The President’s Emergency Plan for AIDS Relief calls for critical interventions in the areas of prevention, care, and treatment. These interventions are designed to:
- Prevent 7 million new infections.
- Care for 10 million people affected by AIDS, including HIV-positive individuals and children orphaned or made vulnerable by HIV/AIDS.
- Treat 2 million HIV-positive people with lifesaving antiretroviral therapy.
The Twinning Center supports these goals by focusing on the following program areas:
Prevention of Mother-to-Child Transmission of HIV (PMTCT)
Simple interventions can significantly reduce the risk of HIV transmission from mother to child. Routine testing of pregnant women, targeted administration of antiretroviral prophylaxis, improved childbirth and breastfeeding practices, and malaria control all play a role.
Promotion of Abstinence and Fidelity
Behavior change programs that promote abstinence and fidelity as methods of prevention can be an effective tool in the fight against AIDS. One Twinning Center partnership, between the Kenya Episcopal Conference-Catholic Secretariat and Chicago’s DePaul University, is expected to reach half a million Kenyan youth with a message of abstinence by early 2006. Such messages resonate culturally and morally with many communities.
Blood Safety
The World Health Organization estimates that transfusions of infected blood account for between 5 and 10 percent of new HIV infections. The establishment of coordinated screening systems—including the infrastructure and personnel to support them—
is necessary to ensure safe blood supplies in the focus countries.
Injection Safety
Safe injection practices at hospitals and clinics can prevent transmission of HIV and other infectious diseases to patients and healthcare workers alike. Applying universal precautions and increasing the availability of post-exposure prophylaxis can also help dispel the reluctance and fear that some practitioners have to treating HIV/AIDS patients.
Other Prevention
Prevention efforts can take many forms, from condom promotion to information campaigns. In one innovative Twinning Center program, the US-based Kaiser Family Foundation is providing technical support to strengthen Zambian journalists’ ability to provide coverage of the HIV/AIDS epidemic. Accurate information is essential to prevention, to reducing stigma, and to encouraging people to seek testing and treatment.
Palliative Care: Basic Healthcare and Support
Palliative care can include everything from pain management to psycho-social and spiritual support. Ideally, palliative care is offered in tandem with lifesaving antiretroviral therapy, but even when such therapy has failed or is not available, palliative care ameliorates symptoms and increases quality of life. With Twinning Center support, the African Palliative Care Association is helping to develop national palliative care associations in Zambia and Mozambique.
Palliative Care: Treatment of Tuberculosis/HIV Co-infection
Tuberculosis is one of the most common opportunistic infections to attack the weakened immune systems of people living with HIV/AIDS. It is a leading cause of death among HIV-positive people in the developing world. With Twinning Center support, Brits Hospital and the Foundation for Professional Development in South Africa are developing a model HIV/AIDS clinic that will provide integrated tuberculosis treatment to co-infected patients.
Orphans and Vulnerable Children (OVC)
Children are hit hard by HIV/AIDS. Those who are infected may not live to see their fifth birthdays. Even those who are healthy often take on heavy burdens of responsibility when a parent falls ill or dies. And conditions of poverty in which many children live make them vulnerable to HIV through sexual predation.
Voluntary Counseling and Testing (VCT)
The majority of people living with HIV/AIDS in the Twinning Center’s focus countries don’t even know they are infected. HIV counseling and testing can encourage people to seek necessary treatment, to plan for the future, and to protect both themselves and others. A partnership between the Zambian Defense Force and the Naval Medical Center in San Diego will make VCT available to remote military health posts in Zambia through mobile health units.
HIV Treatment: Antiretroviral Drugs
Antiretroviral therapy has transformed HIV from a death sentence to a chronic disease in the West. But these lifesaving drugs are making their way too slowly to the developing world. Supplying a consistent stream of drugs will require political will, innovative policies, and improved supply chain management.
HIV Treatment: Antiretroviral Services
Because ARV regimens must be strictly adhered to for life, successful antiretroviral therapy requires healthcare workers who understand proven treatment methodologies, who can monitor patients’ progress on the drugs, and who will provide effective adherence support. In creating an ARV clinic in rural South Africa, Twinning Center partners at Brits Hospital and the Foundation for Professional Development will address all these issues.
Laboratory Infrastructure
Accurate laboratory facilities are crucial to long-term treatment of HIV/AIDS. Lab tests help doctors determine when to start patients on antiretroviral therapy. They are also critical for monitoring the effectiveness of therapy in order to maximize results and limit the development of drug-resistant strains of HIV.
Strategic Information
Without accurate information, it’s hard to plan programs that meet local needs and to assess how successful existing programs are. The Twinning Center supports the strengthening of surveillance and health management information systems in focus countries. All Twinning Center partnerships engage in active monitoring and evaluation of their work to ensure and improve success.
Policy Analysis and System Strengthening
Long-term, sustainable solutions to the AIDS crisis in the focus countries will require strong healthcare systems at local, national, and regional levels. Yet AIDS puts an undue strain on developing systems that are already overburdened. Ensuring sustainability of HIV/AIDS projects requires the creation of supportive political environments and system strengthening to institutionalize change.
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