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New 'From-the-Ground' Report Reformulates Simplistic Argument About HIV/ AIDS and Health Care Systems in a Fundamental Way

Dr. Jim Kim of Harvard School of Public Health joins International Treatment Preparedness Coalition to release new report and call for broad, systematic approach to HIV/AIDS and health care scale up

NEW YORK and HARARE, Zimbabwe and BOSTON and SAO PAULO, Brazil, July 29 /PRNewswire-USNewswire/ -- The International Treatment Preparedness Coalition (ITPC), a group of 1,000+ treatment advocates from more than 125 countries, issued its sixth report on delivery of AIDS treatment today. Missing the Target #6: The HIV/AIDS Response and Health Systems: Building on success to achieve health care for all is available at

The new report, launched during a teleconference with Dr. Jim Yong Kim, Director of the Francois-Xavier Bagnoud Center for Health and Human Rights (FXB) at Harvard University and advocates from around the world, provides some of the first from-the-ground research to inform the debate on HIV treatment scale up and its interaction with health systems. It includes reports from six countries: Argentina, Brazil, the Dominican Republic, Uganda, Zambia and Zimbabwe.

Dr. Kim praised the report and noted that it is both welcome and timely to set the stage for the next phase of research and investigation for AIDS services and health care systems scale up in developing countries.

"The report shows that each country situation is complex. Every country has made thousands of decisions, good and bad. What we are seeing now is that funding for HIV is, for the first time in history, directed at chronic care for a chronic condition. We have the opportunity to think hard about what it will take to keep a large population of people healthy over their entire lives. What we know is that it takes more than just antiretrovirals. This report takes us to the point of reformulating in a fundamental way the argument over HIV and health systems," Dr. Kim said.

Matilda Moyo, a co-author of the report's Zimbabwe chapter said, "What we found was that HIV/AIDS services, particularly provision of antiretrivirals, have become a lifeline for the health care system in Zimbabwe. In the midst of the economic and political crises, a consistent focus on HIV health services has been an oasis in a whole desert of the collapsing health delivery system."

Problems in Zimbabwe include extreme shortages of healthcare workers, with one doctor often responsible for providing services for 8,000 patients, frequent drug stock outs and a crumbling healthcare infrastructure. "Some donors such as the Global Fund have come together to provide much needed financial resources for Zimbabwe," added Moyo. "For example, efforts have been made to invest in infrastructure through HIV programs which has boosted the general health delivery system."

Alessandra Nilo, a co-author of the report's Brazil chapter, said, "In Brazil, HIV/AIDS services have been scaled-up in conjunction with the expansion of general public health. The scale up of AIDS services has also had positive impacts on human rights, education and sexuality in Brazil."

Brazil has been cited as a great success story for developing strong HIV treatment and prevention programs as well as general public health programs. Nilo added, "Despite the success of integrating HIV and general health systems, we still identified clear and distinct benefits for maintaining dedicated HIV-related services."

"The AIDS response in Zimbabwe, Brazil and other countries shows that new investments in health can have dramatic impact. But a simple reshuffling of health resources toward more generalized health functions at the expense of effective disease-specific programs, such as HIV/AIDS, would jeopardize the remarkable advances that have been made and leave the more than six million people who urgently need AIDS treatment without this care," said Chris Collins, a co-coordinator of the report.

"The scale up of antiretroviral therapy in the developing world is the most ambitious public health undertaking of our lifetimes," said Gregg Gonsalves, a co-coordinator of the project. "We were told it couldn't be done, and shouldn't be done, but we persevered, set ambitious goals and targets, and now 3 million people are on antiretroviral treatment."

"AIDS is a disease of primary health care, and we need to strengthen health systems to provide for the future of AIDS treatment," Gonsalves added. "We are the heirs of Alma Ata. We will make comprehensive primary care -- health for all -- a reality. We'll be told again that it is impossible. Well, we've done the impossible and will do it again. What ITPC is about is finding out what people need and what is happening on the ground, and then pushing to make the changes that will save people's lives."

"If the UN's health-related Millennium Development Goals (MDGs) are to have and chance of being realized, we need to do for health systems what we've done for AIDS, while increasing the momentum of the response to AIDS," added Collins.

Key findings from the report include:

1. The HIV/AIDS response to date has had sizeable positive impacts on health care in many settings: building infrastructure and systems, raising the bar on quality, extending the reach of health care to socially marginalized groups, and engaging consumers.

2. But new investments in HIV/AIDS services have also exposed existing fragilities in health systems. In some cases expanding demand has stretched already overextended human resources and placed increasing burdens on infrastructure.

3. The engagement of health consumers and advocates in AIDS scale up has forced global and national leaders toward a more vigorous sense of accountability and urgency, both critical elements in the success of AIDS programming.

About the International Treatment Preparedness Coalition

The International Treatment Preparedness Coalition (ITPC) was born out of the International Treatment Preparedness Summit that took place in Cape Town, South Africa in March 2003. That meeting brought together for the first time community-based HIV treatment activists and educators from over 60 countries. Since the Summit, ITPC has grown to include more than 1,000 activists from over 125 countries and has emerged as a leading civil society coalition on treatment preparedness and access issues. On the web at

SOURCE International Treatment Preparedness Coalition
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