PEPFAR-Funded HIV/AIDS Treatment Programs Meeting Urgent Needs in Africa Under Challenging Conditions; Quality Remains Concern
New HIV/AIDS treatment programs funded under the President's Emergency Plan for AIDS Relief are being launched weekly throughout sub-Saharan Africa, including in rural areas that have scant health infrastructures, according to health care workers attending the second annual meeting of PEPFAR field workers last week in Addis Ababa, Ethiopia, the Boston Globe reports (Donnelly, Boston Globe, 5/29). PEPFAR is a five-year, $15 billion program that directs funding for HIV/AIDS, tuberculosis and malaria primarily to 15 focus countries and provides funding to the Global Fund To Fight AIDS, Tuberculosis and Malaria (Kaiser Daily HIV/AIDS Report, 5/25). Peter Mugyenyi -- director of the Joint Clinical Research Center in Kampala, Uganda, which is one of the PEPFAR focus countries -- said health workers in one rural area of the country set up an open-air tent to house the HIV/AIDS treatment program because the hospital was in poor condition and overwhelmed with patients. Although officials said they believe PEPFAR's June 2005 goal of treating 202,000 people with antiretroviral drugs already has been attained, some attendees said the "rush" to provide drugs might sacrifice the quality of treatment programs, according to the Globe. "Just by saying that Uganda as a whole has 50,000 people on treatment doesn't tell you anything about quality, and it doesn't say anything about adherence," Christian Pitter, CDC's principal adviser for antiretroviral treatment in Uganda, said, adding, "Ultimately, it's all about adherence, making sure people take the drugs. We can start all these people on anything we want, but we will fail and make things worse if they don't stay on treatment." Michael Saag, director of the Center for AIDS Research at the University of Alabama-Birmingham, said survival and adherence rates in Zambia's PEPFAR treatment program are similar to the rates at some U.S. treatment facilities, according to the Globe. Deputy U.S. Global AIDS Coordinator Mark Dybul said he plans to solicit input from domestic AIDS program specialists to determine how to maintain quality in treatment programs (Boston Globe, 5/29).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.