Scaling up antiretroviral therapy: experience of the Joint Clinical Research Centre (JCRC) access programme

Despite Uganda’s success in lowering the rate of HIV infection, numbers of people already infected and progressing to AIDS continue to rise. The JCRC pioneered the use of antiretroviral drugs in Africa since 1992, and developed a successful model that incorporates drugs logistics, adherence and sustainability strategies, as well as regional referral centres of excellence and laboratories. JCRC rapidly established 35 satellite centres in the various districts, currently providing antiretroviral drugs to over 35 000 out of 70 000 patients on therapy. Increased access to treatment proceeds contemporaneously with improving infrastructure, while addressing critical human resource needs by ongoing training. This model provides data that inform a way forward for a robust, high-quality and sustainable ART programme, and aims to integrate into an improved national continuum of health care delivery.