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E-DRUG: E-DRUG AIDS 98 treatment-access forum, [email protected]
As we have mentioned on this and other mailing lists, the UK NGO AIDS
Consortium is holding an International Seminar on Access to Treatment for
HIV in Developing Countries 5 - 6 June (Friday and Saturday) in London,
UK.
The first day will feature a series of presentations by speakers from PWA
groups, activists, healthcare workers in the field, and representatives
from WHO, UNAIDS and the French Government, on issues surrounding Access
to Treatment to HIV.
On the morning of the second day, the participants will meet in five
smaller groups (chosen by themeselves) to discuss five themes (listed
below) in more detail, and to identify key themes and guiding principles.
Our hope is that by the end of seminar, we will have found areas of
consensus which will be a basis to move forward and areas where there is
not yet agreement.
Below we have listed descriptions of the five theme groups and some
questions to consider. I would ask that if the members of this mailing
list have useful contributions on any of these themes, we would welcome
your comments. Please send them as soon as possible, since if we receive
your contributions before 5pm GMT on Thursday 4 June, they will be
incorporated into our discussions on Saturday 6 June.
We will be communicating the results of the seminar on this mailing list
next week. If you would like any more information on the seminar, please
feel free to contact us directly at the address below.
Sue Lucas Siobhan Wilson
Co-ordinator Project Officer
UK NGO AIDS Consortium
37-39 Great Guildford Street
London SE1 OES, UK
Tel: 44 171 401 8231
Fax: 44 171 401 2124
Email: [email protected]
Interim Report available at:
www.bmaids.demon.co.uk/ukaidscon/accrpt.htm
FIVE THEME GROUPS
Group 1
The relationship of treatments and drugs to the concept of care
* How does the supply of drugs (in particular Combination Therapy) relate
to the commitment to care and treatment? Does the symbolic value of drugs
blind us to other humane and meaningful care issues?
* Given that the fight for ARVs has provoked a great deal of
international attention, how has this helped raise issues about the
current inequality about access to treatment between industrialised and
developing countries?
* and how does the fight for the right to ARVs relate to the ability of
governments/local communities/healthcare providers to respond to basic
care issues? Who is driving the debate and who has control?
* What is the current philosophy of care of NGO's and is there any
consensus? Does this involve the explicit procurement and provision of
medication?
* Does this have to change around mother to child transmission and
treatment for PLHA's and if so why?
* The reality of lack of resources can stifle and/or ground us - How do
we respond? - How do we determine priorities in allocating resources?
* What options do we have for more collaborative work with a common
objective?
Group 2
The current health care systems (government, non-profit and private
sector) and how these relate to care for people with HIV/AIDS.
* How are care and treatment currently made available? Do they reach
everyone in need, and if not what are the current gaps and obstacles to
provision of care and treatment?
* Who are the key players in this ?How do government, NGO, activist and
private sector interact? What role is there (if any) currently and in the
future for commercial interests including the pharmaceutical companies?
* Can current systems be adapted to allow for delivery of new ARV
treatments and the supporting services to go with it?
* If a change in systems is required, what would realistically be needed?
* What about sustainability?
Group 3
The differences and similarities between community development principles
and current treatment activism strategies.
A community development approach would be driven by the needs recognised
by affected communities in their own circumstances:
* Is this happening with the demands for the latest HIV treatment, or are
such demands coming from a northern perspective without taking into
account the different needs of a southern perspective?
* Is it appropriate for demands for HIV treatment to take into account
the different circumstances of people in developing countries, or should
demands be for the highest standards for everyone?
* How do these different approaches take into account the maximisation of
quality of life for people affected?
* How do they take into account the need for training and development of
infrastructure?
* If resources are allocated to treatment in response to activist
demands, does this mean that resources for essential support services at
community level will be or should be reduced?
Group 4
Learning from the experience of other diseases and essential drugs
strategies.
* National drug policies and essential drug programmes aim to provide a
safe and sustainable drug supply to meet overall national public health
priorities equitably, and to ensure the rational use of all drugs in both
the public and private sectors. How do the available treatments for
HIV/AIDS fit?
* Can lessons from the drug and non-drug treatments of cancer be applied
to HIV/AIDS? What are the minimum conditions for ARVs to be provided
safely and sustainably and what is the cost of the total package?
* How should palliative care be delivered? Do alternative treatments have
a place?
* What should be learnt from the failures and successes of TB programmes
in terms of development of drug resistance, adherence to treatment and
Directly Observed Therapy (DOTs)?
Group 5
The relationship of treatment and drugs to the links between care and
prevention and public health issues.
There is a close link between care and prevention. Prevention without
care increases the isolation and exclusion of those infected, denies
respect to those infected and implies that those who are infected have
themselves to blame. This is counter productive, since it makes those
uninfected or untested more convinced that "AIDS doesn't happen to people
like me" thus making prevention messages ineffective.
* How does treatment link into this?
* How should we think about allocation of resources as treatments become
more available?
* With better treatment will it be easier to maintain the links which we
already know about between care and prevention, or will the links become
weakened because of a focus on treatment?
* What measures and policies will help to keep the links strong while
making the most of available, accessible treatment?
Treatment is also used directly for prevention
* What priority should be put on provision of AZT for preventing mother
to child transmission?
* Does treatment which reduces viral loads reduce infectivity? What are
the implications for public health policy?
* Effective treatment for TB both prevents the spread of TB and
alleviates the effects of HIV. What are the implications for resource
allocation?
* Treatment of sexually transmitted diseases has been shown to reduce the
incidence of HIV transmission. What are the implications for resource
allocation?
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Carolyn Green
3 Leslie Grove, Croydon, Surrey CR0 6TJ, UK
telephone: +44(0)181 686 3831
email: [email protected]
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