More than 100 staff and others involved in programs developed by the International Center for AIDS Care and Treatment Programs (ICAP) gathered in Maputo, Mozambique, March 13-18, to review accomplishments, challenges, and next steps for ICAP's HIV care and treatment programs in resource-limited settings. Housed at the Columbia University Mailman School of Public Health, ICAP currently supports programs in 11 countries. Mozambique offered an appropriate setting for the meeting: Nearly 15 percent of its adult population is estimated to have HIV. ICAP is assisting the government in expanding care and treatment to those with HIV.
To date, more than 25,000 individuals have received HIV care and treatment through ICAP-supported programs, spearheaded by the groundbreaking MTCT-Plus Initiative (mother-to-child transmission), which began enrolling HIV-infected pregnant women, as well as their infected family members, in early 2003. Through MTCT-Plus, more than 7,000 individuals in nine sub-Saharan African countries and Thailand now have access to life-saving treatments. With a unique focus on the needs of HIV-infected mothers, MTCT-Plus is tackling one of the singular features of the global HIV epidemic: its disproportionate impact on women. And the initiative's efforts toward treating families rather than individuals promise to impact substantially not only those enrolled in the program, but their broader communities as well.
"What began as a vision with the MTCT-Plus Initiative has grown exponentially. Today we are reaching thousands of others throughout sub-Saharan Africa with our programs. Care and treatment of HIV in resource-limited settings is now truly a reality," said Wafaa El-Sadr, director of ICAP and professor of clinical medicine and epidemiology.
Multicountry Columbia Antiretroviral Program (MCAP), established in February 2004, has expanded ICAP activities to reach a broader patient population and provide a wider scope of support services. MCAP provides an immediate response to the urgent need for HIV care and treatment in five countries in sub-Saharan Africa, and more than 15,000 individuals were enrolled for treatment at sites supported by MCAP in its first year. Beyond its immediate clinical impact, MCAP also provides technical assistance to countries at ministerial/provincial levels with an eye toward supporting and enhancing national HIV care programs.
"True partnership with in-country providers and organizations is critical to the success of public health programs," said Allan Rosenfield, dean of the Mailman School of Public Health. "By building these collaborative relationships, we gain a valuable perspective that will inform future efforts."
ICAP programs are characterized by their unifying themes: a focus on comprehensive HIV care rather than antiretroviral therapy alone; family-focused care with attention to the needs of children; links to other key services such as reproductive healthcare and tuberculosis treatment; multidisciplinary teams providing both clinical and psychosocial services; and involvement of persons with HIV and their communities.
Other ICAP programs are located in Cameroon, Cote d'Ivoire, Kenya, South Africa, Rwanda, Uganda, Tanzania, Zambia, Thailand and the Dominican Republic.