The World Bank is to give $60 million to three African countries already beginning to implement antiretroviral treatment for HIV in the first major grant from its Regional HIV/AIDS Treatment Acceleration Project (TAP).
"The project will test the feasibility of scaling up ongoing HIV/AIDS treatment initiatives using a combination of public/private/NGO partnerships to serve the most vulnerable groups while each country strengthens its health system", said Michael Azefor, a member of the World Bank's Task Team Leader (TTL) for the project.
The World Bank is also granting $15 million to Mali through the Multi-Country HIV/AIDS Program (MAP) to begin training health care workers for the arrival of antiretrovirals, alongside scale up of prevention activities.
The TAP grant to Burkina Faso, Ghana and Mozambique has three components. The first Component of the project (US$38.82 million) will finance direct costs of scaling up ongoing care and treatment programs with Burkina Faso, Ghana, and Mozambique receiving US$13.48 million, US$9.86 million, and US$15.48 million respectively
The second component (US$16.51 million) will strengthen institutional capacities for HIV/AIDS care and treatment allocated as follows: Burkina Faso, US$4.63 million, Ghana US$5.72 million, and Mozambique US$6.16 million. These funds will help countries refine and adapt national treatment policy using WHO recommended standards, strengthen health facility response capacity, train required staff and strengthen the drugs supply chain as well as institute effective monitoring and evaluation systems and promote information exchange on lessons learnt.
Ten percent of the IDA grant (US$6 million) will be administered in part by the WHO (US$ 4.0 million) for technical support to the TAP countries and for regional learning facilitation. This will include assistance to countries in refining and treatment guidelines and protocols, in developing curricula and pedagogical methods for training health and related staff, in establishing systems for managing patient compliance, and strengthening monitoring and evaluation. Regional learning consultations and progress reviews and related operational research work will be supported by a small TAP unit within the Regional Commission on HIV/AIDS and Governance in Africa at the UNECA, which will administer the other part of the grant.
TAP will be patient-centered, meet the treatment needs of HIV/AIDS infected persons (PLWHA) and their families within a continuum of five comprehensive elements, including community care and support, prevention of mother to child transmission plus, opportunistic infections, antiretroviral therapy, and antiretroviral treatment.
In Ghana some cost recovery from patients will take place: a charge of 50,000 cedis a month (US$5.50) will be levied for antiretroviral treatment, according to the Accra Mail. Cost recovery information for Mozambique and Burkina Faso has not been reported.
The TAP will strengthen institutional capacity of national treatment committees of public referral treatment centers; monitoring treatment quality and disseminating results achieved; and facilitating inter-country learning activities.
Grassroots organisations, private companies like Private Enterprise Foundation/Pharma Access International in Ghana, faith-based groups like the Communita di St. Egidio in Mozambique and a network of associations of people living with HIV/AIDS (PLWHA) in Burkina Faso will be directly involved in the implementation of the project, building on progress already achieved on a smaller scale in partnership with ministries of health.