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アフリカに関わる活動を行っているNGOのデータベースおよびアフリカのエイズ問題に関するニュース・情報データベースです。
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【2017年3月】アフリカに関わる活動を行っているNGOのデータベースを順次、更新しています。


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サハラ砂漠以南アフリカ諸国での ARV治療の現状

2004年2月

手元に届いているニュース(IRINが中心)で、サハラ砂漠以南アフリカ諸国でのARV治療の現状を追ってみました。

昨年秋以降のニュースで挙げられている数字では、ARV治療を受けている人びとの数は次のとおりです。

今年2月のニュース
NIGERIA: Over 14,000 on subsidised AIDS drugs run out of medication
LAGOS, 3 February (PLUSNEWS)
この記事の概略は、メーリングリスト・viva_hiv_aids(参加希望の方は、AJF事務局宛にメールを下さい)で紹介しました。

去年12月のニュース
UGANDA: New deadline for free anti-retrovirals
KAMPALA, 1 December (PLUSNEWS)
本文中に"Uganda has an estimated 150,000 people in need of ARV drugs, only about 10,000 of whom have access to them at present"とあります。

去年9月のニュース
KENYA: HIV/AIDS - "People''s Tribunal" demands access to life
NAIROBI, 23 September (PLUSNEWS)
本文中に"At least 250,000 Kenyans are in urgent need of antiretrovirals (ARVs), but only between 7,000 and 10,000 can afford them. The government has laid out plans to treat only 9,000 others over the coming year. "とあります。

今年3月のニュース
BOTSWANA: Interview with Dr Ndwapi Ndwapi, director of Princess Marina Hospital''s ARV programme
HARARE, 11 March (PLUSNEWS)
このインタビューでは
"This year, an additional 19 clinics - three located in small towns, the rest in rural communities - will be incorporated into the programme. To date, nearly 16,000 people are on antiretroviral treatment (ART) and an additional 1,500 children are also on ART, so the total public number of people on treatment is nearly 17,500."
と語られています。

今年4月の南ア・ハウテン州ほかの公的医療機関でのARV治療開始を伝えるニュース
SOUTH AFRICA: Slow start of ARV rollout
JOHANNESBURG, 1 April (PLUSNEWS)
には、ハウテン州保健省の担当者のことばが
He anticipates that roughly 30 new patients will be put onto ART per week. Another 18 sites in the province have been earmarked to provide services by next year and the provincial health department aims to reach 10,000 people by the end of March 2005.
と紹介されています。

5月15・16日、アフリカンフェスタ2004の際、AJFブースで上映されたマラウイのエイズ、特に治療と感染者へのスティグマに焦点をあてたビデオ・ドキュメンタリーでは、薬代が高くて払えない人がたくさんいる、という状況が紹介されていました。

ここで紹介したニュースにあるARV治療の費用負担等についてもっと具体的な情報を得るのは、次の課題として重要です。

ボツワナでは、国とデ・ビアスが資金を拠出して無償でのARV治療が実施されています。

3月に来日したフランスのNGO・AIDESのエレンさんのプレゼンによると、西アフリカ・中央アフリカ諸国でAIDESが関わったエイズ治療の規模は7000人を対象としており、MSFの取り組みよりも大きい、とのことでした。

関連して、南ア・西ケープ州カエリチャで国境なき医師団と西ケープ州保健省が取り組んできているARV治療の成果と課題を伝えるIRINのニュースを転載します。

SOUTH AFRICA: Challenges remain for MSF's ART programme

JOHANNESBURG, 30 April (PLUSNEWS) - Three years after its inception, the first project to provide free AIDS drugs to South Africans put the 1,000th patient on antiretroviral treatment (ART) this week.

In May 2001 the Medicins Sans Frontieres (MSF) and Western Cape Health Department project started providing people at an advanced stage of AIDS with ART at three HIV/AIDS clinics in Khayelitsha township, outside Cape Town.

Today the clinics offer about 2,000 consultations every month in the sprawling township. "We estimate that 5,000 people need treatment in Khayelitsha today," MSF campaign coordinator Marta Darder told PlusNews.

Although the programme was recognised in 2003 by the World Health Organisation as one of the models for an integrated HIV programme, Dr Erick Goemaere, Head of Mission for MSF South Africa, said he was still nervous about the challenges ahead.

"The programme has demonstrated that a well-run HIV programme can succeed in resource-limited areas, however, we will have to find new solutions and adapt to new challenges," he said.

New challenges emerging in Khayelitsha, and soon to be faced in other areas as South Africa's national ARV programmes roll out, form the basis of current research that includes developing approaches to identify and support patients not adherent to ART, and when to change therapy due to resistance and treatment failure. Scaling up to meet the year-end target of 1,700 people on ART is another.

The availability of dedicated and well-trained health staff appears to be the biggest constraint and the most difficult to overcome. "Many of the staff are burnt out and tired and have left," said Goemaere. "We have to find ways to motivate people and to attract new doctors, but there needs to be political will to do this."

The objective of the Khayelitsha programme was to show the feasibility of treating people infected with HIV in poor communities.

By the end of 2001, 100 patients were on ART. This increased to 300 by the end of 2002, just 17 months after the programme began. By the end of 2003, a total of 776 patients, including 84 children, were receiving treatment.

"Given that the effectiveness of the intervention is no longer in question, the research emphasis within this project will be more directly focused on the systems of service delivery, with further simplification and emphasis on nurse-based services," said Darder.

Lessons learned from the Khayelitsha programme, no longer a pilot study, will be integrated into the provincial scale-up. Over the next three years, the challenge will be to transfer responsibility for the Khayelitsha programme to the Western Cape Department of Health. An estimated 100,000 people in the province are infected with HIV or have AIDS-related diseases, and around 5.3 million people are living with HIV or AIDS in South Africa.

Another MSF project, supported by the Eastern Cape Department of Health and the Nelson Mandela Foundation, aims to demonstrate the feasibility of providing comprehensive HIV services, including ART, in a rural setting.

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