Critical Interventions: Treatment (December 2005)

	The U.S. Government is keeping its promise to support treatment of people infected with HIV... A historic aspect of the U.S. President’s Emergency Plan for AIDS Relief (the Emergency Plan) is its focus on scaling up quality antiretroviral treatment (ART), helping to create a “Lazarus effect” for people living with HIV/AIDS that turns the despair of suffering and death to the hope of health and life. The Emergency Plan has moved quickly to support national strategies for HIV treatment in partnership with host nations, nongovernmental organizations and other international donors. Patients who begin ART must remain on therapy for life, so it is essential that treatment services be of high quality, and that the programs be locally owned and sustainable for the long term. The Emergency Plan supports the elements that ensure the quality and sustainability of ART services, including training and support for caregivers; adherence training and monitoring for patients; infrastructure enhancement, including clinics and laboratories; antiretroviral drugs (ARVs) and other medications; and much more. By scaling up ART programs with urgency while maintaining focus on these critical elements, the U.S. Government is helping people focus once again on building a better future for their families and communities. To speed drugs to the fight against HIV/AIDS, the U.S. Government has taken action to allow any drug company in the world to seek accelerated review of AIDS drugs from the U.S. Food and Drug Administration. As of December 2005, 15 generic drugs had been approved through this process and orders had been placed for those drugs in many Emergency Plan countries. The following stories are just a few examples of how the Emergency Plan is supporting national strategies and working with host nations to provide treatment that will extend lives and ameliorate the suffering caused by HIV/AIDS. Bringing Antiretroviral Treatment to Rural Uganda Christopher, left, received treatment with the help of the U.S. Government. Christopher Omoit is alive today because of a unique program that delivers lifesaving drugs and education to his home in rural Uganda. The Home-Based AIDS Care Program, supported by the U.S. Government in collaboration with the Uganda Ministry of Health, serves 53-year-old Christopher, his wife Florence, their five children, and two orphans from Christopher’s sister who died of AIDS. The family lives four miles away from the nearest health clinic in an area so remote that even healthcare workers have trouble getting there. Through Emergency Plan support, Christopher’s entire family received HIV counseling and testing, which revealed that Christopher and Florence are discordant - with only Christopher infected with HIV. Because the couple was counseled on prevention strategies, Florence has remained HIV-negative. Christopher, however, kept falling ill until he started receiving ART, delivered to his home each week by community workers on motorcycles. Christopher’s family helps him to remember to take his medication on time, every day, and he is much healthier as a result. Overcoming Obstacles to Bring Hope to HIV-Positive People in China The support of the U.S. Government contributed to China’s effort to institute its national ART program. The Emergency Plan helped to create a manual on Free Antiretroviral Treatment and a single national database cataloguing patients on treatment. When a U.S. Government-sponsored study found that many people in China were not taking their medicine correctly, two projects were launched. The first project created and distributed a video that taught people how to take their medication. The second project employed workers to directly observe people on medication to ensure that people took their doses correctly and on schedule, a method called “directly observed therapy” or DOTS -- in wide use worldwide for treatment of tuberculosis. The initial successes of the HIV DOTS program led the government of Henan province to recommend the expansion of the program throughout China. Supporting a Mother with Antiretroviral Treatment Ruth smiles because she is grateful that she can see her daughter grow. Ruth Nkuya’s small hands worry the hem of her dress as she softly tells her story: When her husband wanted to have another child, Ruth insisted on being tested for HIV first. Ruth, who lives in Malawi, discovered that she was HIV-positive when her only daughter was five years old in 1996. Her husband was two weeks from starting ART when he died in 1993. Ruth also sought treatment, and began ART in 2002 after she was referred to Lighthouse Trust, an institution supported by the U.S. Government. Now a secretary for the National Association for People Living with AIDS, Ruth looks out at the flame trees in Lilongwe’s City Centre, her face breaks into a smile. “Since I started antiretroviral treatment, my CD4 count has gone from 308 to 900. I am able to work now and take care of my daughter,” she says. Soldiers Help to Bring Treatment to People in Senegal With U.S. Government support, the Senegalese Armed Forces assist with HIV/AIDS treatment efforts. The Senegalese Armed Forces (SAF) have been at the forefront of prevention and treatment of HIV since early identification of the virus. Senegal was one of the first countries in Africa to provide free antiretroviral treatment to its citizens. Since the government initiated the free ART program, military physicians and other healthcare providers have been working within the national program, providing treatment to military and civilian patients alike. The SAF SIDA-Armee program was commenced with support from the U.S. Government in 2001 and has been gaining momentum ever since. The SAF operates two hospitals and 16 Garrison Medical Centers, staffed by personnel trained with U.S. Government funds. Members of the military receive treatment at the hospitals, keeping them healthy so they can continue to serve their nation.
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
“When they get the antiretroviral drug, there’s a Lazarus effect and people, all of a sudden, say, ‘I have hope…’ There’s nothing better than a hopeful society in dealing with the pandemic. A hopeful society means you think you can win. A non-hopeful society says, ‘I surrender.’ America is not going to surrender to the pandemic.” 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.