Minutes fifth twg hiv/aids and health

Minutes Fourteenth TWG ‘Health Sector HIV/AIDS Forum’

NAC Conference Room, 12 April 2006, 8.30 hours
1. Opening
The meeting was opened by Douglas Lungu from the Clinical Department of the
MOH at 8.45. All participants were welcomed. Approximately 40 people attended the
meeting
2. Introductions
Self-introductions were made as several new people attended the meeting.
3. Minutes of last meeting
The minutes of the last meeting were discussed and approved.
Matters arising from the minutes:
d4T which strength
4. Agenda
The agenda was adopted.
5. National HIV testing week
Philip Moses informed the meeting that a national HIV testing and counselling
week will take place in the week beginning 10 or 17 July. Districts task forces
will be formed to make preparations. Some 75,000 HIV test kits have been
ordered and are expected to arrive in Malawi by the end of June. There is a
moral obligation to follow up on those found HIV-infected (HAART and/or
CTX). The numbers of people found HIV-infected that are in need for HAART
are expected to be within the capacity of the health system.
A discussion took place on testing of children. National guidelines for testing
of children are being developed.
The question was raised if CTX will be available in syrups for children. It was
noted that CTX in Malawi for children normally comes in tablets and that the
CPT policy prescribes tablets for all including children.
6. HIV test kit supply management
No presentation was made as the responsible person for the HIV test kit
supply management was not present at the meeting. Concern was expressed
that this issue was not discussed.
7. Gap between tested HIV-positive and start of ART
Tony Harries explained the steps from HIV testing to staging and provision of
ART. Is there a need for a ‘pre-ART-Register’ as many people with Stage II
disease are now lost in the system. In 4-5 mission hospitals a chronic care
programme is running. It is not known yet if this gives better results. There is a
need to form a task force looking into the development of this approach for
people with HIV-disease who are not yet eligible for ART. Important questions
are ‘how to manage these patients specifically with CTX and how to provide
CTX to children born out of HIV-infected mothers’

8. Updates
a. ART (HIV Unit)
By the end of March 2006 a total of 46,417 people ever started on ART in the public sector. Some 1,500 people ever started in the private sector. By the end of December 74% of people ever started were alive and on treatment. The Ministry is planning to nominate ART sites that are doing an excellent job. b. Diflucan partnership programme. No update as the responsible officer
c. One d4T regimen
The current first line regimen consists of either 30mg or 40mg d4T. There are reports and some research showing that 30mg d4T reduces the side effects and that therapeutic levels are reached for people with a body weight over 60kg. One d4T regimen would also simplify logistics. d. Decentralisation
there will be a phased approach to decentralisation with a larger role for medical assistants. Operational research will be carried out to determine if nurses can provide ART. e. TB-HIV
The following 4 steps are discussed to be taken: 1. incorporate HIV parameters (HIV testing, status, CPT) in the TB 2. HIV counselling and testing in the process of registration 3. Assistant DTO working in the ART clinic. The ART clinic will 4. there are 100 ART clinic and 44 TB clinics in the public sector and the number of TB clinics are expected to expand. f. CHBC kits
g. Re-supply of therapeutic feeding
There are different types of plumpynut. What is the advice from the MOH to give? • Thyolo district with support from MSF is planning to scale up to universal access to all who need ART by the end of 2007. Plans are being prepared. • The CT flipchart has been pre-tested. The PMTCT flipchart is ready to
10. Closure
The chair closed the meeting at 11.30 hours

Source: http://www.hivunitmohmw.org/uploads/Main/Minutes-Health-Sector-HIV-Forum_14.pdf