Browsing by Author "Ghidinelli, Marcelo"

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    HIV drug and supply stock-outs in Latin America
    (2011) Sued, Omar; Schreiber, Claudia; Girón, Nicolas; Ghidinelli, Marcelo
    When stocks of HIV drugs and supplies run out, unplanned treatment interruptions lead to increased risk of HIV drug resistance, treatment failure, and death.1 In the early days of antiretroviral therapy (ART) programmes, management of HIV supplies outside of national systems was considered acceptable by governments to facilitate scale-up2, but this approach is proving difficult to sustain. In May, 2011, the Pan American Health Organization (the regional office for the Americas of WHO) undertook a survey of national AIDS programmes in 12 countries to characterise stock-outs or episodes where there was a risk of stock-out affecting antiretroviral HIV supplies in Latin America
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    Progress of implementation of the World Health Organization strategy for HIV drug resistance control in Latin America and the Caribbean
    (2011) Ravasi, Giovanni; Jack, Nicola; Alonso Gonzalez, Maria; Sued, Omar; Pérez-Rosales, Marcelo D.; Gomez, Blanca; Vila, Marcos; Riego, Adrian; Ghidinelli, Marcelo
    By the end of 2010, Latin America and the Caribbean (LAC) achieved 63% antiretroviral treatment (ART) coverage. Measures to control HIV drug resistance (HIVDR) at the countrylevel are recommended to maximize the efficacy and sustainability of ART programs. Since 2006, the Pan American Health Organization has supported implementation of the WorldHealth Organization (WHO) strategy for HIVDR prevention and assessment through regional capacity-building activities and direct technical cooperation in 30 LAC countries. By 2010, 85 sites in 19 countries reported early warning indicators, providing information about the extent of potential drivers of drug resistance at the ART site. In 2009, 41.9% of sites did notachieve the WHO target of 100% appropriate first-line prescriptions; 6.3% still experienced high rates ( 20%) of loss to follow-up, and 16.2% had low retention of patients ( 70%) on first-line prescriptions in the first year of treatment. Stock-outs of antiretroviral drugs occurred at 22.7% of sites. Haiti, Guyana, and the Mesoamerican region are planning and implementing WHO HIVDR monitoring surveys or threshold surveys. New HIVDR surveillance tools for concentrated epidemics would promote further scale-up. Extending the WHO HIVDR lab network in Latin America is key to strengthening regional lab capacity to support quality assuredHIVDR surveillance. The WHO HIVDR control strategy is feasible and can be rolled out in LAC. Integrating HIVDR activities in national HIV care and treatment plans is key to ensuring the sustainability of this strategy.(AU)