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Community-based antiretroviral therapy delivery: eperiences of MSF

Published by: UNAIDS


About

This document presents experiences of how community-based antiretroviral therapy (ART) delivery can improve both the level of access to treatment and the quality of health outcomes for people living with HIV. These experiences illustrate that community-based ART delivery is efficient, effective and high quality. This document draws from several Médecins sans Frontières (MSF) reports and articles regarding its experiences with community-supported ART delivery.

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General Information

SDGs Goal 3: Good health and well-being
Published
2015
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Ensure healthy lives and promote well-being for all

Since the creation of the Millennium Development Goals there have been historic achievements in reducing child mortality, improving maternal health and tackling HIV/AIDS, tuberculosis, malaria and other diseases. In 15 years, the number of people newly infected by HIV each year has dropped from 3.1 million to 2 million and over 6.2 million lives were saved from malaria. Since 1990, maternal mortality fell by 45 percent, and worldwide there has been an over 50 percent decline in preventable child deaths globally.  

Despite this incredible progress, AIDS is the leading cause of death among adolescents in sub-Saharan Africa, and 22 million people living with HIV are not accessing life-saving antiretroviral therapy. New HIV infections continue to rise in some locations and in populations that are typically excluded or marginalised.

Chronic and catastrophic disease remains one of the main factors that push households from poverty into deprivation. Non-communicable diseases (NCDs) impose a large burden on human health worldwide. Currently, 63% of all deaths worldwide stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. The cumulative economic losses to low- and middle-income countries from the four diseases are estimated to surpass US$ 7 trillion by 2025. Additionally, there continues to be underinvestment in the social circumstances and environmental factors affecting health. The job on HIV and health is far from done.

Recognizing the interdependence of health and development, the Sustainable Development Goals (SDGs) provide an ambitious, comprehensive plan of action for people, planet and prosperity and for ending the injustices that underpin poor health and development outcomes.

SDG 3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all. Supporting research and development for vaccines is an essential part of this process as well as expanding access to affordable medicines.

Promoting health and well-being is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 3.

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Ensure healthy lives and promote well-being for all

Since the creation of the Millennium Development Goals there have been historic achievements in reducing child mortality, improving maternal health and tackling HIV/AIDS, tuberculosis, malaria and other diseases. In 15 years, the number of people newly infected by HIV each year has dropped from 3.1 million to 2 million and over 6.2 million lives were saved from malaria. Since 1990, maternal mortality fell by 45 percent, and worldwide there has been an over 50 percent decline in preventable child deaths globally.  

Despite this incredible progress, AIDS is the leading cause of death among adolescents in sub-Saharan Africa, and 22 million people living with HIV are not accessing life-saving antiretroviral therapy. New HIV infections continue to rise in some locations and in populations that are typically excluded or marginalised.

Chronic and catastrophic disease remains one of the main factors that push households from poverty into deprivation. Non-communicable diseases (NCDs) impose a large burden on human health worldwide. Currently, 63% of all deaths worldwide stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. The cumulative economic losses to low- and middle-income countries from the four diseases are estimated to surpass US$ 7 trillion by 2025. Additionally, there continues to be underinvestment in the social circumstances and environmental factors affecting health. The job on HIV and health is far from done.

Recognizing the interdependence of health and development, the Sustainable Development Goals (SDGs) provide an ambitious, comprehensive plan of action for people, planet and prosperity and for ending the injustices that underpin poor health and development outcomes.

SDG 3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all. Supporting research and development for vaccines is an essential part of this process as well as expanding access to affordable medicines.

Promoting health and well-being is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 3.

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The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

  • In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.
  • In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.
  • In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.
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The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

  • In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.
  • In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.
  • In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.
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  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
  • By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
  • By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
  • Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
  • By 2020, halve the number of global deaths and injuries from road traffic accidents
  • By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
  • Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
  • Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
  • Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
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  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
  • By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
  • By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
  • Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
  • By 2020, halve the number of global deaths and injuries from road traffic accidents
  • By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
  • Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
  • Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
  • Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
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These experiences illustrate that community-based ART delivery is efficient, effective and high quality. This document draws from several Médecins sans Frontières (MSF) reports and articles regarding its experiences with community-supported ART delivery. [format] => [safe_value] => This document presents experiences of how community-based antiretroviral therapy (ART) delivery can improve both the level of access to treatment and the quality of health outcomes for people living with HIV. These experiences illustrate that community-based ART delivery is efficient, effective and high quality. This document draws from several Médecins sans Frontières (MSF) reports and articles regarding its experiences with community-supported ART delivery. ) ) ) [field_year] => Array ( [und] => Array ( [0] => Array ( [value] => 2015-01-01 00:00:00 [timezone] => America/New_York [timezone_db] => America/New_York [date_type] => datetime ) ) ) [field_publication_keywords] => Array ( ) [field_publisher] => Array ( [und] => Array ( [0] => Array ( [value] => UNAIDS [format] => [safe_value] => UNAIDS ) ) ) [field_region] => Array ( ) [field_thumb] => Array ( [und] => Array ( [0] => Array ( [fid] => 2046 [uid] => 1 [filename] => 20150420_MSF_UNAIDS_JC2707-1.jpg [uri] => public://20150420_MSF_UNAIDS_JC2707-1.jpg [filemime] => image/jpeg [filesize] => 186957 [status] => 1 [timestamp] => 1488634924 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 841 [width] => 595 ) [alt] => [title] => [height] => 841 [width] => 595 ) ) ) [field_featured] => Array ( ) [field_file_fr] => Array ( ) [field_file_ar] => Array ( ) [field_file_pt] => Array ( ) [field_file_es] => Array ( ) [field_external_link] => Array ( [und] => Array ( [0] => Array ( [value] => http://www.unaids.org/sites/default/files/media_asset/20150420_MSF_UNAIDS_JC2707.pdf [format] => [safe_value] => http://www.unaids.org/sites/default/files/media_asset/20150420_MSF_UNAIDS_JC2707.pdf ) ) ) [field_external_link_text] => Array ( [und] => Array ( [0] => Array ( [value] => External Link [format] => [safe_value] => External Link ) ) ) [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [name] => Library Manager 1 [picture] => 0 [data] => a:2:{s:7:"contact";i:0;s:7:"overlay";i:1;} [entity_view_prepared] => 1 ) [#items] => Array ( [0] => Array ( [value] => http://www.unaids.org/sites/default/files/media_asset/20150420_MSF_UNAIDS_JC2707.pdf [format] => [safe_value] => http://www.unaids.org/sites/default/files/media_asset/20150420_MSF_UNAIDS_JC2707.pdf ) ) [#formatter] => text_plain [0] => Array ( [#markup] => http://www.unaids.org/sites/default/files/media_asset/20150420_MSF_UNAIDS_JC2707.pdf ) [#description] => Please enter the full URL, e.g. http://www.example.com [#printed] => 1 )