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9th EACS ADVANCED HIV/AIDS COURSE AIX-EN-PROVINCE 7-9th September

9th EACS ADVANCED HIV/AIDS COURSE AIX-EN-PROVINCE 7-9th September. Dr KANHON SERGE Conseiller technique Soin et traitement PNPEC/MSLS CAP-VERT du 14 au 16 Mars 2011. Dr KANHON SERGE, MD Care and Treatment Senior Technical Advisor NACP/ MoH. OUTLINE.

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9th EACS ADVANCED HIV/AIDS COURSE AIX-EN-PROVINCE 7-9th September

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  1. 9th EACS ADVANCED HIV/AIDS COURSEAIX-EN-PROVINCE7-9th September Dr KANHON SERGE Conseiller technique Soin et traitementPNPEC/MSLSCAP-VERT du 14 au 16 Mars 2011 Dr KANHON SERGE, MD Care and Treatment Senior TechnicalAdvisor NACP/MoH

  2. OUTLINE • BACKGROUND • EPIDEMIOLOGY • RESULTS • STRATEGIES • CHALLENGES • WAY FORWARD • CONCLUSION

  3. BACKGROUND • Location: West Africa • Size: 322 462 sq km • UNDP 2006: 164/ 177 with HDI 41,5% (low) • GDP: 1 136 USD per capita • Population: 20 581 777 inhabitants in 2007 • Death rate: 14/1000 • Child death : 125/1000 • Maternaldeath: 543/ 100 000 • Birth rate - 45/1000; • Life expectancy : 51,3 yrs • Population growth 2,8% • 3 major diseases: Malaria, HIV/Aids, TB

  4. EPIDEMIOLOGY • CI most affected: prevalence 3,2% UNAIDS 2010 ( ANC: 5,6% vs 2,9%) • 1986: 1st case notification • HIV 1 and HIV 2 but dual infection • PlwHIV: 480 000 (180 000 in need of treatment) • 30 000 new infections all age • 35 000 number of death • 40% ART coverage and 50% PMTCT coverage • 39% of HIV-TB coinfection • 102 lab (4 VL) • ARV and lab testing are free of charge

  5. RESULTS

  6. STRATEGIES • PLANIFICATION • NSP: 2011-2015: • To reducefrom 30% new infections and STD on 2015 • To enrolle 80% of adults and adolecentseligible for treatment on 2015 • EXP for healthsector • TRAINNING • Health workers (265 trainnings session to train 5723) • National pool of trainners • Regional pool of trainners • Mentorship • Refreshing sessions • COORDINATION: • TB program, VHB program, MoD • National political documents for CT, PMTCT, PED treatment, TARV, laboratory management

  7. STRATEGIES (2) • INNOVATIVES APPROCHES: • PICT: • Task shiffting: NIMART (Nurse Initiated and Managed ART) pilot project • Emtct: Elimination of MTCT • The Expanded Treatment Program (Decentralized access to treatment: facilities, other than ARV clinics to initiate treatment) • New Treatment guidelines : In line with WHO recommendations, Eligibility Criteria reviewed, TDF in 1st line regimen, to reduce the use of Stavudine, PMTCT and children regimens reviewed. • PARTNERSHIP • Keys Technical Partners: WHO, UNAIDS • Financial Partners: GoCI, PEPFAR, WB, GFATM, UNICEF, UNFPA, WAHO, GIP-ESTHER, • Implementing Partners: EGPAF, FHI, ICAP, ACONDA, PSI, Alliance CI, JHPIEGO, JHU-CCP, URC, HAI, Abt Associates, … • Local partners: Network, NGO, Private Sector…

  8. CHALLENGES • COUNSELLING AND TESTING • available at all health facilities (public, private, community based) • PMTCT AND PEDIATRIC CARE • eMTCT • EID • CARE AND TREATMENT FOR ADULT • To reduce LTFU • Low coverage of ART despite increased sites • LOGISTIC • Commodity stock-outs • Donor driven procurement of commodities • FUNDING • Sustainbility • HIS • Weak health information management systems, • Identifying trends & Using Data Sets for secondary analysis • Need to develop M&E systems that meet multiple needs

  9. WAY FORWARD • Primary Prevention • Advocacy and sensitization • Continue to build systems for improved access and capacity strengthening • Competing for additionnal funding • Maintain the highest level of good business practice and high quality care and treatment • Continue to receive technical assistance from donor agencies • Involvement of other stakeholders including FBOs and private health care providers • Effective monitoring and evaluation • Health system strengthening (logistics and supplies) • Political commitment: Governance and leadership, value for money

  10. CONCLUSION • Significant results were obtained for ART treatment in PLWHIV • However, to maintain this positive dynamic , it remains critical to overcome some keys challenges • Funding sustainability • Avoid stock out (ARV) • Minimize LTFU • Implement WHO new recommendations

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