World Bank $$ to boost standards in AIDS treatment programme
Stabroek News
May 3, 2004

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The World Bank's US$10 million AIDS fight project for Guyana will improve the standards of the country's anti-retroviral therapy (ART) programme, according to the bank.

The bank's website noted that Guyana has already adopted ART in its HIV/AIDS treatment programme with drugs financed through its own budget.

The bank recently announced the US$10 million project grant, which is a part of the World Bank Multi-Country HIV/AIDS Prevention and Control (APL) and will finance significant parts of Guyana's National HIV/AIDS Strategic Plan 2002-2006. The Government of Guyana will also contribute to the project.

According to the bank, the project would support the development of an expanded and rigorous protocol that takes into account important international standards of care for HIV/AIDS and includes other anti-retroviral drugs beyond the ones currently available through local manufacture.

It will also see the implementation of an adequate clinical and laboratory monitoring infrastructure; training of clinicians and nurses on the delivery and monitoring of ART and training of medical technologists. Further, the project will assist in the procurement of laboratory equipment for monitoring of ART; development of clinical care monitoring software and strengthening of the materials management and logistics system.

Care, treatment and support through the health care system will be enhanced, as the project will support the development of standardised protocols and guidelines for HIV/AIDS care at all levels in the health system. Health workers and medical technologists will be trained and essential supplies necessary for treatment and the strengthening of logistical systems to ensure continuity of supplies will be facilitated.

With regards tuberculosis (TB) and HIV the project is expected to play a vital role in the strengthening the national TB control programme. "TB and HIV epidemics are closely intertwined," the bank said. The project will support increased screening for HIV/AIDS and tuberculosis, activities to improve Directly Observed Therapy Short Course (DOTS) coverage and completion rates, training of health workers and medical technologists, provision of equipment and drugs and strengthening of logistical support for the TB programme.

The bank stated that the current high level of blood safety obtained at the national level would need to be maintained and expanded to cover blood transfusion units in the regions. As a result, the project will support the provision of additional reagents for screening out infectious diseases from the blood system, improve the human resource capacity, improve data management and strengthen the logistical systems at the central and regional levels.

And the bank feels that while voluntary counselling and testing (VCT) is a key aspect of the national response to HIV/HIV it has not been sufficiently addressed in the current national response. "Scaling up of voluntary counselling and testing will add 15 VCT [sites] across the country. Refurbishment of some rooms at selected health care facilities, training (counsellors, health care workers, laboratory technologists), provision of test kits and reagents and development of a management information system and linking the VCT centres to the referral system" will be supported.

Also to be addressed under the project are strengthening the management of sexually transmitted diseases (STDs), updating the treatment protocols, improving laboratory capacity through provision of equipment and trained medical technologists, condom promotion, training of health workers and improved contact-tracing by social workers.

And under Prevention of Mother-to-child Transmission (PMTCT) the project will support the programme being integrated with the maternal and child health services of the Ministry of Health (MOH). "It will provide an entry point for wider care and treatment to others who are infected and to their partners."

Funds will also be expended on the proper disposal of health care waste related to HIV/AIDS. In this area the project will support training of health workers on the proper handling of infectious waste and provide equipment for disposal and sterilisation of medical waste at the central and regional levels.

The project will also empower communities to respond effectively to the HIV/AIDS epidemic since the battle against the virus is waged ultimately in the community, and with each individual. Accordingly, civil society groups, community-based organisations, faith-based organisations and the private sector which have access to difficult-to-reach groups that are particularly high risk and vulnerable groups such as youths and orphans will be supported.

Civil society groups will receive grants to support their sub-projects for HIV/AIDS prevention, treatment and care mitigation. Potential implementing entities will be invited to prepare sub-projects for funding in accordance with eligibility criteria to be provided.

According to the bank's website, between 1989 and 2000 AIDS deaths in Guyana rose from 2.7 to 64 deaths per 100,000 population or a 2,270% increase. In the year 2000, more years of potential life were lost due to HIV/AIDS than to the combined total of heart disease, cerebral-vascular disease and respiratory tract infections. The project intends to slow the increase of, or reverse the trend by, preventing and controlling the transmission of HIV and STIs; prolonging and improving the quality of life of people living with AIDS; and mitigating the negative impact of HIV/AIDS on persons infected and affected by the disease.

The project is part of the government's national HIV/AIDS programme and will track the trends in outcome, impact and outputs in the country.