HEALTH - HIV/AIDS IN SUB-SAHARAN AFRICA
Health - HIV/AIDS in Sub-Saharan Africa
Health - HIV/AIDS in Sub-Saharan Africa - South Africa 2
Health - Suzy, 42 year old ARK patient, Mpumalanga, South Africa
Health - HIV/AIDS in Sub-Saharan Africa - Mozambique 1
Health - HIV/AIDS in Sub-Saharan Africa - Mozambique 2
In 2003, the HIV/AIDS pandemic was overwhelming South Africa. Over five million people were infected with the virus, nearly 30% of pregnant women tested positive, and one million children had been orphaned.ARK saw an opportunity to develop a targeted programme to keep HIV+ mothers and caregivers alive, in order to prevent children from being prematurely orphaned.In just six years, ARK’s extraordinary programme enrolled over 10% of total patients on treatment in South Africa, the countrywith the highest need.In 2003, the South African government had an emerging plan to treat patients with HIV/AIDS, but little had happened. Working with the Western Cape provincial government, ARK set out to rapidly scale up AIDS care by establishing and supporting treatment centres inside government hospitals and clinics.
ARK’s approach
In order to achieve its aim of keeping mothers and caregivers alive, in 2003 ARK:
- hired, trained and deployed SWAT (Swift-Acting Treatment) teams of medical professionals
- created an innovative community
- care programme
- built pharmacies
- added temporary clinic space
- delivered antiretroviral drugs
In 2005, ARK expanded its programme to KwaZulu-Natal province, adding the Eastern Cape and Mpumalanga a year later. This rapid expansion was made possible by the partnership ARK developed with the US President’s Emergency Plan for AIDS Relief (PEPFAR) and its grant management partner, Pact.
Patient numbers accelerated, and from nothing ARK was rapidly established as a major contributor to public health, eventually enrolling over 10% of patients on AIDS treatment nationally. ARK also began to achieve sustainability, handing over clinics to government, while continuing to support more through SWAT teams.
Over the course of the programme between 2003–2009, ARK supported a total of 93 clinics in four provinces. PEPFAR played a significant role both in funding the programme and also in ensuring its long term sustainability.
Community Access and Adherence
Antiretroviral therapy (ART) is not simple to take and requires patients to adhere to a strict regime. Missing even a few doses can cause treatment to fail. To address this problem, ARK launched an innovative community adherence programme. Patient Advocates were recruited to support patients to take their pills as required and ensure they returned to clinics for their appointments. They also supported patients to overcome stigma.
As a result of this initiative, as wellas the care and support provided by clinical staff, ARK achieved exceptional adherence rates - 83% of patients remad on treatment at 24 months compared to a national average of 62%. ARK’s Community Adherence model has now been selected by The Global Fund, an international financing institution, which is funding 1,000 new patient advocates across South Africa.
Grant Access
In 2006, ARK launched its Grant Access programme to support eligible families to access governmentfunded social care grants. A recent report compiled by the Economic Policy Research Institute in South Africa provided evidence of the developmental impact of grants.
The report demonstrated that children in households receiving grants were healthier, more likely to attend school and perform better at school than their counterparts from households which do not receive grants. In addition, in the households receiving grants, the adults had more success in finding jobs, helping these families find a way out of poverty.
“HIV/AIDS is no respecter of persons. It was difficult to communicate how desperate the situation was becoming. We needed help and ARK responded wonderfully. God bless you.”