Regional High Level Consultation on HIV and the Law

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Regional High Level Consultation on HIV and the
Law

• 11-13 April, 2007
• Auckland, New Zealand
• PANEL 2
• Access to Medication, Care and Information
• Dr. Arvin C. Chaudhary
• MBBS (Fiji), MSc in STI/HIV Medicine (London)
• Coordinator for Sexual Health, STI HIV Medicine
• Western Health Service
• Lautoka Fiji Islands

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The Magic of ART
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• ART is a good servant BUT a bad master
• ARV reduces the effects of HIV
• It does not eliminate the virus BUT makes a vital
  difference in the lives of PLWHA
• If controlled and delivered properly, studies
  have shown that it can prolong life up to 65years
• BUT if misused
• Side effects, resistance and treatment failure

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FOR ART to succeed

• Need to have a multi-sectoral approach

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The circle of ART
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Personal Experience CLIENT

• Client not ready
• No proper counseling, preparation
• No proper OI management
• No baseline tests
• ART initiated
• Severe side effects
• Deterioration of health
• DEATH

• Full screening
• All OI controlled
• Client given education
• Client counseled on adherence
• Clients readiness sorted
• Clients support assessed
• ART started
• MAGICAL CHANGES noted

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Personal Experience Health System

• Pregnant patient HIV
• Chest infection bacterial pneumonia
• No ward wanting to keep the patient
• Pushed into TB ward
• Rushing to put patient on ARV though she did not
  meet the criteria

• Occupational exposure of a HCW
• Weekend
• No one on duty to do PEP assessment
• Official notification done after 72 hours
• NOW PEP Officer on call.

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Personal Experience Health System

• Pregnant patient HIV
• Chest infection bacterial pneumonia
• No ward wanting to keep the patient
• Pushed into TB ward
• Rushing to put patient on ARV though she did not
  meet the criteria

• Occupational exposure of a HCW
• Weekend
• No one on duty to do PEP assessment
• Official notification done after 72 hours
• NOW PEP Officer on call.

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Personal Experience Society

• A friend who is HIV positive in UK
• Put on ARV and later develops lipodystrophy
• Some members of his community related it to ART
  and HIV
• Friend felt discrimination stopped ART
• Developed resistance and had to be put on another
  expensive regimen

• Any GOOD story?
• Have not come across yet
• Our society still scared, judgemental
• More education and awareness needed.

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Personal Experience Health System

• Pregnant patient HIV
• Chest infection bacterial pneumonia
• No ward wanting to keep the patient
• Pushed into TB ward
• Rushing to put patient on ARV though she did not
  meet the criteria

• Occupational exposure of a HCW
• Weekend
• No one on duty to do PEP assessment
• Official notification done after 72 hours
• NOW PEP Officer on call.

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Personal Experience Governments CPA

• Denying existence of targets and problem
• Blaming the problem on immoral behaviour
• Hence not willing to use public funds to purchase
  ARV
• Avoidable deaths rocketed and then the issue was
  addressed

• Hon. Ratu Epeli Nailatikau and his presence,
  encouragement and enforcement Positive changes
• HIV allocation in budget
• Is giving money enough?
• Need for active participation in raising
  Awareness

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Summary

• Patient readiness, education and awareness
• Community involvement
• Provider capacity up-to-date clinical
  information and patient assessment
• Making the best use of available resources
• Sustainable and reliable supplies
• Sharing lessons learnt
• Addressing issues on Gender equality and rights
  of a child

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Finally

• Access to ART is the beginning of the show
• When majority of young people go on proper ART,
  they will live longermuch longer
• Then other needs and issues will surface which
  will need addressing at some stage
• So our scope should be beyond the accessibility
  frame

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Thank you, Vinaka