Global Enhancing Care Initiative Develops Comprehensive Framework To Improve HIV/AIDS Care in Resource-Poor Countries

Local Experts Join Together to Improve the Levels of Care and Provide Long-Term, Sustainable Solutions. A new nine-point AIDS care framework which outlines a comprehensive approach to enhance HIV/AIDS care within resource- poor regions is now available through the Enhancing Care Initiative (ECI). The ECI AIDS Care Framework has been designed to assist countries in developing programs to analyze the impact of AIDS in their region and create concrete improvements in AIDS care for those affected by the disease. During a roundtable today at The Fourth International Conference on Home and Community Care for Persons Living with HIV in Paris, France, representatives from Brazil, Senegal, South Africa and Thailand presented local findings from their countries or provinces and examined the nine-point framework, which addresses epidemiology and availability of medical services, cost and economics of care, and ethics and human rights in relation to the provision of improved care for those living with HIV. Participants in the Enhancing Care Initiative have highlighted the needs of their own countries and also agreed on the need to prioritize HIV/AIDS care around the world. "We need to mobilize our communities and ensure that the campaign against HIV is active in every sector of our society and that every household and every individual is involved in the fight against HIV and AIDS," said Dr. Zweli Mkhize, minister of health, Kwa Zulu-Natal, South Africa. Dr. Mkhize's comments reflected the overall agreement by ECI participants that countries must work together to prioritize HIV/AIDS care. "In Senegal," said Professor Souleymane Mboup, president of the Senegalese Committee for AIDS Prevention in Dakar and team leader for ECI in Senegal, "we are delighted that we will be able to incorporate the improvements to HIV clinical care that have resulted from the ECI team evaluation into our future national AIDS care planning. The Senegal ECI team will enable us to enhance the clinical healthcare efforts considerably." During the Paris roundtable, each country team was able to clearly identify its particular care needs. The participants then described specific projects undertaken to date within the ECI framework, highlighting programs and results. The ECI will use this information to prepare an outline for specific care problems anticipated in each country for the year 2000 and to establish priorities for implementing solutions by the year 2005. This roundtable is part of the promotion, development and consultative process that is integral to The Enhancing Care Initiative, a team approach to the HIV/AIDS pandemic which has developed individualized models for resource- challenged countries. The Initiative includes participation by community groups, governmental and intergovernmental organizations, international bodies such as the WHO, UNAIDS, ICASO, and the International HIV Alliance, as well as local non-governmental organizations (NGOs) and AIDS service organizations (ASOs). The Enhancing Care Initiative, which began in 1998, is coordinated by the Harvard AIDS Institute and the Francois-Bagnoud Center for Health and Human Rights of the Harvard School of Public Health and sponsored by The Merck Company Foundation. ECI PREMISE: LOCAL CHALLENGES REQUIRE LOCAL EXPERTISE Designed as a five-year program, The Enhancing Care Initiative facilitates the development of multidisciplinary teams which research needs and set specific priorities to enhance HIV care on a regional basis in Latin America, Africa and Asia, the areas of the world hardest hit by HIV. The ECI AIDS Care Framework promotes the formation of a team consisting of a combination of local specialists, including people living with and affected by HIV, and experts drawn from areas of clinical care and medical research, epidemiology, social behavior, human rights, political science, economics and health planning, as well as government and policy making. This interdisciplinary team works together to first evaluate the clinical and community care needs and then propose feasible and cost-effective improvements particular to its own region or country. "We are extremely pleased with the results so far," commented Dr. Richard Marlink, executive director of the Harvard AIDS Institute and one of the designers and key team members of the Enhancing Care Initiative. "We are delighted that the ECI AIDS Care Framework is proving a broad model to create locally applicable improvements in care. While the AIDS care problems and solutions will vary from team to team, we are hopeful that this large team approach may also apply in other care settings to help develop sustainable programs within resource-constrained countries." The Enhancing Care Initiative has developed AIDS Care Teams in four regions of the world and is expanding its reach through the use of the ECI AIDS Care Framework. The philosophy of the ECI is based on the belief that concrete and practical improvements in HIV/AIDS care can and must be developed. The effective improvement in care of persons living with HIV/AIDS in vastly different settings requires the participation of local experts who best understand the unique challenges of their region. As such, the heart of the ECI lies with the ECI partner AIDS Care Teams -- formed, comprised of, and lead by nationals of that region. Information about the Enhancing Care Initiative and the nine- point AIDS Care Framework can be found at: ots Original Text Service: Enhancing Care Initiative Internet: Contact: Michael Broder of Harvard AIDS Institute, +617-432-4121, or Kelley P. Dougherty of Merck & Co., +908-423-3112 Web site: Web site:

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