1. Overview of HIV/AIDS Care and Treatment Country Situation & KATH Lambert T. Appiah Lambert T. Appiah

2. Outline A brief background of HIV AIDS in Ghana A brief background of HIV AIDS in Ghana National Response National Response KATH situation KATH situation

3. HIV prevalence from population-based surveys in countries in West and Central Africa, 2003–2006 Mali Burkina Faso Cameroon Central African Republic Chad Cote dIvoire Democratic Republic of Congo Guinea Nigeria Senegal Sierra Leone Togo Niger Gambia Guinea-Bissau Equatorial Guinea Gabon Congo Ghana Benin Liberia Adult HIV prevalence % 6.0 – 8.0% 4.0 – <6.0% 2.0 – <4.0% 0 – <2.0% No available data 7 Sources: Various surveys and reports.

4. The median HIV prevalence Country population of 24 million Courtesy NACP

5. 2/12/2014NACP_ HSS 20105

7. What is Driving the Epidemic in Ghana? Factors Driving the Epidemic Youthful population 41% under 15 years PovertyUrbanisationMigration Cultural practices- widowhood rites, polygamy Protective Factors Awareness of HIV is High 98-99% (GDHS 2003) Condom use with non-cohabiting partners -28% (GDHS 2003)

8. National Strategic Framework (NSF II) 2006-2010 Policy advocacy and enabling environment Prevention and behavioural change communication Treatment care and support Mitigating the social, cultural, legal and economic impact Coordination management and institutional arrangements Research Monitoring and evaluation Resource mobilisation Key Components Ghana HIV/AIDS Strategic Framework 2006-2010 Republic of Ghana Ghana HIV/AIDS Strategic Framework 2006-2010 Republic of Ghana

9. Challenges Addressing HIV DR Differential performance across regions Long lag phase between setup and initiation of services Strengthening TB/HIV collaboration

10. Komfo Anokye Teaching Comprehensive care programme situation

11. BACKGROUND Set up within the Chest Clinic. Privacy for Clients/Families. Stigma/Discrimination within hospital Privacy for Clients/Families. Stigma/Discrimination within hospital Trained staff already dealing with DOTS- skills needed for effective delivery of HAART. Core group of TB/HIV co-infected patients to kick start HAART

12. Clinic Days: DAILY for CT inflow 2 Major Clinics: Mondays/Fridays Wednesdays for Adherence Counseling sessions Mondays/Fridays for Clinical Consultation, Ave 4 Doctors on Mondays & 4 on Fridays. Paediatric Clinic on Fridays The laboratory operates throughout the week

13. 2/12/2014Limbe Regional Hospital13 Important milestones HIV tests free for children 0-14 years and pregnant women and for the general population CD4 test free Pre-treatment work (FBC, FBS, Liver enzymes) at <$1 Follow-up lab tests (CD4, FBC, FBS, Liver enzymes) at $5 Free cotrimoxazole, fluconazole, TB treatment, and treatment for cerebral toxoplasmosis

14. Challenges Human Resource – Lack and high turn over rate Motivation PMTCT – improved considerably Overwhelming workload Diagnosis and management of some opportunistic infections Diagnosis and management of ADR/treatment failure Mx Infrastructures and equipments Data management constraints

15. The road is long…!!

16. The road is rough…!!

17. The road is winding …!!

18. HAART TB epidemic Integration/scale-up Challenges HIV epidemic The problem, the solution

19. Thank you for your attention Contributions+Qs Contributions+Qs