Darkoh E, Ramotlhwa SL, Mphele TS, Hulela E, Mothatego D, Mosenki K, Fantan T, Mazonde PN, Naidoo P, Haidari A, Riley A; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. ThPeB7144.
Achap, Min of Health, Gaborone, Botswana
Issue: Botswana has been scaling up ARV therapy in the public sector for 24 months with promising results. Description: Using eligibility criteria of a CD4 count of< or =200 and/or presence of an AIDS defining illness, or HIV positive child, 110,000 people would immediately be eligible for ART. Unfortunately low levels of testing means that over 90% of people do not know their status. Besides approximately 5,800 private sector patients, all others are to be catered for by the Government program. 12 sites have been launched and after 24 months the results have been as follows: [table: see text] Source: Botswana National ARV Team Statistics and Botswana Harvard Partnership Abstract Data Lessons learned: Strong political will of leadership, public-private partnerships and early cross-sectoral mobilization is critical for successAlthough finance is a critical hurdle, capacity building at all levels (including managerial) is the most formidable challengeTraining is the rate determining step for future scale-upHands-on, onsite, preceptor training is most cost effective and efficacious in human resource limited settingsA electronic patient, laboratory sample and pharmacy monitoring system should be implemented early (even if very rudimentary)Initial cohorts present very late (average CD4 count of 50) and when symptomatic resulting in need for heroic measures and high revisit rates which exacerbate staffing shortages Recommendations: Programs and policies to promote early testing should be aggressively enacted as it is the only means by which demand can be managed rationally. Once ARV is established, consider augmenting VCT with routine "opt out" testing.
Publication Types:
Keywords:
- Antiretroviral Therapy, Highly Active
- Botswana
- Child
- HIV Seropositivity
- Health Resources
- Humans
- Private Sector
- Public Policy
- Public Sector
- drug therapy
- therapy
Other ID:
UI: 102280924
From Meeting Abstracts