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[Hove, United Kingdom], International HIV / AIDS Alliance, 2012 Jun.  p.Our vision is a world in which people do not die of aids. For us, this means a world in which communities: have brought HIV under control by preventing its transmission; enjoy better health; and can fully exercise their human rights. Our mission is to support community action to prevent HIV infection, meet the challenges of AIDS, and build healthier communities.We take great pride investing in a community-based response that understands what works in a local context, and that is strengthened by learning from a global partnership of national organisations. In 2011 this approach enabled us to reach 2.8 million people.
AFRICA HEALTH. 1997 Nov; 20(1):19-20.About 80,000 cases of tuberculosis (TB) are reported annually in South Africa. However, control measures have failed to check the growing numbers of TB cases and the spread of HIV is bound to exacerbate the situation. The Western Cape has almost 3 times the national notification rate (663 vs. 225 per 100,000). With only 60-70% of patients in Western Cape found to adhere to treatment, the Community Health Association of South Africa (CHASA) recommended using the DOTS strategy to control TB. The DOTS method, however, burdens both health workers and those patients who have to travel long distances to reach a health center. Such inconvenience contributes to poor treatment compliance. Any strictly medical approach to TB eradication will fail. Medical interventions must instead be set within, and supported by, a strong social and political network. A change in attitude is needed in order to ensure the success of DOTS. The creation of the Western Cape TB Alliance (TBA), TB control-related research, DOTS implementation, and project objectives and achievements are described.
BMJ (CLINICAL RESEARCH ED.). 1997 Nov 29; 315(7120):1395-6.Unless improvements are made in controlling tuberculosis (TB), 30 million people are expected to die from infection with and morbidity due to Mycobacterium tuberculosis in 1990-2000. Most TB patients can be treated in the community without an increased risk of them infecting people with whom they have contact. The feasibility of community-based treatment is especially welcome in sub-Saharan Africa where the epidemic of TB associated with HIV has ruled out the possibility of comprehensive hospital-based care. For example, the caseload in Malawi increased from 5334 in 1985 to 19,195 in 1995. Over a similar period, the cure rate for smear-positive cases decreased from 90% to 63% and bed occupancy reached 400% in cities. The consequences of overcrowding include the nosocomial transmission of TB, including multidrug-resistant strains. Crowded wards are also likely to deter admission and adherence. Moreover, there is evidence that hospital-based TB treatment is about 3 times more expensive for both the patient and the health system than directly observed treatment in the community. The direct observation of treatment, rather than hospitalization, is advocated to promote adherence within the World Health Organization's (WHO) current global TB control strategy of directly-observed treatment, short-course (DOTS). While communities should be expected to sustain DOTS, the limitations of the community must be understood, while other elements of the WHO strategy are refined and monitored.