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Carlos F. Cáceres Multidisciplinary Research on ARV-based Prevention 30 June 2013 Kuala Lumpur. IAS Policy and Advocacy priority on Treatment as Prevention . TasP Advisory Group, IAS. Goal - PowerPoint PPT Presentation
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IAS Policy and Advocacy priority on
Treatment as Prevention Carlos F. Cáceres
Multidisciplinary Research on ARV-based Prevention30 June 2013 Kuala Lumpur
TasP Advisory Group, IAS
GoalTo expand access to antiretrovirals for individual and societal benefit and to investigate and address programmatic and implementation challenges
Objectives
To disseminate the results of research on the individual and community benefit of antiretrovirals and on their use for prevention, bridging the gap between science and implementation
To work with civil society, National AIDS programmes and other stakeholders to deliver services and to ensure increased access to high quality prevention, care and treatment, including antiretrovirals
To create opportunities for dialogue and discussion at national, regional and international levels on increasing access of quality antiretrovirals for treatment and prevention
Key areas of TasP implementation
economic issues policy, legal, legislative and regulatory issues impact on health care systems and health
care providers, and additional challenges or benefits it can bring
Individual and social issues
Zambia consultation- March 2013
Concerns: HIV testing done when people
seek medical help for health symptoms or pregnancy
inadequacies in staffing and workload
low quality of care and health worker attitudes
unacceptable waiting time poor confidentiality poor follow up difficulties in reaching people
in rural areas urban bias in services
Ways forward: ensure efficiency and
effectiveness of health service task shifting of community health
workers investment in long term security
of drug supply to ensure diversity, sufficiency, affordable production/ acquisition
national analysis on cost modeling based on the PopART
work across disciplines and departments
shortening the time between HIV diagnosis and ART initiation
mobile companies to support adherence
Zambia consultation- March 2013
•new partnerships and alternative funding mechanisms: mining licenses, corporate social responsibility programmes, levies
•tracking investment of the government in treatment and health care
Financing
•investment in prevention•adherence to ARTBehavioural
issues•making testing accessible and acceptable •reduction of barriers to ART initiation Patient centred
approach
•voluntary and confidential testing•patients’ choice when to start treatment•decriminalization of sex work, IDU and MSM
Human rights
•adoption of TasP as a national policy •TasP as a way to establish National Health Fund•opportunity to consolidate policiesCountry
ownership
France consultation- April 2013
knowledge of TasP reduction of the number of people not knowing they have
HIV status responsibility of all stakeholders
risk of categorising people living with HIV TasP must not become a new moral standard no enthusiasm or consensus on TasP
use of condoms remaining the main part of combined prevention incorporating the effects of preventive treatment
for the populations most exposed to HIV, TasP seems to complement pre-exposure prophylaxis (PreP)
certain consensus on TasP to guide the next national recommendations on care for people living with HIV
Recommendations: France
A common position on forms of treatment needs to be developed, highlighting in a more positive way the individual benefits of taking part in an ARV programme
More research is needed on the effect of TasP on MSM how TasP and PreP complement each other effect of early treatment on treatment options and choices
Prevention needs to incorporate the effects of preventive treatment, promoting lifelong individualised combined prevention and be based on the use of condoms
A major focus needs to be put on screening as a way of revealing the "hidden epidemic” Improving access to care and getting people to remain in care
the needs of patients need to be at the centre social determinants of health GP- incorporation of sexual health and quality of life are further challenges in
improving care effects of long-term treatment
Advocacy priorities, mainly focused on the issue of funding improvements in the fight against AIDS in France (financing prevention, sexual health education and sexual health centres, etc.). Such advocacy can be the precursor to a discussion on treatment costs, based on the introduction of generic drugs in France.
IAS – WHO Pre-Conference- 29 June
Presented and discussed scientific evidence and programme experience across regions on maximizing the treatment and prevention benefits of ART for key populations
Discuss human rights and ethical implications of maximizing the treatment and prevention benefits of ART for key populations
Formulated research questions in the context of maximizing the treatment and prevention benefits of ART for key populations
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