Converging in Washington, DC last Thursday, participants from Mozambique, Ghana, Burkina Faso and representatives of sponsoring organizations - the World Health Organization (WHO), the United Nations Commission for Africa (UNECA) and the World Bank - engaged in a one-day marathon exchange of lessons learned.
"The issues we are trying to learn about in this session and going forward include drug resistance, efficacy and efficiency of drugs,"Â says Albertus Voetberg, team leader of the TAP. "We are also examining the determinants of adherence - is it gender, income, social status or comprehension of issues?"Â
Various approaches in HIV testing is one of the issues being examined in the learning process. Originally, voluntary counseling and testing, which included pre- and post-testing counseling, was the norm. In TAP countries, however, HIV testing is increasingly done on a routine basis, only requiring a universal consent form.
Of the 4.6 million Africans infected with HIV and who need life-prolonging ARV drugs, only about a million of them are getting the drugs, according to UNAIDS.
In 2004, the World Bank, WHO and UNECA launched TAP to look for the best way to provide and monitor AIDS treatment, with the view to scaling up the capacity of health systems to deal with the problem and incorporating lessons learned into existing and future AIDS programs.
"We are looking into political and financial sustainability to help move from emergency response to long-term, sustainable and predictable response,"Â says Elizabeth Lule, Manager of the AIDS Coordinating Team for Africa at the World Bank.
Ghana is one of the countries that stands out as an example with strong public private partnerships in the fight against AIDS. The public sector, non-governmental organizations (NGOs), faith-based organizations (FBOs), as well as private enterprises, work together on the country's TAP project, with clear division of labor. While the public sector mandate is treatment, care and support as well as research, NGOs and FBOs manage the TAP sites that deliver treatment services as well as home-based care, and the private enterprise champions the Workplace AIDS program.
"Private public sector partnerships have worked well in scaling up and have been part of the collective global responsibility,"Â says Lule.
The learning agenda includes the whole array of social and economic benefits of treatment, as well as health system issues, promotion of public private sector partnerships (PPPs). The evaluation of the PPPs is currently taking place in Burkina Faso and initial reports will be ready sometime in January.
Participants in this one-day program also learned about the economic benefits at the household level - how patients on treatment benefit from participating in the workforce, as does the whole system. They also discussed who benefits and what kind of selection criteria is being applied since not everyone gets treatment.
TAP is funded by a grant of 59.8 million from the World Bank's International Development Association (IDA).
By World Bank
Posted December 7th, 2006 by ruzik_tuzik
