Public private partnerships to end AIDS
25 February 2016
More needs to be done to increase the numbers of people receiving lifesaving antiretroviral (ART) drugs. The Alliance has been exploring innovative solutions to increase the capacity of community-based health services through public private partnerships, including this project in Myanmar.
In Myanmar there are currently 212,000 people living with HIV. At the end of 2014, 85,626 (40%) of these were receiving treatment. However, the Myanmar government has committed to expand this number to 110,370 (52%) by the end of 2016, moving towards the UNAIDS target of 90% of all people to be receiving ART by 2020.
Given these rising demands, the current public health infrastructure for treatment delivery will require innovation, including greater engagement with the private health sector.
Since 2009, Alliance Myanmar has been working in partnership with private sector general practitioners (GPs) in Yangon. Dr. Soe Naing, MD, Executive Director of Alliance Myanmar, said “This partnership brings together our extensive outreach experience delivered through a network of community-based organisations with a group of private GPs who are trained and contracted to conduct HIV clinical care for HIV-positive patients, including testing, initiating ART, and clinical follow-up services.”
Alliance Myanmar supports these GPs by offering commission-based funding, training, logistical supplies of ART and laboratory services. They also work with their community-based partner organisations to provide adherence counselling, home-based care, and tracing of ‘lost to follow-up’ patients.
The partnership has achieved good outcomes. It has increased patient access to ART, delivered retention rates of over 96% over five years, and achieved excellent immunological (CD4 cell count) recovery.
“This model provides an example of how public private partnerships can support the de-centralisation of HIV treatment delivery, complement over-burdened government health facilities and provide additional options for people living with HIV in terms of where they can access care”, said Dr. Soe Naing.
Myanmar still has a long way to go to achieve universal access to HIV services. It needs to scale up treatment, strengthen human resources, and improve the overall health and laboratory infrastructure. Developing innovative partnerships like this will be vital if the global UNAIDS targets to have 90% of people living with HIV on treatment by 2020 are to be met.