Despite the increased emphasis on providing medication to people living with HIV and AIDS in developing countries, difficulties is providing consistent treatment still exist. In developing countries, a challenge for the initiation and expansion of HIV treatment has been the limited capacity of health commodity supply chains to ensure a reliable supply of medication at service delivery sites. Estimating the need and ensuring a constant supply of HIV medication to hospitals is a difficult task, especially in regions already plagued with sub-standard infrastructure. As a result, health ministries experience stock-outs of both adult and pediatric formularies. Such stock-outs have a devastating clinical impact on the individuals who are unable to receive their medication, weaken regional healthcare-delivery infrastructure, and result in greater healthcare expenditures.
Past evaluation of drug management systems have focused on information gleaned solely by government officials and/or individuals from cooperating agencies (such as the WHO or UNAIDS). Instead, AFAI will target civil society, a group with increasing leverage in the HIV and AIDS arena. Civil society’s engagement ensures recognition and compliance with basic human rights, expands implementation capacity, and improves services, especially for marginalized groups. Civil society groups are increasingly being included in the development, implementation, and monitoring of national HIV strategies, and offer a unique perspective on medication delivery systems. Over the past 8 years, AFAI has built a Department of Advocacy renowned in the Latin American and Caribbean region, characterized by dedication, passion, and professionalism. AFAI staff and programs have developed countless contacts throughout the region, which will be a vital resource during the assessments.
For the remainder of 2009, AFAI will pilot the needs assessment in 3 countries: Peru, Guatemala, and Honduras. Based on the experiences and outcomes from the pilot countries, AFAI will make any necessary adjustments in the tool and/or format of the evaluations and submit a request to continue the needs assessment in 7 additional countries during 2010.
Our hope is that our completed reports, based on data derived from civil society, will be merged with existing reports from governments and cooperating agencies, thus presenting a comprehensive picture of the system for procurement and delivery of pediatric antiretrovirals in each country.