Sustainability of ARV provision in developing countries: challenging a framework based on program history.

Area of Science:

• Public Health
• Global Health
• Health Systems Strengthening

Background:

• Antiretroviral drugs (ARVs) are vital for HIV/AIDS management, improving disease course and quality of life.
• While initial ARV costs have decreased, ongoing expenses pose a challenge to long-term treatment program success.
• Program sustainability is a critical factor for effective and continuous HIV/AIDS care.

Purpose of the Study:

• To develop a conceptual framework for assessing the sustainability of ARV provision.
• To evaluate the sustainability of ARV provision schemes in selected countries.
• To identify factors influencing the long-term viability of ARV access.

Main Methods:

• Development of a conceptual framework and data collection instruments.
• Pilot study involving data collection in Brazil, Bolivia, Peru, and Mozambique.
• Qualitative data collection through interviews with key informants.

Main Results:

• Peru demonstrates high sustainability potential, with ARV provision integrated into the national HIV/AIDS program and government-funded.
• Mozambique relies on external aid but actively works to integrate ARV care into routine healthcare.
• Bolivia faces challenges in implementation and routinization, alongside external dependence for financing and supply chain management.

Conclusions:

• The conceptual framework effectively identified key events influencing sustainable ARV provision.
• Country-specific factors, including national program integration and funding sources, significantly impact ARV provision sustainability.
• Strategies for enhancing ARV provision sustainability require tailored approaches based on national contexts.