Following on from the results of the DART Trial
this project aims to demonstrate, outside the context of a clinical trial, how treatment for HIV can be decentralised to lower-level health care centres in sub-Saharan Africa. The aim is to show that it is possible to increase coverage and access to treatment in a cost-effective manner in Uganda, Malawi and Zimbabwe. The project has 3 overall aims:
• To map and describe delivery of training and clinical care , use of laboratories and treatment monitoring in HIV treatment centres through a survey of representative sites
• To demonstrate how decentralised strategies of clinical care and use of laboratories, informed by results from DART, would work in basically equipped health centres away from major hospitals
• To assess the economic consequences of different ART delivery strategies– in particular the cost-effectiveness, budget impact, equity effects and health system implications of the delivery strategies for ART roll-out in Africa.
A cross-cutting area of work will be in communicating to influence policy.