The epidemic of AIDS is global. Of the world's 36 million people infected with the HIV virus, 70 per cent, or 25 million live in sub-Saharan Africa. The continent is home to areas with some of the world's highest disease prevalence rates, up to 35 percent. Worldwide, 21 million people have died since the epidemic began, 17 million of which perished in Africa. The effects of HIV/AIDS in Africa are tragic and far-reaching, not only bringing suffering to afflicted individuals, but also having devastating effects on families, communities and nations. AIDS affects women and children in Africa disproportionately, creating orphans, and widows without earning power. Besides being plunged to poverty, these orphans and widows are often also infected with the HIV virus. Nations with small budgets and high debt burdens are struggling under the economic weight of this devastating global epidemic.
The AIDS Collaborative Project was launched in Beth Israel Deaconess Medical Center's Healthcare Associates in Boston. The project was born out of a collaborative effort with the Foundation for African Relief, a non-profit, faith-based organization engaged in the fight against AIDS in Africa.
The Project seeks to reduce the burden of AIDS in Africa. It will do so by:
Creating opportunities for health care professionals, educators and concerned citizens living in the United States of America to collaborate with their counterparts living in African communities in the fight against HIV/AIDS.
Empowering health care professionals caring for people living with HIV/AIDS in Africa by providing them with the resources, education and training needed to effectively care for their patients.
Making available highly effective antiviral therapy to people living with AIDS in Africa.
Promoting and enhancing the opportunity for early testing of HIV/AIDS by providing the hope of treatment to the millions of people living with HIV infection in Africa.
Sponsoring programs aimed at health education, promoting healthy life styles, and empowerment of individuals and communities with the ultimate goal of promoting primary prevention of HIV infection.
Currently, the efforts of the project are concentrated in Ghana, with plans to expand to other countries in sub-Saharan Africa.
Training and educational programs in HIV/AIDS Care
The AIDS Collaborative project will seek to provide training opportunities for health care professionals caring for people living with HIV/AIDS in resource- poor communities in Africa. The training opportunities will be offered in three different settings: on-site, off-site and through distance learning.
Visiting Scholar's program - an offsite training program
We have designed an intensive, 12 week fellowship in AIDS care for health care leaders directly involved in the care of HIV/AIDS patients in Africa. The fellowship is primarily based at Beth Israel Deaconess Medical Center in Boston, a Harvard Medical School affiliated institution. Our first visiting scholar was Dr. Peter Preko a Founder of AIDS ALLY, a non- governmental organization based in Ghana, whose mission is to create a comprehensive model of care patients with HIV/AIDS in Ghana.
During the 12 week long program, a visiting scholar spends time with experts in HIV care, learning about how to effectively care for patients with antiviral therapy. Several faculty members of Healthcare Associates, a multidisciplinary primary care practice with an integrated HIV unit serve in advisory and preceptor roles in the program as do other experts in HIV/AIDS involved in clinical care throughout BIDMC and affiliated community health centers. The scholar learns critical skills in monitoring patients on therapy, how to enhance adherence and when to initiate prophylactic therapy against opportunistic infections. The scholar is also enrolled in relevant courses at Harvard Medical School. The scholar is expected to complete an independent project, in an area of choice in HIV care that can be applied to clinical care upon the scholar's return home. The project is completed under the supervision of an advisor who is an expert in the area of concentration.
International workshops on AIDS care - an offsite educational opportunity
Healthcare Associates faculty members alongside several of their colleagues within the larger community of Beth Israel Deaconess Medical Center will also be involved in the planning and delivery of training workshops on HIV/AIDS care for health care providers involved delivering care within African communities. We recently conducted the first of such training conferences in December 2001 which took place in Kumasi, Ghana.
In addition to conferences, ACP will also provide opportunities for US- based physicians wishing to spend extended periods of time delivering direct care to patients with HIV/AIDS within Africa. These medical missions will be part of a volunteer effort, and will target areas or communities lacking adequate access to care and health care workers. Residents and students wishing to gain experience in international health will be able to participate in these medical missions, under the supervision of trained local and international faculty.
Internet-based educational resource and distance learning - Telemedicine program
Using on site as well as virtual (internet-based resources) educational resources, we will seek to maintain and renew the clinical skills of providers in the field. The faculty for this Telemedicine project will consist of a team of experts in the clinical, research and public health aspects of HIV/AIDS.
Providing Medical Resources
In addition to the educational and training efforts, ACP seeks to provide medical resources, including computer technology and pharmaceuticals for health centers caring for patients with HIV/AIDS in resource poor communities in Africa. ACP works in collaboration with the Foundation for African Relief's HAART for Africa project to provide much needed antiviral therapy and related AIDS treatment for patients with HIV/AIDS. Using donations from private organizations and businesses, the program will finance the purchasing of affordable antiviral and AIDS-related medications. We will work closely with local churches and private, philanthropic organizations in our fund-raising efforts.
We actively seek and welcome cooperation from local and international pharmaceutical companies who produce antiviral medications and other AIDS-related medications. We seek to collectively explore ways in which we may bring affordable drugs to all people living with HIV/AIDS.
Infrastructure and Distribution Needs
We recognize that providing medications is only part of the solution to the treatment divide that exists in most African countries. Lack of adequate infrastructure and health care systems hamper proper distribution to and monitoring of patients. Many health providers lack the clinical expertise and skills set necessary to care for patients living with AIDS, mainly because treatment options and training have, to date, not been available to them. We hope to address these issues by working closely with local health officials to enhance current care delivery systems. Where a rudimentary health care system is non-existent, we will work to establish outreach clinics and health posts, with the support of the local communities.
Clinic: FAR has partnered with AIDS ALLY, a non-governmental organization based in Ghana with a common goal of improving access to comprehensive HIV/AIDS care and counseling for people living with HIV/AIDS in Ghana. In November 2001, the two organizations worked collaboratively to open a clinic in Kumasi, where comprehensive, compassionate and affordable AIDS care will be provided. In addition to providing financial support for the clinic, FAR has donated free medications, computers, medical supplies and books to the clinic. FAR seeks potential donors of these items as well as financial supporters to help sustain the operation of this novel clinic.
Community Activation and Empowerment
We also plan to utilize community-based volunteers in providing outreach initiatives aimed at supporting patients in their communities to enhance adherence to treatment and monitoring requirements. These efforts will include providing transportation for patients needing it to and from clinic visits, reinforcing patient education on how to take medications properly and how to recognize adverse effects. The peer educators will also serve the critical role of being patients advocates, helping patients gain access to the care and services they need. Finally, these peer educators will play a critical role in our educational and outreach efforts aimed at promoting early detection and primary prevention of HIV. We also seek to work collaboratively with community leaders, churches and grassroots, volunteer organizations doing work in this area.
Using rapid cycle methods, we hope to study important clinical issues such as adherence and the impact of simple interventions, such as patient education, community support and reinforcement. We also hope to apply rapid cycle techniques to help us determine the best approaches to clinician education and skills training. We hope to measure and monitor important quality markers throughout the process and promote an atmosphere of continuous improvement.
We will welcome collaborations with individuals and agencies interested in clinical and outcomes research relating to effective treatment and prevention of HIV/AIDS.