Treatment of AIDS in conflict-affected settings: a failure of imagination

Ellman, Tom; CULBERT, H; TORRESFECED, V

doi:10.1016/s0140-6736(05)70166-5

Cited by 16 publications

(8 citation statements)

References 5 publications

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“…In 2003, MSF began a pilot program to provide cART in confl ict settings in the Democratic Republic of Congo (DRC) and has since established programs in a number of confl ict-affected countries [3]. The organization's willingness to develop approaches to treating HIV in a confl ict setting built on past efforts to address tuberculosis (TB).…”

Section: The Médecins Sans Frontières Experiencementioning

confidence: 99%

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Providing antiretroviral care in conflict settings

Mills

Ford²,

Singh³

et al. 2009

Curr HIV/AIDS Rep

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Section: The Médecins Sans Frontières Experiencementioning

confidence: 99%

“…One population that appears almost systematically excluded are people living in settings of violent confl ict. This is in large part because of a long-standing and largely unchallenged view that the provision of medical assistance for chronic illnesses is not feasible in such settings [3].…”

Section: Introductionmentioning

confidence: 99%

Providing antiretroviral care in conflict settings

Mills

Ford²,

Singh³

et al. 2009

Curr HIV/AIDS Rep

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“…Because of these concerns, international guidance has until recently been hesitant about promoting access to ART in humanitarian emergencies (Ellman, Culbert, and Torres-Feced 2005; The Sphere Project 2011). However, emerging evidence suggests that ART provision is feasible in conflict and disaster humanitarian settings (Kiboneka et al 2009;O'Brien et al 2010), and more recent guidelines published by UNHCR and SPHERE have acknowledged the need to provide ART to displaced populations (UNHCR and Southern African HIV Clinicians Society 2007; The Sphere Project 2011).…”

Section: Introductionmentioning

confidence: 99%

Provision of antiretroviral care to displaced populations in humanitarian settings: a systematic review

Griffiths

Ford

2013

Medicine, Conflict and Survival

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Providing antiretroviral treatment (ART) in humanitarian settings is challenging. Reports suggest that ART provision is feasible, but the evidence base is scarce. We systematically searched three databases for studies reporting ART outcomes among displaced populations in settings of conflict, natural disasters or political instability, and estimated overall mortality using random effects models. Fourteen studies were identified, six in conflict areas, five in areas of post-election violence and three in natural disaster settings. The pooled proportion for mortality was 7.6% (95% CI 5.3-10.0%) at six months and 9.0% (95% CI 5.8-12.2%) at 12 months. Loss-to-follow-up at six months was 6.3% (95% CI 4.3-8.3%) and at 12 months was 8.1% (4.9-11.2%). Adherence was comparable to stable settings. Strategies used to support ART provision included additional drug stocks and establishing peer communication networks. Good clinical outcomes can be achieved with ART in disaster setting, in particular if supported by regional collaboration, standardized drug regimens and contingency planning.

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“…With regard to HIV/AIDS, it is thought that conflictrelated population movements, augmented civil Á/ military interactions, declined population health status (e.g. compromised immune system through nutritional deficiencies) and enhanced poverty render affected populations more vulnerable to HIV transmission (Bates et al, 2004;Ellman et al, 2005;Mock et al , 2004;Spiegel, 2004;UNAIDS, 2004).…”

Section: Introductionmentioning

confidence: 99%

Effect of an armed conflict on human resources and health systems in Côte d'Ivoire: Prevention of and care for people with HIV/AIDS

et al. 2006

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In September 2002, an armed conflict erupted in Cô te d'Ivoire which has since divided the country in the government-held south and the remaining territory controlled by the 'Forces Armées des Forces Nouvelles' (FAFN). There is concern that conflict-related population movements, breakdown of health systems and food insecurity could significantly increase the incidence of HIV infections and other sexually-transmitted infections, and hence jeopardize the country's ability to cope with the HIV/AIDS epidemic. Our objective was to assess and quantify the effect this conflict had on human resources and health systems that provide the backbone for prevention, treatment and care associated with HIV/AIDS. We obtained data through a questionnaire survey targeted at key informants in 24 urban settings in central, north and west Cô te d'Ivoire and reviewed relevant Ministry of Health (MoH) records. We found significant reductions of health staff in the public and private sector along with a collapse of the health system and other public infrastructures, interruption of condom distribution and lack of antiretrovirals. On the other hand, there was a significant increase of non-governmental organizations (NGOs), some of which claim a partial involvement in the combat with HIV/AIDS. The analysis shows the need that these NGOs, in concert with regional and international organizations and United Nations agencies, carry forward HIV/AIDS prevention and care efforts, which ought to be continued through the post-conflict stage and then expanded to comprehensive preventive care, particularly antiretroviral treatment.

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Treatment of AIDS in conflict-affected settings: a failure of imagination

Abstract: CitationTreatment of AIDS in conflict-affected settings: a failure of imagination., 365 (9456):278-80 Lancet

Cited by 16 publications

References 5 publications

Providing antiretroviral care in conflict settings

Providing antiretroviral care in conflict settings

Provision of antiretroviral care to displaced populations in humanitarian settings: a systematic review

Effect of an armed conflict on human resources and health systems in Côte d'Ivoire: Prevention of and care for people with HIV/AIDS

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