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

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ZAMBIAFindings in particular provincesNCHELENGE DISTRICTLuapula ProvinceThe Nchelenge district has one major provider of ART services, MSF Holland, whichearlier this year indicated it would pull out of the country. This has caused muchuncertainty for people on ART and for people considering enrolling on an ARTprogram, since they are not sure about the sustainability of the program.Sources at the MSF office said they are acting under an agreement with thegovernment to hand over ART service provision at the end of 2008. The governmenthas not informed the national or local PLWHA what plans have been made, andPLWHA remain unsure what will happen after MSF leaves.Long distances to the nearest ART centers are a major problem, with many peopleunable to access treatment when needed. Missed appointments are common andmany patients have dropped out of the program.SOLWEZI DISTRICTNorth-Western ProvinceSolwezi district, a mining region undergoing an economic boom with the openingof new mines throughout the province, faces many challenges. People from all overthe country arrive in Solwezi in search of jobs and there has been a huge influx ofcommercial sex workers. This district borders the Democratic Republic of Congo andhas also seen a flow of refugees and illegal immigrants coming into Zambia. Dueto similarities in tribes these people have sometimes enrolled themselves in the ARTprograms, increasing the burden on the health care system. Our findings show thatthe population has outgrown the capacity of the ART services. There is great needfor implementers to double their capacity as many people in need of these servicesexperience problems in accessing them. Solwezi is semi-rural, and many peopleneed to travel long distances to reach the nearest ART center.MWINILUNGA DISTRICTMwinilunga district borders Angola and is mostly rural and remote. Long distances,poor nutrition, low treatment literacy levels, lack of diagnostics, and stigma anddiscrimination by unskilled counselors who are believed to divulge the resultsof people who go for VCT are some of the challenges to accessing treatment inMwinilunga.43
ZAMBIAEastern ProvinceMAMBWE DISTRICTComplaints from respondents in Mambwe highlighted the lack of CD4 count testingequipment (available only at the Kamoto Seventh Day Adventist (SDA) MissionHospital) out of the nine antiretroviral treatment centers in the district. Reagents forchemistry and hematology for laboratory analysis, as well as the continued shortageof qualified health personnel to handle the clinical responsibilities, were otherconcerns cited. Similar concerns were raised for Katete, Nyimba, Petauke/Sinda,Chama, Chadiza, and Lundazi districts.Lack of money for ART clients to pay for transport to Kamoto SDA Mission ARTcenter was another handicap cited.CHAMA DISTRICTOnly the Chama District Hospital out of a total of 10 district-based healthgovernment centers is providing ART. Some ART clients are forced to travel up to750 kilometres (600 miles) to reach the District Hospital for ART services. Manymore are forced to make way through the lion, leopard, and hyena-haunted NorthLuangwa Game Reserve—either on foot for weeks or by wrecked bicycles—to reachthe ill-equipped District Hospital ART Centre. Several travelers are said to havebeen mauled by lions, while some crossing the crocodile-swarmed Luangwa Rivermet the same fate from human-feasting crocodiles.Chama district experiences floods every rainy season as it lies below the MuchingaEscarpments and receives the Mozambican torrential rains. This renders the journeyto the District Hospital ART Center a seasonal one. Defaults and failure to acquiremedication have become a common phenomenon, with the majority of ARTclients rendered impoverished due to rains and floods, which limits adequate foodsupplements to support their ART uptake.CHADIZA DISTRICTThe District AIDS Task Force Coordinating Advisor (DACA) for Chadiza district wasreported to have vehemently refused to carry a batch of ARVs from Chipata GeneralHospital to Chadiza after she was pleaded with to do so by a group of personsliving with HIV and AIDS as she was driving her official vehicle from the Hospitalto Chadiza. The DACA was reported to have met the group at Chipata GeneralHospital, where, through the hospital management, they requested her assistancein delivering the drugs to the local district hospital as they had no other transportalternatives. She refused, saying that was not what she had traveled to Chipata for,and furiously drove off, forcing the support group members to hire a private van todeliver the drugs a few days later.44
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 48 and 49: only available in the capital, Yaou
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
Page 100 and 101:
Increase training and capacity buil
Page 102 and 103:
treatment practice. The Minster ann
Page 104 and 105:
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
Page 114:
PAKISTANAccess for marginalized gro
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Missing the Target #5: Improving AIDS Drug Access ... - CD8 T cells

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