1. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 1 HIV Prevention, Care and Treatment The Rwandan Experience Dr Anita Asiimwe, Treatment and Research AIDS Centre Rwanda

2. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 2 Administrative Structure Principal Institution : MINISANTE Coordination : TRAC Training and Supervision : H.D Executing organ : FOSA

3. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 3 VCT Pilot Phase: 1997 Extension: After three years  Support from different partners Beginning of activities in Rwanda

4. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 4 Evolution of VCT

5. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 5 Begining of Actvities in Rwanda(1) PMTCT Pilote Phase: April 1999  UNICEF Support Extension: March 2001  Support from different partners

6. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 6 Evolution of PMTCT

7. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 7 VCT and PMTCT Centers in Rwanda

8. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 8 Private ARVs since 1999  CHUK, CHUB, KMH  Cost/month/dose ~ USD 340 Extension: March 2003 to today  Support from different partners Care and treatment

9. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 9 Evolution of ARVs

10. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 10 How this was achieved Vision  Increased longevity and improved quality of life for people living with HIV/AIDS (PLWHA) in Rwanda Approach  Decentralisation  Integration with existing health infrastructure  Community mobilization  Linkage between treatment, care and prevention  Joint procurement to reap economies of scale  Rapid scale-up, including iterative learning

11. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 11 Role of TRAC Orientation of partners Setting of standards and development of guidelines and norms Training of trainers and Supervisors Elaboration and dissemination of tools: Training protocol Providers’ manual Data management Supervision Research

12. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 12 Percentage of patients on ARVs per DP

13. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 13 Lessons learned Decentralization of HIV/AIDS services is the mainstay to increase accessibility without which both the quality and quantity of services remain limited HAART is desirable, feasible and has become an ever improving reality in the Rwandan setting Participation of beneficiaries, communities and the population at large forms a vital element of HIV/AIDS care and treatment

14. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 14 Lessons learned Human resource development plays a pivotal role in the success of these programmes More than any campaigns, the advent of HAART has reduced the level of stigma in people living with HIV AIDS

15. Downloaded from http://www.hiv-msd.infohttp://www.hiv-msd.info 15 The way forward Transferring lessons & successes from HIV/AIDS to other programs Clear vision Strong political commitment Good will of all partners Broad based community & civil society participation