access to HIV treatment through community-based organizations

[Guest guest]

This joint publication of SIDACTION, UNAIDS and WHO entitled " Expanding

access to HIV treatment through community-based organizations " is

available at:

http://www.sidaction.org/pro/assocetran/accescommun/index_html/view

This report describes a ground-breaking research by Sidaction, a

Paris-based treatment rights group which supports community responses to

AIDS in low- and middle-income countries. The results show that many

African community-based organizations are already dispensing

antiretroviral therapy on a significant scale. Others will soon begin, and

still others are facilitating access to treatment through advocacy,

education, voluntary counselling and testing, bulk purchasing of

medicines, and mutual support.

Indeed, some are providing comprehensive, free-of-charge " total patient

care " services, from entry into testing, followed by treatment,

monitoring, and support for adherence to treatment regimens. These

community efforts are often mounted by people living with HIV and are in

direct response to the actual needs of those affected, including

underserved groups such as women and children.

The research confirmed that community efforts to provide treatment

represent an important opportunity to enrol more people in antiretroviral

therapy. To seize this opportunity, national governments and the

international community need to quickly provide support to expand the

coverage and impact of community-based treatment. The aim is not to

replace work rightfully done by the public sector with action by

community-based organizations. The challenge is to find ways for community

organizations to mobilize to respond to their particular HIV situation,

while working hand-in-hand with the public health sector, so that each

reinforces the efforts of the other.

This is already happening in many places-community-based organizations are

coming together and joining with the public sector to provide services

that complement public health efforts. But community efforts need support.

These organizations need funding to finance the purchase of

antiretrovirals, other medicines and diagnostics. They need national and

subnational policies that support decentralizing treatment beyond urban

centres and selected physicians. They need the ability to train staff and

clients in treatment literacy, and they need technical assistance to

improve and monitor quality of services.

As they have done throughout the AIDS epidemic, communities will rise to

confront the challenges they face and will struggle to do what needs to be

done. They should not have to struggle alone. They should be recognized as

full partners and supported in a united effort to reduce the tragic and

unnecessary deaths and suffering caused by this epidemic, and by the

glaring inequities in health care and treatment throughout the world.

SIDACTION

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