Critical Interventions: Sustainability (December 2005)

	The U.S. Government is working with over 80% indigenous partners to build sustainable HIV/AIDS services… To win the global war against HIV/AIDS, each nation must truly own its fight. The heart of the U.S. President’s Emergency Plan for AIDS Relief (the Emergency Plan) is support for national strategies to reach prevention, treatment and care goals while also building sustainable HIV/AIDS networks. Many resource-limited nations face common barriers to the expansion and maintenance of HIV/AIDS services, including lack of human resources and capacity, limited institutional capacity, and weaknesses in health care systems such as physical infrastructure. In many of the 15 focus countries, as much as 40 percent of the population has no access to formal health care. Emergency Plan efforts to promote sustainability include: Building human resources and capacity with innovative approaches to health worker training and retention, as well as promotion of volunteer and twinning relationships Strengthening health care systems with support for local health networks, infrastructure, and quality assurance Building institutional capacity by strengthening the ability of local community- and faith-based organizations, as well as national governments, to meet citizens’ needs The following stories are just a few examples of how the Emergency Plan is supporting national strategies and working with host nations to build a sustainable response to the HIV/AIDS pandemic. Improving Record-Keeping in Malawi In Malawi, the U.S. Government is supporting the Baobab Health Partnership to develop and pilot a touch screen client information system at the Malawi AIDS Counseling and Resource Organization (MACRO). MACRO is the largest provider of counseling and testing in Malawi, serving approximately 50,000 individuals each year. The touch screen system was developed to improve the accuracy, completeness, and timeliness of information collected on clients tested and counseled at MACRO. The new system replaced the two-page paper form previously used to collect the information about clients. Accurate, complete, and timely information enables MACRO to monitor services, understand the characteristics of clients served, and plan for needed supplies such as HIV test kits. Ultimately this information can strengthen organizations’ capacity to plan and provide the highest quality services. Building Capacity for Antiretroviral Treatment in Kenya Kenya’s scale-up of antiretroviral treatment (ART) was limited by its pharmaceutical and laboratory systems. Support from the U.S. Government helped the Rational Pharmaceutical Management Plus program to develop solutions by assessing the factors that affect the success of ART. With the support of the U.S. Government and the Rational Pharmaceutical Management Plus program, the Government of Kenya and its local partners began an ART program at four facilities in the city of Mombasa. The program trained staff and established drug management procedures. Now Mombasa has tools to help expand treatment programs to other Kenyan provinces. Developing a Training Package for HIV Rapid Tests Lab technicians work on HIV Rapid Tests. To meet the growing demand for a well-trained and competent workforce to perform rapid HIV tests, the U.S. Government worked with the World Health Organization to develop the HIV Rapid Testing Training Package. The package includes a training video/DVD, presentations slides, a trainer’s guide, and a manual for participants. All training package materials are available in English and plans are under way to make them available in Spanish, French and Portuguese. The training package also provides flexibility for meeting specific country requirements. HIV/AIDS Training Improves Infection Control Nurses from the Government Hospital of Thoracic Medicine have taken on key roles in the hospital’s efforts to improve its infection control policies. Infection control is an essential component of quality HIV care and treatment in hospitals. The U.S. Government and the Government Hospital of Thoracic Medicine (GHTM) in the Indian state of Tamil Nadu, the country’s largest AIDS care center, have been collaborating formally since September 2002. Essential training is an important component of the U.S. Government’s work with GHTM. In addition to building critical skills among the hospital’s medical staff, the strengthening of training at GHTM had profound effects on hospital infection control and the empowerment of nurses. GHTM established an infection control committee with the support of the U.S. Government that resulted in a new “infection control mindset” within the hospital. GHTM now is addressing its water supply issues, providing its staff with hepatitis B vaccinations, improving tuberculosis control through better ventilation, monitoring glove reserves, and practicing a post-exposure program to reduce HIV infection risk from medical transmission such as needle sticks.
President George W. Bush's Emergency Plan for AIDS Relief is the largest commitment ever by any nation for an international health initiative dedicated to a single disease' a five-year, $15 billion, multifaceted approach to combating the disease around the world. U.S. Department of State U.S. Agency for International     Development U.S. Department of Defense U.S. Department of Commerce U.S. Department of Labor U.S, Department of Health    and Human Services Peace Corps Mailing Address: SA-29, 2nd Floor 2201 C Street, NW Washington, DC 20522-2920 www.pepfar.gov
“We want to help build and equip hospitals and clinics. In other words, we want the infrastructure to be there. Part of the money goes to make sure there’s an infrastructure… We really don’t care here in America if it takes a bicycle or a moped to get antiretrovirals out of these big cities, but that’s what we’re going to do. And part of the challenge we face is to help poor countries have the capacity to absorb the drugs and compassion of America. That’s one of our challenges.” President George W. Bush June 23, 2004
President George W. Bush's Emergency Plan for AIDS Relief is working in 15 of the nations most impacted by the HIV/AIDS pandemic and in other nations worldwide to keep the American people's commitment to support treatment for 2 million HIV-infected people, support prevention of 7 million new infections, and support care for 10 million HIV-infected individuals and AIDS orphans.