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

In a significant improvement for patient care, a standard patient medical
record has been established and each clinic now maintains centralized
records for patients. Prior to the development of this system, patients were
given a hand-written record after each physician visit and were responsible
for keeping their own records and bringing them to the doctor at each visit.
As a result, patient medical records were not always reliable.
CSte d'Ivoire
With a population approaching 13 million and, by 1998, an HIV-infected
population of over 800,000, C6te d'Ivoire was, like Uganda, chosen for the
pilot programme with the full commitment of its government. The Minister of
Public Health later announced that the equivalent of US$ 1 million would be
made available, in the form of a Solidarity Fund, to help the poorest
categories of patient to meet the cost of treatment. The "Fonds de Solidarit6
Th6rapeutique International" has also provided US$1.3 million for the next
two years to provide long-term antiretroviral treatment to HIV pregnant
women who are symptomatic or at the stage of immune depression as well as
to help people on double therapy to reach triple therapy.
* More than 190 physicians, other health care workers, and social workers
have been trained in three large 5-day workshops. The sessions included
training on the use of ARVs, drugs for opportunistic infections and
psychosocial counselling.
/ Approximately 650 patients are receiving drugs through the Initiative. This
number is expected to increase rapidly as the rebate schemes of the
National Solidarity Fund and of the International Therapeutic Solidarity
Fund become operational.
* Participating facilities include 8 referral centres and 4 follow-up centres in
Abidjan, and 4 follow-up centres outside the city (Bouak6, Korhogo, Daloa
and Bondoukou). Plans are underway to upgrade the follow-up centres to
referral centres through the expansion of laboratory facilities.
* Each referral centre employs at a minimum a medical officer, several
nurses, a person responsible for the delivery of ARV and a social
assistant. Follow-up centres are provided with drugs for opportunistic
infections.
Advisory Board
A 26-member advisory board was appointed in June 1998 and is meeting
regularly. The board reports to the Health Ministry and is chaired by the first
ministry advisor. Board members include representatives of other ministries,
the UNAIDS-funded manager of the initiative, the non-profit company
manager, HIV/AIDS researchers, and NGOs representing persons living with

HIV. The board is assisted by a technical secretariat, who prepares the
technical issues prior to discussions in the board meetings.

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