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

Viral load tests are available, but samples must be sent to Trinidad for analysis. TheNational AIDS Program anticipates acquiring a viral load machine through the PANCaribbean Partnership against HIV/AIDS (PANCAP). The MoH purchased a CD4count machine in March 2007 although it is uncertain if operators have as yet beentrained in its use.Challenges and obstaclesBELIZEDespite important steps forward in recent years in regard to increasing access toARVs, significant challenges and obstacles persist. These include:Drug stock-outs. There were reports in 2007 of shortages of particularmedications. Government officials assert that such problems, if they exist,stem from inadequate forecasting or problems with delayed payments ordelayed funding. Generally stock-outs are avoided by borrowing neededmedications from neighboring countries.Insufficient human resources. Health workers are unevenly distributedthroughout the country. Moreover, there are far too few personnel who areadequately trained in HIV/AIDS care and treatment. This makes it difficult toensure consistent service delivery, in particular for people in rural areas.Price shocks and quality assurance. Belize does not produce medicinesdomestically. As such, it remains especially vulnerable to price hikes in ARVsand treatments for OIs and STIs. ARV medications purchased through PAHO’sprequalified list of manufacturers have good quality assurance, but donateddrugs remain vulnerable due to poor in-country quality control mechanisms.Limited treatment uptake. As noted previously, more than 4,000 people inBelize were living with HIV as of August 2007. The number actually needingART has not been ascertained as of the second quarter of 2007. Factorsrestricting greater access to treatment include widespread HIV-related stigmaand discrimination, and infrastructure limitations, including lack of trainedpersonnel. Individuals living in rural areas also find it difficult to obtaintreatment and care because of costly and limited transportation options.Sustainability concerns. Demand for treatment will likely increase in thefuture. It is unclear to what extent Belize will be able to pay for the increasingcost of ARVs, especially expensive second-line medications, after Global Fundsupport ends.65