UNAIDS HIV Drug Access Initiative: Providing Wider Access to HIV-related Drugs in Developing Countries, Pilot Phase

The Treatment Centres

The use of clear qualification criteria for the participation of treatment centres
in the Initiative has created a positive climate of competitiveness, in which
centres try to improve their delivery systems in order to be selected.
Participation in the Initiative has resulted in the definition of clear standards
and guidelines for:
* the clinical monitoring of ARV treatment
* psychosocial support
* the regular updating of the technical capacity of medical and psychosocial
support personnel involved in ARV treatment inside and outside the
Initiative
* the continuous availability of drugs for opportunistic infections at the
centres
Ability of households to pay
Patients on ARVs may be able to obtain significant funding for their treatment
from their extended families, including the possibility of having ARVs sent
from abroad. Therefore the mechanisms of financing and the ability of
households to pay should be measured on the basis of the extended family
and not the household per se.
NGO Involvement
In Uganda, there is little NGO involvement in the counselling or follow up of
patients who are monitored at the treatment centres. In Cote d'lvoire, NGOs
are involved in psychosocial support at the treatment centres, but in a manner
that lacks clear systems, mandates, or functions.
Most psychosocial support is provided by qualified social workers who are
employed to do this job. Psychosocial support could be further optimized
through a formal collaboration between NGOs and people living with HIV,
particularly in terms of peer support groups and follow up at home.
Ideally, NGOs and organizations of PWLA should be present to support
patients in all centres. This has not happened to date, primarily for the
reasons listed below:
* Not all NGOs have the technical capacity to assure adequate
psychosocial support at the clinics. Those individuals who are qualified
have been employed as social workers on an individual basis.
* NGOs that are not qualified to replace social workers in psychosocial
support activities could still play an important role in providing peer

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