Regional Advisory Panel on TAP Maputo, Mozambique June 22nd 23rd 2006 GHANA Status of TAP Implementa

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Regional Advisory Panel on TAPMaputo,
MozambiqueJune 22nd - 23rd 2006
GHANA Status of TAP Implementation Patient
Tracking SystemDrug Resistance Monitoring
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PART I

• Status of TAP Implementation
• in
• Ghana

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HIV/AIDS in Ghana

• Population
• 20 M people
• HIV/AIDS burden
• Prevalence 2.7 (2005)
• 400,000 PLWHA
• 70,000 in need of treatment
• Number on ART 4600 (Mar 2006)
• Country policy on HIV/AIDS
• ? New infections
• ? Impact of HIV/AIDS on infected and affected
• Promotion of healthy lifestyle

2.6
2.6
1.2
1.9
3.3
3.0
4.7
2.1
2.9
2.9
lt 2 lt3 lt4 gt4
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HIV/AIDS in Ghana

• Cost of Treatment
• VCT 5000 cedis (.50)
• PMTCT Free
• Clinical care 50,000 cedis 5 / month
• Funding
• Government of Ghana
• Global Fund
• TAP
• DfID
• GTZ
• Royal Netherlands Embassy
• Others

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TAPPublic and Private Sector Partners

• Public sector
• NACP/MOH/GHS
• Mandate HIV treatment, care and support
• Private sector TAP implementing partners
• Family Health International (FHI)
• Worldwide TA in HIV/AIDS
• Piloted ART in Ghana June 2003
• National Catholic Health Service (NCHS)
• Responsible for 25 health delivery
• Pioneer in home based care
• Private Enterprises Foundation
• Workplace HIV/AIDS programmes
• Prospective IP

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TAP Achievements Scaling up HIV Care

• FHI
• 4 private protégé sites operating March 2006
• Staff trained ART, AC, VCT/PMTCT, LMIS, HMIS,
  Good laboratory practice
• Refurbishment

• NCHS
• 6 prospective sites in preparation
• Assessment done
• Refurbishment
• Some equipment procured CD4 machines
• Staff trained ART, LMIS, AC, VCT/PMTCT
• ART take off June/July 2006

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TAP AchievementsStrengthening Institutional
Capacity

• Technical Advisory Services
• WHO technical support
• TAP NPO, 2 new NPO expected
• TA to adapt /develop IMAI training manuals
• Support for Technical Working Group on ART
• Support for Program Expansion
• Strengthening infrastructure CD4 machines
• Human resource development
• M and E of Quality Service
• Sequencer procured for resistance monitoring

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TAP Achievements Regional Learning

• Participation in RAP meetings
• IPs to document lessons from TAP implementation
• Private business participation in HIV care PEF
  proposal
• Research agenda on household surveys
• Meetings to discuss modalities held

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TAP Challenges

• Slow implementation of TAP
• Multiple stakeholders
• Obstacles working with private sector facilities
• Charges
• Human resource
• Public sector constraints
• Procurement of drugs, logistics
• Collaboration with public health institutions
• Fund transfer

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Way Forward

• Roll out comprehensive care in TAP sites
• Advocate for acceptance of PEF proposal
• Develop HIV Care Training Manual with TA from WHO
• Documentation of TAP learning experiences
• Household survey to the next level

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PART II

• Ghanas Experience
• in
• Patient Tracking Systems (PTS)

Elmina Castle Central Region
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Experience in PTS

• PTS software installed
• In pilot ART sites and Teaching Hospitals
• Patient demographic and clinic data entry
• Facilitates
• Contact tracing of defaulting clients
• Retrieval of patient data
• Not networked
• Manual referral between sites

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Taking PTS to the Next Level

• Comprehensive PTS in evolution
• Locally generated PTS
• Data entry
• Patient demographic data
• Clinical management information
• Pilot trial at Regional Hospital
• Next stage
• Roll out to other ART sites
• Networking between sites and NACP

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Taking PTS to the Next Level

• Anticipated benefits
• Access to data at national level
• Facilitate inter-site referrals
• Anticipated challenges
• No national identification system for efficient
  tracking
• Maintenance of confidentiality
• Way forward
• Strengthen Ghana PTS
• Eager to learn from others experiences

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PART III

• Drug Resistance Monitoring
• Ghanas Experience

Wli Falls, Volta Region
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Experience inResistance Monitoring

• Pilot Resistance Study October 2003
• FHI/ NMIMR/NACP collaboration
• Local capacity built in resistance testing for
  HIV
• Training in South Africa, Spain
• Fifty-four samples
• Analysis in NIHCIII, Madrid, Spain

NMIMR - Noguchi Memorial Institute for Medical
Research NIHCIII National Institute of Health
Carlos III
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Resistance Monitoring

• Outcome of Pilot Study
• Technology transfer to improve skills
• Local capacity in resistance monitoring
  strengthened
• Recommendation to procure Sequencer for
  in-country analyses

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Taking Resistance Monitoring to the Next Level

• Subsequent progress/ Way forward
• Sequencer procured TAP funds
• Proposed OPEC/Global Fund/NACP collaboration
• Formation of drug resistance expert committee
• Drug resistance research
• Baseline analysis 10 of new patients starting
  ART
• Establish system for monitoring drug resistance

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Thank you
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