World Vision

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World Vision Experiences in Making ART
Treatment Affordable and Available Dr. Daniel J
Malleboyina M.B.B.S, MBA, MPH Regional Advisor
HIV AIDS- Asia Pacific Region WORLD VISION
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ACCESS to TREATMENT

• Understanding the dynamics of treatment is
  critical to facilitate access. (Technical,
  Availability of drugs Compliance)
• Free ARV's does not mean that there will be a
  free ride. It still costs to get ARV's
• Expanded response of Access to treatment of ART
  decreases the incidence of HIV
• Children need special budgetary allocation for
  HIV treatment and custom made drugs - WV is
  advocating for 12 budgetary allocation for
  children

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AFFORDABILITY

• ARTs are being made Affordable (132-140US per
  year in low economic countries and 3-4 dollar
  for CD4 test)
• Affordability to treatment is directly dependent
  on Leadership. (Individuals, International bodies
  (UNGASS), NGO's(Positive Action Foundation in
  Philippines), Governments and the communities)
• Treatment Affordability is becoming possible
  through true commitment in multi-sectoral
  partnerships
• There is a lot still to be accomplished and more
  advocacy for ARTs is still needed.

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Elements of the ART Capsule

•  
• Costs - Drugs take 50 - 75 of the budget for
  HIV reduce mortality and morbidity, decrease in
  hospitalizations costs, decreases in new HIV
  infection
• Capacity Building of the health care system
  Docs, nurses lab staff
• Lab facilities equipment, maintenance,
  continuous supply of electricity
• Supply chain management of ARVs, OI drugs and
  laboratory material
• Financial management is also very critical
• Leadership is critical and control of corruption
• Adherence Money for OI and Transportation
• Other issues like confidentiality, home based
  care, counseling, etc

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ARV financing

•  
• 50-80 of the funding is from external sources
  in low income countries either from
  individuals, Global Fund, PEPFAR, Bilateral
  Multilateral donors, Faith Based Organizations
  Foundations, UN and WHO
• PLWHAs their personal contribution to
  treatment of ART and OI is much higher than
  governments
• Clinton Efforts in making ARVs affordable to
  the poorest should never be forgotten

6
Government Financing

• Mainstreaming - into Government budget has been
  effective. ex Kenya Tanzania (Tanzania - from
  36 million in 03 to 286 million in 06-07)
  Increases non-health sectoral involvement need
  coordination,
• Universal Access to therapy in Brazil
  Government is making this possible though there
  are challenges. 17 of the ARV drugs available
  with 8 being produced in Brazil

7
Community Financing

• African Health Project (Kogi State in Nigeria)
  worked with 212 public schools (140,000 children)
  secondary schools and raised funds for the
  infected.
• Capacity building of 5000 General doctors South
  Africa for ART treatment

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World Vision Financing - CSO have been financing
some elements of ART capsule

• Cambodia build capacity National Pediatric
  hospital into excellence center for pediatric
  ART Home based care and OI for PLWHAs WV
  assisting 3000 to 5000 to get ARVs in 9
  provinces with home based care team
• India HIV doctor giving ART and OI treatment in
  Chennai in India the center provides VCT and
  Micro-nutrition, linkages to the TB center for
  1400 PLWHAs
• Ghana WV spends 60 of the National budget on
  ARVs
• PNG Assistance provided to 300 PLWHAs
• Financing for transportation, OIs nutrition

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World Vision Financing

• Somalia ART treatment commenced by WV and taken
  over by UN Agencies
• Armenia Principal recipient of ARVs (Global
  Fund)
• Zambia in 19 districts WV does comprehensive
  programs on ART coverage with nutrition in 2
  districts
• Referrals to Government and Follow up Malawi,
  Vietnam, Thailand and Brazil
• Several PMTCT programs Cambodia Zambia

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World Vision Advocacy Focus

• UNGASS
• Advocated for special focus on childrens
  treatment with 800 other CSOs
• World Leaders agreed to ensure that HIV infected
  women and infants have access to effective
  treatment to reduce mother to child transmission.
  
• Commitment to intensify investment in research
  and treatment and R and D for pediatric ART
  formulations. World leaders recognized the need
  to provide 20 billion - 23 billion annually to
  address the global response to HIV and AIDS by
  2010.
• World Vision welcomes the decisions to set
  ambitious targets during 2006. However, with the
  absence of any other timeliness or targets, WV is
  concerned that with no other time bound targets
  this may not be achieved.

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WV Advocacy Focus Con

• 1. Stop the needless deaths of parents - ensure
  at least 80 of adults in need of treatment have
  access to appropriate antiretroviral therapy.
• 2. Stop the needless deaths of children - ensure
  that at least 80 of all children in need of
  treatment have access to HIV and AIDS treatment,
  including antiretroviral therapy, and at least
  80 of HIV-positive pregnant women have access to
  prevention of mother-to-child-transmission
  (PMTCT) services.
• 3. Improve the lives of orphans and vulnerable
  children
• 4. Preserve an HIV-free generation
• 5. Reduce the unacceptable vulnerability of girls
  
• 6. Faith based Approach