available or appropriate.Source: Adapted from World Health Organization. Cancer Pain Relief and Palliative Care. Technical Report SeriesNo. 804. Geneva: WHO, 1990.U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 389