Missing the Target #5: Improving AIDS Drug Access ... - CD8 T cells

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only available in the capital, Yaoundé, and the largest city, Douala. Such limitationsoffer ample evidence that treatment monitoring is substandard and problematic.Marginalized groupsCAMEROONThe Bororo Fulanis and the pygmies in the rural areas of Cameroon are the mostvulnerable of the country’s more than 250 ethnic groups in terms of HIV-relatedhealth risks. Most of them are not aware of HIV and AIDS, let alone the availabilityof free ART. They also tend to live far from treatment centers, which adds yetanother barrier to ART scale up for these Cameroonians.Sex between men is a crime in Cameroon; even talking about it is taboo. Men whohave sex with men (MSM) therefore hide their actions from most people in theirlives, even though doing so may place themselves and others (including wives) atrisk for HIV. Socially difficult yet vital steps should be taken to reach out to theseindividuals and offer them non-discriminatory education, care, and treatment.Sex workers also face widespread stigma. They constitute a major at-risk group andshould be catered for more extensively and thoroughly. Sex workers are a commonsight on the streets of most big cities, namely Yaoundé, Douala, Bamenda, andLimbe, yet they are usually denied access to appropriate services.RecommendationsThe following actions and activities would help improve the response to HIV/AIDS inCameroon:Educate PLWHA on the importance of good nutrition and adherence totreatment.Involve civil society representatives from the entire country on the GlobalFund CCM.Establish a permanent country office for the CCM.Donors and civil society organizations should implement programs tomore strictly control and monitor the government’s use of the funds forHIV/AIDS.Greater efforts must be made to inform rural residents and members ofmarginalized groups as to the existence of free ART.Government entities at all levels should implement initiatives designed toreach out to and provide appropriate care to members of marginalizedgroups. Such efforts are likely to help reduce HIV-related stigma anddiscrimination as well.41
A district-by-district surveyBy Felix Mwanza and Paul KasonkomonaChallenges to access to treatment and related servicesMethodologyThis research examines access to treatment and care in Zambia throughstakeholders’ consultations, focus group discussions, interviews with key informants,and empowerment forums. Findings were analyzed from the perspectives of gender,rural versus urban settings, and human rights.Lessons learntThe government often fails to consult with grass roots and rural partners;funding organizations and urban-based partners have a greater voice in shapinggovernment responses. The exclusion of rural partners from government decisionmakingmay be part of a strategy to disempower and limit the political strength ofthis sector of society.Eighty percent of the Zambian population is poor and life is not easy for them,particularly so when HIV and AIDS are added to existing challenges. Access tohealth care is difficult. Long travel times to and from health care facilities arecommon; charges for services such as diagnostics and transport costs are a burden;poor nutrition, illiteracy levels in general, and treatment illiteracy in particularinhibit demand for services; unskilled health care providers, counselors, andcommunity heath care workers hamper the quality of care; and unregulated claimsby traditional healers and advertising of fake cures by opportunists further victimizepeople in desperate situations.New formulations of ARV drugs are not widely dispensed and patients find it difficultto access them even in places were they are available. Patients have little say indeciding which drugs they are prescribed. The lack of essential drugs to treat OIs isanother great challenge.Patients commonly encounter poor attitudes and lack of respect by health careproviders, which makes people reluctant to engage with these services. People mayarrive at 5:00 AM and stand in long queues only to be attended to at 4:00 in theafternoon. This is demoralizing for women who might be required to travel 2-3hours to reach home.42
Page 1 and 2: Missing the Target #5:Improving AID
Page 4 and 5: ArgentinaDr. María Lorena Di Giano
Page 8 and 9: Executive SummaryAt the G8 meeting
Page 12: • UN agencies should provide incr
Page 16 and 17: Price should not be a barrier when
Page 18 and 19: The Global Fund and UNITAID: The Fu
Page 20 and 21: The real cost of free treatmentBy a
Page 22 and 23: Remaining work for asuccessful prog
Page 24 and 25: DOMINICAN REPUBLICto access rapid t
Page 26 and 27: DOMINICAN REPUBLICIn Santo Domingo
Page 28 and 29: ZIMBABWEtreatment, representing 35
Page 30 and 31: ZIMBABWEAccording to the Medicines
Page 32 and 33: ZIMBABWEZimbabwe’s application fo
Page 34 and 35: ZIMBABWENational government• Addr
Page 36 and 37: RUSSIAMigrantsRussia, with the seco
Page 38 and 39: a person with HIV will die very qui
Page 40 and 41: FamiliesIn Kenya, families are the
Page 42 and 43: INDIA2. Provide pediatric formulati
Page 44 and 45: Linking nutrition and treatmentBy W
Page 46 and 47: Most people living with advanced HI
Page 50 and 51: ZAMBIAFindings in particular provin
Page 52 and 53: The DACA for Chadiza District was a
Page 54 and 55: Many health care workers are inadeq
Page 56 and 57: DRUG REGISTRATION BARRIERS & LOGJAM
Page 58 and 59: Country ATV RLPV/rLPV/r(HS)TDFArgen
Page 60 and 61: development and registration. Likew
Page 62 and 63: Capacity issues and delays in the W
Page 64 and 65: Lack of post-approval quality assur
Page 66 and 67: ARV PROCUREMENT, REGISTRATION,AND S
Page 68 and 69: ARGENTINAParallel importingRelating
Page 70 and 71: ARGENTINAAccess to ARVsNo difficult
Page 72 and 73: Viral load tests are available, but
Page 74 and 75: Cambodiaby Mony PenOnly pharmacists
Page 76 and 77: ChinaBy anonymous Missing the Targe
Page 78 and 79: CHINAThe current process for regist
Page 80 and 81: Dominican RepublicBy Eugene Schiff
Page 82 and 83: IndiaBy Abraham KK, Celina D’Cost
Page 84 and 85: MalawiBy Lot Nyirenda and Grace Bon
Page 86 and 87: MALAWIStock-outsAccording to an ext
Page 88 and 89: MoroccoBy Othman MelloukMorocco has
Page 90 and 91: Determine the patent status of all
Page 92 and 93: MOROCCOThe shortage occurred becaus
Page 94 and 95: As of November 2007, the unit cost
Page 96 and 97: NIGERIADiagnostic testsDiagnostic t
Page 98 and 99:
The government’s initial inabilit
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Increase training and capacity buil
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treatment practice. The Minster ann
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Ugandaby Richard Hasunira, Prima Ka
Page 106 and 107:
UGANDAExtracts from the MoH’s rep
Page 108 and 109:
ZAMBIAIn gathering this information
Page 110 and 111:
However, since manufacturing prices
Page 112 and 113:
105SHORT SUMMARY
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PAKISTANAccess for marginalized gro
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