Targeting criteria in national arv programs mexico senegal and uganda
Download
1 / 10

Targeting Criteria in National ARV Programs: Mexico, Senegal, and Uganda - PowerPoint PPT Presentation


  • 101 Views
  • Uploaded on

Targeting Criteria in National ARV Programs: Mexico, Senegal, and Uganda. XV International AIDS Conference Bangkok, July 2004. Catherine Chanfreau, MD, MPH Sara Bennett, PhD Abt Associates, Bethesda, USA . Presentation objectives .

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Targeting Criteria in National ARV Programs: Mexico, Senegal, and Uganda' - dee


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Targeting criteria in national arv programs mexico senegal and uganda

Targeting Criteria in National ARV Programs: Mexico, Senegal, and Uganda

XV International AIDS Conference

Bangkok, July 2004

Catherine Chanfreau, MD, MPH

Sara Bennett, PhD

Abt Associates, Bethesda, USA


Presentation objectives
Presentation objectives Senegal, and Uganda

  • Identify explicit factors used to target government-subsidized ART in Uganda, Senegal, and Mexico

  • Review priority criteria used in two national ART programs and one major pilot project


Background
Background Senegal, and Uganda

  • Continued gap between access to and need for ART

  • Explicit policy commitment to provide ART to all those in need

  • Not always feasible in the short term: interim targeting is occurring

  • International clinical guidelines on how to scale up ART exists

  • Lack of policy guidance on how best to allocate scarce life-saving resources


Selection process in the proposed ugandan national arv policy
Selection process in the proposed Ugandan National ARV Policy

HIV+ Individual

Meets clinical eligibility criteria

Assessment of likely adherence

Unlikely to

comply: excluded

Likely to comply:

Eligible HIV+ individual

  • Priority eligibility for:

  • Pregnant women (PMTCT)

  • Health workers (PEP)

  • Mothers identified in PMTCT and their HIV infected family members (PMTCT+)

  • Orphans and vulnerable children

  • People enrolled in support activities

  • Participants in research projects

Ordinary eligibility

ACCESS TO

FREE ART

IMMEDIATE ACCESS TO

FREE ART


Selection process in the initiative s n galaise d acc s aux arv isaarv
Selection process in the Initiative Sénégalaise d’Accès aux ARV (ISAARV)

HIV+ Individual

Senegalese Residency

Meets clinical eligibility criteria

Social investigation: adherence & ability to pay

Likely to adhere:

Exempted from payment:

HIV/AIDS activists

Health workers

Unlikely to

adhere: excluded

Likely to adhere:

Eligible HIV+ individual

Determination of

patient’s

contribution

Patient accepts

contribution rate

ACCESS TO ART


Selection process in national arv policy in mexico
Selection process in National ARV policy in Mexico aux ARV

HIV+ Individual

Meets clinical eligibility criteria

Uninsured Individual

Insured Individual

  • Meets MoH program for free care (SSA*) eligibility criteria

  • Citizenship

  • Residency

  • Inability to pay for ART

  • Commitment to adhere to treatment

Consent to start and

Adhere to treatment

No prior history of

ART treatment:

Placed on waiting list

Previously

Treated on

ART

Priority accorded to

those at more acute stage

of disease

ACCESS TO ART

SSA: Programa de accesso gratuito a tratamiento Antiretroviral para la poblacion no asegurada de bajos recursos economicos


An anatomy of prioritization
An Anatomy of prioritization aux ARV

  • Biomedical factors: patient’s clinical ability to benefit from ART

  • Prospects for adherence to treatment: patient’s likelihood to comply

  • Prevention-driven factors: “focused ART ” is the matching piece of UNAIDS “focused prevention” strategy


An anatomy of prioritization cont
An Anatomy of prioritization (cont.) aux ARV

  • Social and economic benefits: positive externalities associated with sub-groups

  • Social and political empowerment: selection based on gender or role that individuals have played in the fight against HIV/AIDS

  • Financial factors: ability/inability to pay for treatment

  • Ethical arguments: poor and vulnerable children


Conclusions
Conclusions aux ARV

  • Targeting enables the scale-up of universal access to ART using a “step by step” approach

  • Explicit targeting criteria are used to allocate public subsidies andformulate policy strategies

  • Biomedical criteria are evidence-based

  • Prospects for adherence to treatment and biomedical criteria are used in virtually all settings

  • Social and political empowerment is a recurrent factor

  • Prevention-driven factors are internationally endorsed ( PMTCT plus)


Thanks merci
Thanks … Merci aux ARV

  • Governments of Uganda and Mexico

  • ISAARV team

  • USAID Uganda


ad