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Progress of implementation of the World Health Organization strategy for HIV drug resistance control in Latin America and the Caribbean.
Revista Panamericana De Salud Publica. 2011 Dec; 30(6):657-62.By the end of 2010, Latin America and the Caribbean (LAC) achieved 63% antiretroviral treatment (ART) coverage. Measures to control HIV drug resistance (HIVDR) at the country level are recommended to maximize the efficacy and sustainability of ART programs. Since 2006, the Pan American Health Organization has supported implementation of the World Health Organization (WHO) strategy for HIVDR prevention and assessment through regional capacity-building activities and direct technical cooperation in 30 LAC countries. By 2010, 85 sites in 19 countries reported early warning indicators, providing information about the extent of potential drivers of drug resistance at the ART site. In 2009, 41.9% of sites did not achieve the WHO target of 100% appropriate first-line prescriptions; 6.3% still experienced high rates (> 20%) of loss to follow-up, and 16.2% had low retention of patients (< 70%) on first-line prescriptions in the first year of treatment. Stock-outs of antiretroviral drugs occurred at 22.7% of sites. Haiti, Guyana, and the Mesoamerican region are planning and implementing WHO HIVDR monitoring surveys or threshold surveys. New HIVDR surveillance tools for concentrated epidemics would promote further scale-up. Extending the WHO HIVDR lab network in Latin America is key to strengthening regional lab capacity to support quality assured HIVDR surveillance. The WHO HIVDR control strategy is feasible and can be rolled out in LAC. Integrating HIVDR activities in national HIV care and treatment plans is key to ensuring the sustainability of this strategy.
Geneva, Switzerland, UNAIDS, 2007 Mar. 97 p. (UNAIDS/07.08E; JC1311E)In April 2003, the Committee of Cosponsoring Organizations of the Joint United Nations Programme on HIV/AIDS (UNAIDS) approved a Learning Strategy to help UN system staff develop competence on HIV and AIDS. The goals of the Learning Strategy are: to develop the knowledge and competence of the UN and its staff so that they are able to best support national responses to HIV and AIDS; and to ensure that all UN staff members are able to make informed decisions to protect themselves from HIV and, if they are infected or affected by HIV, to ensure that they know where to turn for the best possible care and treatment. This includes ensuring that staff members fully understand the UN's HIV and AIDS workplace policies and how they are implemented. To support UN country teams to implement the Learning Strategy, Learning Facilitators were selected at country level and trained in a series of regional workshops. The Learning Facilitators were then expected to ensure - along with the country teams-that the standards of the Learning Strategy were realized. This report is comprised of UN HIV/AIDS Learning Strategy case studies from sixteen countries: Botswana, Brazil, Burkina Faso, Cape Verde, India, Indonesia, Macedonia, Madagascar, Morocco, Nigeria, the Pan American Health Organization headquarters (United States), Pakistan, Paraguay, Vienna (Austria), Viet Nam, and Yemen. It presents each country's unique experience in implementing the strategy since its adoption in 2003. (excerpt)