Transcript vietnam
Accessing to ARV in HIV/AIDS care and treatment programme in Vietnam Dr.Nguyen Van Kinh Head, Department of care and treatment HIV/AIDS situation in vietnam First case of HIV infection reported:Dec.1990 First case of AIDS reported: 1993 As of Sept.30th, 2003, cumulative reported cases of HIV/AIDS through out the country including: –101,291 cases of HIV infection –16,528 AIDS patients; 9554 deaths by AIDS Estimated HIV/AIDS number in 2005: 263,000 Estimated number of PLWHA need to accessing ARV treatment during 2005-2010 2005 : 14.775 2006 : 18.975 2007 : 23.040 2008 : 27.690 2009 : 33.075 2010 : 37.275 Accessing to ARV • • • • Started since 1995 1995-2003 : 50 patients/year (2 combination) 2004: 500 patients ( three combination) Current number of patients on treatment (2005) – Central level: 900 patients – Provincial level : 2,100 patients – District level: 140 patients Total : 3,140 patients At the end of this year: Estimated 5,600 patients ARV accessing • Treatment regime : - First line : d4T +3TC + NPV; d4T + 3TC + EFV ZDV + 3TC + NVP: ZDV + 3TC + EFV - Second line:TDF/ ABC + ddI + LPV/r or SQV/r or NFV • Funding sources: Government Global fund ESTHER project PEPFAR Current HIV/AIDS care and treatment system in Vietnam VAAC Subdivision for Treatment Subdivision for M&E Subdivision for PMCT SubDivision for STIs NIOTD/TB Hue General Hos. TDC -HCMC NIHE Regional Pasteur Ins. CHOGO CHOC NIDV Provincial Health service -PMC; MCH Hospital/Center General Hospital/STD center/TB Hospital/Center Rehab. Centers District Health Center PLWAs and their families NGOs/CBOs Commune Health Station Task force calculating needs for ARV drugs and regimens Main assumptions for planning: • Following protocol of MOH • 70% of adults weighed under 60kg • Estimated 5% children patients • Mean weigh of children patient :15kg • About 10% of patient needs second line regimen • Newborn weigh about 3.0 kg REGIM ENS ADUL TS d4T/3TC/NVP 35% d4T/3TC/EFV 35% ZDV/3TC/NVP ZDV/3TC/EFV ddI/ABC/NFV 7.50% 12.50% 10% PEDIATRICS d4T/3TC/NVP 40% d4T/3TC/EFV 40% ZDV/3TC/NVP ZDV/3TC/EFV 7.50% 12.50% PM CT ZDV/3TC/NVP 100% AZT 100% Current situation MOH GF PEPFAR ESTHER Forecasting Based M&E Based on funds available Method in place Based on funds available Procurement. Open bidding Decision 88, buffer stocks? UNICEF, buffers? Direct proc. brand, FDA approved, buffer incl. HCMC-Tender Hanoi-local market Storage/ Distribution Medinsco Medinsco CPS1, Quart. Deliveries. Pharmacy in Hospital Patient M&E system Some sites (HCMC) have, As MOH System in place Working with PEPFAR Inventory control Exists in some facilities Not prepared System being developed Not prepared Buffer/minimal stock level at facility level 6 months ? Yes/2months ? Number of patients started in the Month with Weight and Age status Number of patients started in the Month with regimen and drugs Current Active number of patients by regimen Graph Patient Intake trend over months in a given year Standard Reports Weight status Adults that visited Pharmacy in the month Cumulative number of patients up to the date Number of visits in the Month by regimen more indicator • Number of health workers trained to deliver ARV/palliative care • Number of service outlets providing ARV and OIs • Number of service outlets providing palliative care • Number of patients change into second regimen • Number of patients died during treatment Next strategy • Completed M&E system • Completed ARV accessing action plan • Set up indicators system for ARV using, procurement... • ARV source Co-ordinating