Having completed a first phase of providing treatment for HIV/AIDS within government clinics in the Western Cape, ARK is proposing to roll out a second phase across a further 17 sites. The objectives are to save lives - particularly to ensure that children are not prematurely orphaned by AIDS, by keeping their HIV-positive caregivers alive, and to treat infected children - as well as to build sustainable capacity within the public health system to provide care and treatment on an ongoing basis. This commitment builds on previous work, which was launched when very few patients were receiving treatment for HIV/AIDS in South Africa. This second phase seeks to address the fact that only 21,000 patients were receiving treatment in the Western Cape in 2007, against a large and growing need of 80,000.
ARK provides 'SWAT teams' - flexible teams of doctors, nurses, and pharmacists, as well as data capturers and others needed to provide bridging capacity for clinics to be able to provide anti-retroviral treatment services, until government can take over. For this project, the provincial government has asked for ARK's help in developing and implementing a refined model of care. To manage the potential shortage of doctors, the new model will focus more heavily on nurse-led care at the smaller, primary-level sites, with doctors providing support and oversight.
The sites have been identified by the government as those requiring new anti-retroviral service. They will mostly enroll new patients, but will also take patients transferred from secondary and tertiary hospitals. This enables patients to receive care in clinics closer to where they live and frees capacity at the hospitals to enroll more patients.
The service includes Community Access and Adherence (CAA) support, whereby trained community workers offer support at home and in the community for prospective and existing patients. This service is provided by local community-based organizations, which is the element of the program provided by third parties. ARK also provides a data system to capture clinical and other information to record patient progress and treatment success.
ARK plans to open the proposed sites quickly, which should create further capacity for additional sites later in the project if needed.
This commitment aims to launch 14 new ARV sites by August of 2008. By the end of its duration (March 2010), this project will allow 10,433 caregivers, their partners, and children to be enrolled on treatment (out of 16,000 total patients at the clinics supported), with a below 10 percent mortality after two years on treatment.