Dr. Jim Kim of Harvard School of Public Health joins International

Treatment Preparedness Coalition to release new report and call for broad,

systematic approach to HIV/AIDS and health care scale up



    NEW YORK and HARARE, Zimbabwe and BOSTON and SAO PAULO, Brazil, July 29

/EMWNews/ -- The International Treatment Preparedness

Coalition (ITPC), a group of 1,000+ treatment advocates from more than 125

countries, issued its sixth report on delivery of AIDS treatment today.

Missing the Target #6: The HIV/AIDS Response and Health Systems: Building

on success to achieve health care for all is available at

http://www.aidstreatmentaccess.org.



    The new report, launched during a teleconference with Dr. Jim Yong Kim,

Director of the Francois-Xavier Bagnoud Center for Health and Human Rights

(FXB) at Harvard University and advocates from around the world, provides

some of the first from-the-ground research to inform the debate on HIV

treatment scale up and its interaction with health systems. It includes

reports from six countries: Argentina, Brazil, the Dominican Republic,

Uganda, Zambia and Zimbabwe.



    Dr. Kim praised the report and noted that it is both welcome and timely

to set the stage for the next phase of research and investigation for AIDS

services and health care systems scale up in developing countries.



    "The report shows that each country situation is complex. Every country

has made thousands of decisions, good and bad. What we are seeing now is

that funding for HIV is, for the first time in history, directed at chronic

care for a chronic condition. We have the opportunity to think hard about

what it will take to keep a large population of people healthy over their

entire lives. What we know is that it takes more than just antiretrovirals.

This report takes us to the point of reformulating in a fundamental way the

argument over HIV and health systems," Dr. Kim said.



    Matilda Moyo, a co-author of the report's Zimbabwe chapter said, "What

we found was that HIV/AIDS services, particularly provision of

antiretrivirals, have become a lifeline for the health care system in

Zimbabwe. In the midst of the economic and political crises, a consistent

focus on HIV health services has been an oasis in a whole desert of the

collapsing health delivery system."



    Problems in Zimbabwe include extreme shortages of healthcare workers,

with one doctor often responsible for providing services for 8,000

patients, frequent drug stock outs and a crumbling healthcare

infrastructure. "Some donors such as the Global Fund have come together to

provide much needed financial resources for Zimbabwe," added Moyo. "For

example, efforts have been made to invest in infrastructure through HIV

programs which has boosted the general health delivery system."



    Alessandra Nilo, a co-author of the report's Brazil chapter, said, "In

Brazil, HIV/AIDS services have been scaled-up in conjunction with the

expansion of general public health. The scale up of AIDS services has also

had positive impacts on human rights, education and sexuality in Brazil."



    Brazil has been cited as a great success story for developing strong

HIV treatment and prevention programs as well as general public health

programs. Nilo added, "Despite the success of integrating HIV and general

health systems, we still identified clear and distinct benefits for

maintaining dedicated HIV-related services."



    "The AIDS response in Zimbabwe, Brazil and other countries shows that

new investments in health can have dramatic impact. But a simple

reshuffling of health resources toward more generalized health functions at

the expense of effective disease-specific programs, such as HIV/AIDS, would

jeopardize the remarkable advances that have been made and leave the more

than six million people who urgently need AIDS treatment without this

care," said Chris Collins, a co-coordinator of the report.



    "The scale up of antiretroviral therapy in the developing world is the

most ambitious public health undertaking of our lifetimes," said Gregg

Gonsalves, a co-coordinator of the project. "We were told it couldn't be

done, and shouldn't be done, but we persevered, set ambitious goals and

targets, and now 3 million people are on antiretroviral treatment."



    "AIDS is a disease of primary health care, and we need to strengthen

health systems to provide for the future of AIDS treatment," Gonsalves

added. "We are the heirs of Alma Ata. We will make comprehensive primary

care -- health for all -- a reality. We'll be told again that it is

impossible. Well, we've done the impossible and will do it again. What ITPC

is about is finding out what people need and what is happening on the

ground, and then pushing to make the changes that will save people's

lives."



    "If the UN's health-related Millennium Development Goals (MDGs) are to

have and chance of being realized, we need to do for health systems what

we've done for AIDS, while increasing the momentum of the response to

AIDS," added Collins.



    Key findings from the report include:



    1. The HIV/AIDS response to date has had sizeable positive impacts on

health care in many settings: building infrastructure and systems, raising

the bar on quality, extending the reach of health care to socially

marginalized groups, and engaging consumers.



    2. But new investments in HIV/AIDS services have also exposed existing

fragilities in health systems. In some cases expanding demand has stretched

already overextended human resources and placed increasing burdens on

infrastructure.



    3. The engagement of health consumers and advocates in AIDS scale up

has forced global and national leaders toward a more vigorous sense of

accountability and urgency, both critical elements in the success of AIDS

programming.

    About the International Treatment Preparedness Coalition



    The International Treatment Preparedness Coalition (ITPC) was born out

of the International Treatment Preparedness Summit that took place in Cape

Town, South Africa in March 2003. That meeting brought together for the

first time community-based HIV treatment activists and educators from over

60 countries. Since the Summit, ITPC has grown to include more than 1,000

activists from over 125 countries and has emerged as a leading civil

society coalition on treatment preparedness and access issues. On the web

at http://www.itpcglobal.org