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

Abstract

English: 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.

Afrikaans: Ten spyte van Uganda se sukses in die verlaging van die MIV-infeksiekoers, is daar steeds ’n styging in die getalle van diegene wat reeds geïnfekteer is en na Vigs vorder. In 1992 het die JCRC die gebruik van antiretrovirale middels in Afrika ingelui en sedertdien ’n suksesvolle model ontwikkel wat medisynelogistiek, terapietrou en vol- houbaarheidstrategieë behels, asook uitnemende streeksverwysingsentra en laboratoria. JCRC het spoedig 35 satellietsentra in die distrikte gevestig wat tans antiretrovirale middels aan meer as 35 000 van die 70 000 pasiënte wat terapie ontvang, verskaf. Toe- nemende toegang tot behandeling gaan hand aan hand met verbetering van infrastruk- tuur en die aanspreek van kritiese menslike hulpbronbehoeftes by wyse van voortgesette opleiding. Hierdie model bied inligting om ’n hoë gehalte program daar te stel — ’n program wat robuust en volhoubaar is en daarna streef om deel van ’n verbeterde nasionale kontinuum van gesondheidsorglewering te wees.