Global Post Covers MSH Satellite Session on HIV and Non-Communicable Diseases

MSH’s satellite session on HIV and Non-Communicable Diseases is featured among the Global Post‘s highlights from AIDS 2012.

Learn more about the session:

The session included opening remarks by MSH’s President and CEO, Dr. Jonathan Quick, and Global Post reporter John Donnelly. Donnelly also authored the MSH 40th anniversary book, Go to the People: 40 Years of Improving Health.

The Vision for Success Beyond MDG 6: Chronic NCDs, Health System Strengthening, and UHC

2012 July 22 AIDS 2012 Satellite Session: Beyond MDG 6

Panelists at AIDS 2012 Satellite Session: Beyond MDG 6, July 22, 2012. (Photo credit: S. Holtz/MSH)

On Sunday, July 22, 2012, Management Sciences for Health (MSH) hosted a satellite session, Beyond MDG 6: HIV and Chronic NCDs: Integrating Health Systems Towards Universal Health Coverage at the XIX International AIDS Conference (AIDS 2012). The session panelists were (left to right): Dr Ayoub Magimba, Till Baernighausen, Dr Jemima Kamano, John Donnelly (moderator), Sir George Alleyne, Dr Doyin Oluwole, and Dr Jonathan D. Quick

This week at the XIX International AIDS Conference — as panelists and pundits debate whether an AIDS-free generation is actually possible — we must not neglect the other chronic diseases that remain an emerging and alarming threat to both aging HIV-positive and sero-negative populations in these settings. Today, chronic non-communicable diseases (C-NCDs), including cancer, lung and heart disease, and diabetes, kill over 28 million people annually in low and middle-income countries, many of whom are HIV-positive.

According to Till Baernighausen of the Harvard School of Public Health, the total number of HIV-positive people aged 50 years and older is likely to triple over the coming decades from 3.1 million in 2011 to maybe 9 or 10 million in 2040. “We would really expect dramatic increases for the need for C-NCD screening and treatment.”

TURNING THE TIDE THROUGH INTEGRATED HEALTH SYSTEMS

Once deemed a death sentence, HIV is now considered a manageable chronic condition through the use of lifelong antiretroviral therapy (ART). HIV-positive individuals are now living longer, particularly in resource-limited settings where HIV care and treatment were not previously available. In fact, through the global scale-up of HIV and AIDS services, health systems in low- and middle-income countries are now better prepared to tackle other C-NCDs — like cancers, diabetes, chronic lung diseases, and cardiovascular diseases — by leveraging the existing investments, infrastructure, and systems put in place in recent decades.

BUILDING ON THE SUCCESS OF HIV & AIDS PROGRAMS

Over a decade ago, many critics said that bringing life-saving HIV treatment to the most hard-to-reach areas would be impossible. Yet today, more than 8 million people have access to antiretroviral treatment in low-and middle-income countries. The same models used for lifelong ART can be adapted and used for managing and monitoring patients with other C-NCDs. MSH firmly believes we can apply the lessons learned from our experiences with HIV to the C-NCD epidemic. For example, service delivery models — e.g. scaling up of ART and prevention of mother-to-child transmission (PMTCT) — innovations in funding, health care financing models, pricing for drugs and laboratory supplies and equipment, and new technologies for care diagnosis, among other innovations, provide a model for chronic diseases in low- and middle-income countries.

While proven solutions to tackle such conditions exist, the global health community is only now starting to realize the importance of designing cost-efficient, integrated health systems. According to Dr. Jemima Kamano of AMPATH, “One of the hardest things for me as a practicing clinician in Africa is to sit at the HIV clinic and treat HIV patients, counsel them and give them drugs and see them improving. But the minute they develop diabetes or hypertension, then I tell them unfortunately I can’t help them.”

By integrating current health systems and leveraging the existing groundwork laid by HIV and AIDS intervention scale-up, we can leverage existing public infrastructure, pharmaceutical supply chains, and human resources management, among other developments, to benefit patients with chronic diseases.

HIV & AIDS, C-NCDS, AND UHC

HIV and other C-NCDs have serious socioeconomic consequences, often creating a financial barrier for individuals in need of proper care and treatment, and forcing them to pay high out-of-pocket fees. Despite advancements in service delivery, only twenty countries worldwide currently have Universal Health Coverage (UHC) plans in which everyone can receive basic health services.

While some advocates in the AIDS community may see UHC as a threat to the provision of HIV & AIDS resources, others see it as a solution. Sir George Alleyne from the Pan American Health Organization (PAHO) reminds us that UHC is “feasible, socially desirable, and economically possible.”

“We have acceptance that UHC is possible. It is a myth that poor countries cannot afford UHC. There is no country that cannot afford UHC,” Sir Alleyne says. “It is a matter of social justice.”

According to Dr. Jonathan D. Quick, President and CEO of Management Sciences for Health, “UHC is becoming the driving vision for prevention, care and treatment of, and assuring access for, HIV positive and HIV affected people. They live long enough to get chronic diseases and to care for children — and they need the services that are provided through universal health coverage programs.”

The long-term nature of chronic diseases, including HIV, poses many challenges for the health system, but it is crucial that the prevention, care, and treatment of chronic disease be integrated in order to save many more lives.

MSH believes that in order to effectively combat the rise of C-NCDs — and turn the tide against HIV and AIDS — we must strengthen current health systems while leveraging existing platforms and ensuring access at an affordable cost in the context of UHC.

For a more in depth discussion on this topic, watch the webcast of MSH’s recent panel at the International AIDS Conference (via Kaiser Family Foundation).

Gloria Sangiwa, MD, is Management Sciences for Health’s global technical lead for chronic non-communicable diseases and the director of technical quality and innovation in MSH’s Center for Health Services.

Webcast: Beyond MDG 6: HIV & Chronic NCDs: Integrating Health Systems Towards Universal Health Coverage

Watch the entire session:

(Via the Kaiser Family Foundation website.)

SESSION DETAILS

While building on the momentum of the UN Summit in September 2011, this satellite recognizes that people living with HIV both treated and untreated, suffer from co-morbidities due to chronic NCDS. This satellite will examine the role of chronic NCDs and their link with HIV. More specifically, we will review lessons learned from the AIDS Decade of the 2000s and determine what lessons can be leveraged and applied beyond 2015 in the context of an emerging global burden of chronic NCDs. We will also discuss how we can use this current momentum to re-engineer the primary health care model so that it leads to sustainable, cost-efficient, comprehensive and integrated health systems that facilitate the achievement of universal health coverage for chronic NCDs in lower and middle income countries. Partners include: MSH; Government of Tanzania; Sir George Alleyne (Pan American Health Organization); AMPATH; Harvard and University of KwaZulu-Natal, South Africa.

Mildred, a mother and patient with STAR-E, Uganda

Mildred, a mother and patient with STAR-E, Uganda

Welcoming remarks

  • John Donnelly, United States
  • Dr. Jonathan Quick, United States

Why We Still Need Advocacy for Chronic NCDs Post UN-Summit, How Do We Create Shared Responsibility of This dual Epidemic and Why Here at the AIDS 2012 Conference

  • Sir George Alleyne, Barbados

What We Know About HIV Today and Its Implication Beyond 2015

  • Till Baernighausen, United States

Evidence-based service delivery models for care and treatment of persons with HIV

  • Jemima Kamano, Kenya

Leveraging Public and Private Investments in Global Health to Combat Cervical and Breast Cancer / Pink Ribbon Red Ribbon Initiative

  • Doyin Oluwole, United States

The Tanzania Model and Government Perspective on Tackling the Dual Epidemics

  • Ayoub Mmbando, United Republic of Tanzania