Care and support for people living with HIV/AIDS

Care and support for people living with HIV/AIDSBox 16. Strengthening “horizontal” collaboration on HIV and sexuallytransmitted infections in Latin America and the CaribbeanBuilding on a long tradition of joint collaboration in the region, and the desire formore self-reliance and less dependency on donors, the Directors of national AIDSprogrammes from 12 countries agreed in 1996 to set up a new process for “horizontal”interregional technical cooperation. As part of the reciprocal process ofexchanging experience, information and technology on equal terms, for example, theHorizontal Technical Collaboration Group (HTCG) has encouraged intercountry visitsso that members can see first-hand how to improve drug management and distributionin rural areas. Through a multicountry survey conducted by the Group on theprices being paid for HIV-related drugs and commodities, countries became awareof major price differences and were in a better position to negotiate price reductionswith pharmaceutical companies. Argentina, for instance, was able to reduce the costof measuring viral load from US$ 250 to US$ 70. The HTCG also provided the initialimpetus for establishing a revolving fund for HIV-related drugs under the auspices ofthe Pan American Health Organization, WHO’s Regional Office for the Americas. Thefund is now in its initial trial phase.As of May 1999, 21 countries belonged to the HTCG* and efforts are now under wayto incorporate national AIDS programme Directors from Central America and fromthe English-, Dutch- and French-speaking countries in the Caribbean.* Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador,Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay and Venezuela.Comprehensive care and support strategy neededIn the early 1990s, WHO’s Global Programme on AIDS advocated that care and supportfor people living with HIV or AIDS should be comprehensive – embracing thepsychological/spiritual, social and medical dimensions – and integrated, with thevarious providers offering a “continuum of care” centred on the clients’ needs.This vision remains relevant today. As discussed earlier (see page 85), people withHIV infection need a range of measures to support them (and their families) in copingwith their situation and to enable them to live healthy, productive lives for as longas possible. Counsellors, religious communities and family members should providevital care and support at home and in the community. For diagnosis and therapy,patients and their carers must in turn be able to rely on the support of health services,such as home and community care programmes, private practitioners, localhealth centres, and clinics and hospitals.91