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Therapeutics Information and Pharmacovigilance Centre’s Analysis of Spontaneous Adverse Events due to Antiretroviral and Other Medicines

The use of antiretrovirals (ARVs) in combination for treating patients with HIV has greatly ameliorated morbidity and mortality by reducing viral load to undetectable levels and boosting the body’s immunity. However serious adverse reactions causing long- or short-term effects have been associated with ARV treatment. These reactions have caused major concerns internationally, potentially threatening patient adherence to long-term treatment. The duration of treatment of patients infected with HIV; co-morbid conditions, such as tuberculosis (TB) and malaria; and the complications due to HIV infection or AIDS make it difficult to determine the exact cause of the adverse events (AEs) experienced by patients taking ARV medicines. The prevalence of co-morbid conditions differs across socioeconomic groups and geographical regions, which may contribute to differences in ARV toxicity profiles. Hence, it is recommended that national HIV treatment programs establish population-level ARV toxicity profiles for their countries. Therefore, with increased survival of patients and the long-term duration of antiretroviral treatment (ART), it is important for national pharmacovigilance centers to monitor the immediate and long-term effects of these ARVs on the population. A simple, practical, and cost-effective method for evaluating the safety of drugs approved for human use is the spontaneous reporting of AEs to a pharmacovigilance center. This method is helpful for identifying serious and rare medicine-associated AEs. The evaluation of these AEs informs regulatory decisions on improving the safety of medicines in the country and globally. The objective of the Analysis of Namibia Therapeutics Information and Pharmacovigilance Centre’s Data was to identify drug safety concerns associated with the use of antiretroviral medicines in Namibia’s HIV treatment program, by analyzing pharmacovigilance data generated from spontaneous reports of suspected adverse events (AEs).

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OSPSANTE: Guide de l’Utilisateur

L’objectif de l’outil OSPSANTE est de capturer, de suivre, d’agréger et de diffuser des informations sur les produits de Nutrition et de lutte contre le paludisme, la PF, la SMI et le VIH, pour soutenir la prise de décision basée sur des éléments de preuve au Mali. L’outil OSPSANTE aidera le pays et les organisations internationales, telles que l’USAID, l’ONUSIDA, l’OMS, le Fonds mondial et autres parties prenantes à améliorer les prévisions, la planification de l’approvisionnement et les achats pour permettre la disponibilité continue des produits de Nutrition et de lutte contre le paludisme, de la PF, de la SMI, et du VIH. Le présent guide de l’utilisateur permettra d’utiliser facilement l’outil OSPSANTE. Il fournit des conseils pas à pas pour accéder à l’outil OSPSANTE et générer des rapports.

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Toward Building Resilient Pharmaceutical Systems: SIAPS Final Report

SIAPS final report showcases achievements across 46 countries. Interventions are described by intermediate results and health areas and demonstrate how SIAPS successfully worked with a range of stakeholders, including Ministries of Health, to bolster pharmaceutical systems and address country-specific needs.

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Decentralizing ART Services through the Differentiated Care Model in Namibia

SIAPS has supported the ART program and the Division of Pharmaceutical Services to implement ART decentralization strategies. SIAPS has collaborated with other USAID-funded implementing partners in the development of standard operating procedures (SOPs) for implementing CBART services and in designing process flows for the movement of patients between the community and ART facilities, including pharmacy visits for ARV refills. SIAPS trained more than 80 health workers in PEPFAR priority, high HIV prevalence regions on the SOPs and process flows for CBART implementation, dispensing tools, and procedures at NIMART sites. SIAPS has also supported the ART program by developing monitoring and evaluation tools to ensure that the care provided to patients accessing services from community service points and NIMART sites is well documented to allow health practitioners at the main ART sites to ensure that patients still receive the same high standard of care required in the delivery of ART services.

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Implementing a Dashboard for Pharmaceutical Information in Namibia

SIAPS supported the MoHSS to design and implement a web-based electronic information system (dashboard) for both patient and stock status in Namibia. It was designed to improve coordination among facility, district, regional, and national stakeholders involved in HIV commodity management; increase the use of pharmaceutical information for management decision making at all levels of health care; and improve planning for financial resources for pharmaceutical commodities. The dashboard comprises a module for monitoring 22 pharmaceutical services delivery indicators, a module that summarizes the number of people accessing ART services, and an early warning system against stock-outs of antiretrovirals (ARVs) and other essential medicines.

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Capacity Building for Healthcare Personnel to Manage Pharmaceutical Services at ART and NIMART Sites, October 2015 to September 2016

SIAPS supported the Ministry of Health and Social Services to enhance capacity of pharmaceutical HR to manage pharmaceutical services in public health facilities in Namibia. The major objectives of the activities were to build HR capacity in pharmaceutical management and service delivery for improved HIV and AIDS treatment outcomes and improve availability and use of pharmaceutical service data for improved quality of ART services. Activities comprised onsite staff mentoring through supportive supervision visits and training sessions adapted to the needs of the target healthcare workers.

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Community-based Group ARV Dispensing Improves ART Services in Namibia

The US Ambassador to Namibia, H.E. Thomas F. Daughton, launched CBART group ARV refills on June 1, 2017. These groups are implemented widely in Onandjokwe and other districts in northern Namibia, where the HIV burden is high. During the CBART group ARV refill initiative launch, the ambassador remarked “simple solutions = best solutions; bring the pharmacy to the people rather than sending people to the pharmacy”. Since then, SIAPS has been supporting Namibia’s Ministry of Health and Social Services (MoHSS) and partners to implement this initiative. The MoHSS, with support of partners, has decentralized ART services to achieve the ambitious UNAIDS 90-90-90 targets for ending the AIDS epidemic by 2020. Although Namibia faces a high HIV burden, with approximately 220,000 living with HIV, the MoHSS has successfully expanded its ART patient coverage to more than 80%. With more than 150,000 people receiving ART from public health facilities countrywide, the MoHSS is making efforts to ensure retention of ART clients on treatment to minimize the development of HIV drug resistance.

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Dashboard data improves pharmaceutical supply-chain decision-making in Namibia’s public health facilities

Yousef Makar is the Chief Pharmacist at the Windhoek Central Hospital, Namibia’s national referral hospital for specialised health care services for the past five years. Before July 2016, Yousef and other pharmacy managers in government health facilities faced huge challenges in managing the inventory of pharmaceuticals with frequent stock-outs of key pharmaceuticals because consumption information […]

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HIV/TB Pharmaceutical Management and Supply Chain Training Report

According to the World Health Organization, many countries spend 30–40% of their health care budgets on medicines and medical commodities, and a significant amount of the funds are wasted because of irrational medicines use and inefficiencies in stock management due to lack of skills. Other serious problems that health care organizations face include the overuse of antimicrobials, which increases the risks of antimicrobial resistance, leads to increased adverse drug reactions (ADRs), and results in considerably higher costs associated with drug use. Training pharmacy personnel on proper handling of medicines can help improve the proper handling and dispensing of medicines, rational use of medicines, and adherence to treatment to improve patient health outcomes. The primary objective of the HIV/TB pharmaceutical management and supply chain training was to develop the skills of the pharmacy personnel on proper management of HIV and TB medicines in health facilities.

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Toward Building Resilient Pharmaceutical Systems: SIAPS Final Report

SIAPS Final Report showcases achievements across 46 countries. Interventions are described by intermediate results and health areas and demonstrate how SIAPS successfully worked with a range of stakeholders, including Ministries of Health, to bolster pharmaceutical systems and address country-specific needs.

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