KSF Hospital  HIV/AIDS patients  challenges after June 2010 Emmanuel Lavieuville – MSF-F Cambodia
KSF Hospital (KSFH) MSF-F Project (1997-2010) <ul><li>MSF-F at KSFH </li></ul><ul><ul><li>Before June 2010 </li></ul></ul>...
Main challenges for  KSFH HIV/AIDS post June 2010 (1) <ul><li>Cost recovery scheme introduction by KSFH for all HIV/AIDS p...
Main challenges for  KSFH HIV/AIDS post June 2010 (2) <ul><li>Phnom Penh HIV/AIDS prisoners still supported by MSF-F withi...
Main challenges for  KSFH HIV/AIDS post June 2010 (3) <ul><li>Threat to Phnom Penh PLHA access to care & treatment?  </li>...
Upcoming SlideShare
Loading in …5
×

Presentation 5 by msf f

186
-1

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
186
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Presentation 5 by msf f

  1. 1. KSF Hospital HIV/AIDS patients challenges after June 2010 Emmanuel Lavieuville – MSF-F Cambodia
  2. 2. KSF Hospital (KSFH) MSF-F Project (1997-2010) <ul><li>MSF-F at KSFH </li></ul><ul><ul><li>Before June 2010 </li></ul></ul><ul><ul><ul><li>1997-2001: treatment OI </li></ul></ul></ul><ul><ul><ul><li>2001: first patient under ART </li></ul></ul></ul><ul><ul><ul><li>2003: decentralization to Kg Cham PRH </li></ul></ul></ul><ul><ul><ul><li>2005: initial focus & activities to keep under ttt HIV patients of cohort jailed in PP prisons </li></ul></ul></ul><ul><ul><ul><li>2006: d evelopment of an ambulatory strategy for co-infected DR-TB cases management </li></ul></ul></ul><ul><ul><ul><li>2007: ARV treatment supplied by NCHADS (almost 100%) </li></ul></ul></ul><ul><ul><ul><li>2008: s tart the HIV cohort integration process into the public health system. MoU signed between MSF & MoH. </li></ul></ul></ul><ul><ul><ul><li>2009: c ontinued progressive integration of the KSFH cohort treatment and follow up within KSF Hospital. Working plan & regular TWG for the formal handover to KSFH and to NCHADS. Initial informal request of NCHADS to extend its support until March-June 2010. MSF-F agree for technical support up to March and OI essential drugs stock up to June 2010. </li></ul></ul></ul><ul><ul><ul><li>2010: formal request of th e MoH to MSF-F to extend its support up to June. MSF-F overall financial support kept up to June 2010. June 2010 formal end of the handover. </li></ul></ul></ul><ul><ul><li>After June 2010: </li></ul></ul><ul><ul><ul><li>Financial support to AUA </li></ul></ul></ul><ul><ul><ul><li>Specific support to Phnom Penh Prison HIV/AIDS prisoners kept (MoU with MoH) </li></ul></ul></ul><ul><ul><ul><li>Ensure the continuation of the care & treatment for the patients of KSFH cohort </li></ul></ul></ul>
  3. 3. Main challenges for KSFH HIV/AIDS post June 2010 (1) <ul><li>Cost recovery scheme introduction by KSFH for all HIV/AIDS patients </li></ul><ul><ul><li>From 1st July: </li></ul></ul><ul><ul><ul><li>OPD HIV/AIDS patients must pay 8000 Riel/consultation (+ cost of other tests) </li></ul></ul></ul><ul><ul><ul><li>IPD HIV/AIDS patients must pay 10 000 Riel/hospitalisation per day and have to pay 7 days in advance to be admitted (+ medical equipment, OI essential drugs & relevant investigations needed) </li></ul></ul></ul><ul><ul><li>No budget & no partner? </li></ul></ul><ul><ul><ul><li>MSF-F identified partners & solutions for specific groups of patients </li></ul></ul></ul><ul><ul><ul><ul><li>2008: Paediatric cohort h/o to CHC. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>2009: DR-TB co-infected patients h/o to CHC, h/o to Magna of all cohort pregnant mothers. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>2009-2010: access to HEF for poor patients of the cohort with URC, FHD & AUA help. </li></ul></ul></ul></ul><ul><ul><ul><li>NCHADS & KSFH </li></ul></ul></ul><ul><ul><ul><ul><li>Global Fund Round 8 transferred to Round 9 includes the KSFH cohort </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Aids Healthcare Foundation (AHF) is the Sub-Recipient of NCHADS for KSFH and other cohorts </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Global Fund R9 fund for Year 1 of the grant not before January 2011 at best! NCHADS asked AHF to advance fund for KSFH from July 2010 to fill the gap but nothing yet! </li></ul></ul></ul></ul><ul><ul><ul><li>Urgent Issues! </li></ul></ul></ul><ul><ul><ul><ul><li>No funds to support the functioning of the cohort & therefore establishment of a cost recovery by the KSFH against national policy principle! </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Increase the access for patients to HEF : agreement of URC to support a post-ID system at KSFH IDD. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>No information at all on GF R9 budget lines & estimated timeline </li></ul></ul></ul></ul><ul><ul><ul><ul><li>No formal information to all partners on AHF funds to fill the gap </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Other options? MSF-F provided formal information on current situation to main stake holders and KSFH is initiating a regular meeting with all PLHA organisation involved at KSFH to help define solutions </li></ul></ul></ul></ul>
  4. 4. Main challenges for KSFH HIV/AIDS post June 2010 (2) <ul><li>Phnom Penh HIV/AIDS prisoners still supported by MSF-F within KSFH project </li></ul><ul><ul><li>Since 2005 MSF-F identify specific issue for continuation of treatment for patients of the cohort jailed in PP Prisons </li></ul></ul><ul><ul><ul><li>2005-2007: agreement with PP jails to extract HIV/AIDS prisoners on regular basis for consultation and to receive treatment at KSFH </li></ul></ul></ul><ul><ul><ul><li>From 2007: because of progressive increase of the number of prisoners under ART MSF-F set up a regular mobile clinic to CC1 & CC2. Still running until today. </li></ul></ul></ul><ul><ul><ul><li>Since end 2008 MSF-F support access to VCCT for Phnom Penh Prisoners </li></ul></ul></ul><ul><ul><ul><li>Since February 2010 MSF-F implements a systematic screening for HIV & TB in PP prisons. </li></ul></ul></ul><ul><ul><ul><li>Today: 73 on ART and 36 on OImore than 100 patients under ART in PP prisons followed by MSF-F </li></ul></ul></ul><ul><ul><li>MoU </li></ul></ul><ul><ul><ul><li>Prisoners project is part of MSF-F MoU with the MoH (2008-2010) </li></ul></ul></ul><ul><ul><ul><li>Additional MoUs with MoI, Cenat & PPMHD </li></ul></ul></ul><ul><ul><li>Challenges since handover of KSFH project: </li></ul></ul><ul><ul><ul><li>MSF-F cannot receive the ART from the KSF Hospital as in the past. </li></ul></ul></ul><ul><ul><ul><li>MSF-F faces difficulties to register in a Phnom Penh cohort the newly screened HIV/AIDS patients imprisoned. </li></ul></ul></ul><ul><ul><ul><ul><li>Is KSFH still the CoC centre for the Phnom Penh prisons? Still the closest CoC! </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Both NCHADS & KSFH silent. No clear policy. </li></ul></ul></ul></ul><ul><ul><ul><li>Number of prisoners under treatment is not so high but CC1 & CC2 with many judicial extraction on weekly basis does not have the capacity to extract such a no. of patients! </li></ul></ul></ul><ul><ul><ul><li>The Global Round 10 proposal does not include the HIV/AIDS prisoners ! What is going to be the policy in the future? </li></ul></ul></ul>
  5. 5. Main challenges for KSFH HIV/AIDS post June 2010 (3) <ul><li>Threat to Phnom Penh PLHA access to care & treatment? </li></ul><ul><ul><li>In 2010 because of planned withdrawal or cut in funding different major actors involved in HIV care & treatment in Phnom Penh are reducing or h/o their HIV/AIDS activities: </li></ul></ul><ul><ul><ul><li>KSFH – MSF-F (3395 patients on ART; 290 on OI) : largest cohort & with 60 beds one of the main national referral ward for complicated cases! 30 beds for HIV+ patients only since July 2010. </li></ul></ul></ul><ul><ul><ul><li>Sihanouk Hospital – Hope worldwide (2401 patients on ART; 379 on OI): GF R9 funding reduction lead to reduce activities to 3 new admission per day since Jan 2010 and the closure of 10 beds in Aug 2010. </li></ul></ul></ul><ul><ul><ul><li>Preah Ketomelea – IPD supported by Douleur Sans Frontières (855 patients on ART; 172 on OI): will reduce activities due to contraints of funding from GF. 30 beds to 15 beds in March 2010. </li></ul></ul></ul><ul><ul><ul><li>Kossamak – SEAD (2550 patients on ART; 470 on OI) with 18 IPD beds: h/o to AHF with GF Round 9 money planned in Aug. 2010. </li></ul></ul></ul><ul><ul><ul><li>Maryknoll activities h/o in Dec 2010. </li></ul></ul></ul><ul><ul><li>Main consequences: </li></ul></ul><ul><ul><ul><li>Whether stopped or h/o over the services provided are not free of charge anymore & HEF not accessible in most cases to HIV/AIDS patients. Immediate & direct limitation to the access of care & treatment for the poorest HIV/AIDS patients of Phnom Penh affected cohorts . </li></ul></ul></ul><ul><ul><ul><li>Significant drop in the capacity of inclusion for new HIV/AIDS patients in Phnom Penh area </li></ul></ul></ul><ul><ul><ul><li>Significant decrease in the Hospitalisation capacity and access for Phnom Penh HIV/AIDS patients </li></ul></ul></ul><ul><ul><ul><li>Some HIV related specific complications (CMV, etc…) may not be treated anymore in Phnom Penh </li></ul></ul></ul><ul><ul><ul><li>Significant decrease of the supported laboratory investigations to help clinicians in the f/u of the patients </li></ul></ul></ul>
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×