HIV/AIDS in Ethiopia: - Clinton Health Access Initiatives

EXECUTIVE SUMMARYSince the turn of the century, the global ecosystem of world’s most studied disease—HIV/AIDS—has experienced vital transformation. Motivated in no small part by generous increasesin disease-specific official development assistance (ODA) and a re-committed focus by worldleaders, major advancements in the fight to control HIV/AIDS have begun to take hold. InEthiopia, these transformations have produced deep and widespread changes in the nationallandscape of public health.Playing a major role in combating HIV/AIDS in Ethiopia are newly emergent internationalactors who, despite ever-increasing budget tightening and global financial uncertainty, havedeveloped innovative ways to finance solutions to some of our generation’s greatest globalhealth challenges. No better organization fits this description than UNITAID. Arising from anunwavering commitment to develop unique and innovative financing solutions to combatHIV/AIDS, malaria and tuberculosis, UNITAID has provided over $1.5 billion in health funding,effectively treating nearly 50 million people throughout 94 countries worldwide. 1In Ethiopia alone, UNITAID—in collaboration with The Clinton Health Access Initiative—hasfunded the procurement of nearly $15 million USD worth of HIV/AIDS commodities betweenJune 2007 and May 2011. This report is a summary of the progress made in the diagnosis andtreatment of HIV/AIDS in Ethiopia with the contribution of those funds.develop new guidelines for the use of ready-tousetherapeutic food (RUTF)—more commonlyknown as Plumpy’nut. Starting in 2009, RUTFwas fully incorporated into the Ethiopia’spharmaceutical supply and distribution system.LABORATORY SERVICESLaboratory Services coordinates with theEthiopian Health and Nutrition ResearchInstitute (EHNRI) to implement programsaimed at improving the quality of the nation’slaboratory system. The SMS Printer Projectis an example of such an initiative. Piloted in2009 with funding from UNITAID, SMS printersimprove patient care by expediting test resultsfrom central labs to rural health facilities.Currently, 25 health facilities are equipped withthe new technology. The pediatric HIV testinginitiative known as Early Infant Diagnosis (EID)is another laboratory program facilitated byCHAI and funded by UNITAID with operationsin health facilities nationwide. By scaling upcapacity in the EID program—1,840 tests wereperformed in 2007 and 24,500 are estimatedto be performed in 2011—thousands ofotherwise-undiagnosed Ethiopian children areable to receive essential ARV treatment. 3SUMMARY OF UNITAID COMMODITY FUNDING * CHAI and UNITAID in Ethiopia 2Since the launch of the CHAI/UNITAID Pediatricantiretroviral therapy (ART) program in 2007,Ethiopia has experienced a 486% increasethe number of children receiving therapy.This equates to over 14,000 HIV positivechildren receiving ART today. On a globalscale, CHAI/UNITAID initiatives have led to thedevelopment of fixed-dose combination drugs(FDCs) for pediatric ART. Quickly adoptedand recommended as the primary method ofpediatric treatment by the Ethiopian FederalMinistry of Health (FMoH), FDCs offerednumerous advantages over existing syrupformulations, showing marked improvementin patient compliance and distribution. Today,full access to free pediatric ART is providedthroughout Ethiopia.1SUMMARY OF PROGRAM ACCOMPLISHMENTSpediatric ARV SCALE UPAdult 2nd line ARV SCALE UPIn 2007, the price of 2nd line ART regimenswere roughly 10 times more expensive than1st line therapies. As 1st line treatmentpopulations grew and patients continuedto live longer, so, too, grew the demand for2nd line ART. By addressing inefficiencies inthe relatively nascent-stage 2nd line therapymarket, in less than five years, CHAI/UNITAIDeffectively reduced the annual cost of treatingpatients with a combination of Tenofovir (TDF),Lamivudine (3TC) and Lopinovir/ritonavir (LPV/r)—a popular 2nd line ART regimen—by over50%. 2Ready-to-use therapeuticfoodChild malnutrition is a major public healthconcern in Ethiopia. In an effort to improveexisting treatment programs for HIVpositive children suffering from severeacute malnutrition (SAM), CHAI/UNITAIDcollaborated with the Ethiopian government toSource: 1 UNITAID; 2 2007 WHO GPRM pricing for Low Income countries and 2011 lowest UNITAID pricing; 3 EHNRIINITIATIVE 2007 2008 2009 2010 2011 GRAND TOTAL PEDIATRIC ART $819,791 $1,921,518 $1,095,899 $1,720,731 $464,022 $6,021,961 2ND LINE ADULT ART $543,482 $1,041,223 $1,644,007 $555,657 $0 $3,784,369 RUTF $215,824 $1,373,404 $934,950 $498,525 $0 $3,022,703 LAB & DIAGNOSTICS $122,281 $360,299 $478,519 $852,383 $143,024 $1,956,506 $1,701,378 $4,696,444 $4,153,375 $3,627,296 $607,046 $14,785,539 UNITAID CONTRIBUTION BY PROGRAMPEDIATRIC ART 2ND LINE ART LAB & DIAGNOSTICS RUTF * The stated number reflects commitments for products purchased in the noted budget year. Actual paymentsagainst orders are made as products are delivered, so some payments will be made in the following year.