December 6, 2007- The Multisectoral HIV/AIDS project (MAP) in Mali, which seeks to help combat poverty, has initiated the “biological monitoring of patients on anti-retroviral (ARV) drugs.” This project is a successful example of private sector involvement in the fight against HIV and AIDS, and a good model for combating this pandemic. The aim of the project is to provide biological monitoring of persons living with HIV who are receiving anti-retroviral therapy, but not yet benefiting from biological monitoring at another facility that provides care free of charge. The Executive Secretariat of the National High Council for AIDS (Secrétariat Exécutif du Haut Conseil National de Lutte contre le SIDA SE/HCNLS), in partnership with the Ministry of Health and the Malian network of People Living with HIV, instituted this therapy. The project, which is being executed by a private, local laboratory and financed by the MAP for one year, is a typical example of private sector participation and intervention in AIDS prevention. In order to strengthen laboratory analysis and biological monitoring, the SE/HCNLS signed a consultancy contract for the provision of services with this biological analysis laboratory, a private sector medical company. The services provided by the private clinic are not charged to the patients and comprise a package of quality services, which include, among other things: Making monitoring of the effectiveness of anti-retroviral treatment available; monitoring of tolerance and side effects of ARV treatment, in the District of Bamako (the capital), as well as in other towns across the country; Taking regular samples in the main areas selected based on a map designed by the sectoral unit responsible for combating AIDS within the Ministry of Health; and Conducting the tests recommended in the national policy of providing anti-retroviral treatment to People Living With HIV for approximately 3,000 persons.
Because of these various services, approximately 6,000 viral load tests and 8,200 CD4s were performed between April 18, 2006 and December 18, 2006. On average, 8,000 tests were performed for the baseline measurement, approximately 3,000 cholesterol and other tests, about 2,400 gastrointestinal tract tests, and 400 pregnancy tests. These actions have already had a tremendous impact: Headquarters and center of the Yeretanga NGO operating in Zégoua and Kadiolo (South Mali).
© World Bank. Timeliness, accuracy, and speed in the delivery of results; Improved access to the measurement of viral loads; Ease in making treatment decisions; Shorter inclusion periods; Increase in the number of persons receiving ARV therapy because of the availability of biological assessments; Good collaboration between public and private facilities in biological monitoring; Improvement in communication between patients and resource laboratory personnel regarding results; Establishment of an efficient file management procedure (traceability);
 Synergy and complementarity of actions with other partners such as the Global Fund, the Network for Therapeutic Solidarity in Hospitals [Ensemble pour une Solidarité Thérapeutique Hospitalière en Réseau ESTHER], Therapeutic Solidarity and Initiatives for AIDS [Solidarité thérapeutique et initiatives contre le SIDA SOLTHIS], and BIOMALI, which also conduct biological monitoring within the context of combating HIV and AIDS.
Biological monitoring of patients receiving ARV therapy under the MAP project has provided an effective, quality, treatment solution, while minimizing the risks of the side effects of ARVs and disease complications. This boosts the patient’s morale and the “freeness” of this service mitigates the socioeconomic impact of HIV and AIDS, while helping to improve the living conditions of the beneficiaries and combat poverty in general. By Moussa Diarra, World Bank, Mali (In collaboration with the SE/HCNLS) |
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