Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen
Abstract Background Unstable settings present challenges for the effective provision of antiretroviral treatment (ART). In this paper, we summarize the experience and results of providing ART and implementing contingency plans during acute instability in the Central African Republic (CAR) and Yemen....
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | Conflict and Health |
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| Online Access: | http://link.springer.com/article/10.1186/s13031-018-0161-1 |
| _version_ | 1828837309641916416 |
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| author | Cecilia Ferreyra Daniel O’Brien Beatriz Alonso Abdulbasset Al-Zomour Nathan Ford |
| author_facet | Cecilia Ferreyra Daniel O’Brien Beatriz Alonso Abdulbasset Al-Zomour Nathan Ford |
| author_sort | Cecilia Ferreyra |
| collection | DOAJ |
| description | Abstract Background Unstable settings present challenges for the effective provision of antiretroviral treatment (ART). In this paper, we summarize the experience and results of providing ART and implementing contingency plans during acute instability in the Central African Republic (CAR) and Yemen. Case presentation In CAR, MSF has provided HIV care in three conflict-affected rural regions; these were put on hold throughout the acute phase of violence. “Run-away bags” containing 3 or 4 months of ART were distributed to patients at MSF facilities. Among 1820 HIV patients enrolled into care, 1440 (79%) initiated ART. By December 2016, 782 (54%) patients were still under ART, 354 (25%) have been lost to follow up and 182 (13%) had died. In 2013, when violence disrupted services, 683 patients were receiving ART. Between September–December 2013, 594 (87%) patients received runaway bags and by February 2014, 313 (53%) of these patients returned to the clinic. In Yemen, when violence erupted, patients received a health card that included a helpline to call in case of drug shortages in admission to emergency stocks; this was not possible in CAR due to lack of a functioning telephone network. One thousand six hundred fifty-five PLWHA have been enrolled in care and 1470 (89%) initiated ART; 1056 (72%) are still followed on ART, 126 (9%) were lost to follow up, and 288 (20%) died. In January 2011 clashes began and by April 2011 MSF medical activities were interrupted. Of the 363 patients receiving ART, 363 (100%) received emergency bags to cover 9 months and by February 2012, 354 (98%) patients returned to care. In March 2015 a new wave of conflict affected Yemen, forcing HIV activities to revert to contingency planning. Conclusions This experience provides further evidence that provision of HIV treatment and emergency drug stocks can be successfully provided to most patients in both conflict-affected settings. |
| first_indexed | 2024-12-12T18:39:15Z |
| format | Article |
| id | doaj.art-b4997b3e73f14736b873456f60eb2352 |
| institution | Directory Open Access Journal |
| issn | 1752-1505 |
| language | English |
| last_indexed | 2024-12-12T18:39:15Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Conflict and Health |
| spelling | doaj.art-b4997b3e73f14736b873456f60eb23522022-12-22T00:15:42ZengBMCConflict and Health1752-15052018-07-011211710.1186/s13031-018-0161-1Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and YemenCecilia Ferreyra0Daniel O’Brien1Beatriz Alonso2Abdulbasset Al-Zomour3Nathan Ford4Médecins sans Frontières SpainMédecins sans FrontièresMédecins sans Frontières SpainNational AIDS ProgramCentre for Infectious Disease Epidemiology and Research, University of Cape TownAbstract Background Unstable settings present challenges for the effective provision of antiretroviral treatment (ART). In this paper, we summarize the experience and results of providing ART and implementing contingency plans during acute instability in the Central African Republic (CAR) and Yemen. Case presentation In CAR, MSF has provided HIV care in three conflict-affected rural regions; these were put on hold throughout the acute phase of violence. “Run-away bags” containing 3 or 4 months of ART were distributed to patients at MSF facilities. Among 1820 HIV patients enrolled into care, 1440 (79%) initiated ART. By December 2016, 782 (54%) patients were still under ART, 354 (25%) have been lost to follow up and 182 (13%) had died. In 2013, when violence disrupted services, 683 patients were receiving ART. Between September–December 2013, 594 (87%) patients received runaway bags and by February 2014, 313 (53%) of these patients returned to the clinic. In Yemen, when violence erupted, patients received a health card that included a helpline to call in case of drug shortages in admission to emergency stocks; this was not possible in CAR due to lack of a functioning telephone network. One thousand six hundred fifty-five PLWHA have been enrolled in care and 1470 (89%) initiated ART; 1056 (72%) are still followed on ART, 126 (9%) were lost to follow up, and 288 (20%) died. In January 2011 clashes began and by April 2011 MSF medical activities were interrupted. Of the 363 patients receiving ART, 363 (100%) received emergency bags to cover 9 months and by February 2012, 354 (98%) patients returned to care. In March 2015 a new wave of conflict affected Yemen, forcing HIV activities to revert to contingency planning. Conclusions This experience provides further evidence that provision of HIV treatment and emergency drug stocks can be successfully provided to most patients in both conflict-affected settings.http://link.springer.com/article/10.1186/s13031-018-0161-1HIVConflictContingency planEmergency response |
| spellingShingle | Cecilia Ferreyra Daniel O’Brien Beatriz Alonso Abdulbasset Al-Zomour Nathan Ford Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen Conflict and Health HIV Conflict Contingency plan Emergency response |
| title | Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen |
| title_full | Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen |
| title_fullStr | Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen |
| title_full_unstemmed | Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen |
| title_short | Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen |
| title_sort | provision and continuation of antiretroviral therapy during acute conflict the experience of msf in central african republic and yemen |
| topic | HIV Conflict Contingency plan Emergency response |
| url | http://link.springer.com/article/10.1186/s13031-018-0161-1 |
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