Letter from One to One Childrens Fund
We welcome and are pleased to respond to the
Committee's Inquiry, "Acting through Intergovernmental Organisations
to control the spread of diseases".
Since the early 2000s, One to One Children's
Fund has helped thousands of children suffering from trauma, or
living with HIV/AIDS or amid political conflict to gain resilience,
health and hope. We work with local partners to create models
of psycho-social and medical care and education that have been
replicated by governments and communities in Africa, Kosovo and
India as well as the Middle East.
This submission focuses on our engagement
with HIV/AIDS treatment in Africa outlining how we have worked
with local practitioners to develop and support innovative models
of best practice, such as the Paediatric AIDS Treatment for Africa
(PATA). We urge policymakers in Britain and internationally to
consider how they can co-ordinate better to deliver greater focus
and resource to enable extension of this and other successful
blueprints for the treatment of HIV/AIDS in children. The One
to One Children's Fund programme has been acknowledged as a key
stage in the development of a national rollout plan for children
in South Africa.
In 2002, One to One Children's Fund began working
in partnership with Kidzpositive and its co-founder Dr Paul Roux,
paediatric consultant at the Groote Schuur Hospital in Cape Town.
We funded a pioneering programme of anti-retroviral (ARV) research
and treatment for infected children from the townships of the
Western Cape. Over 90% of the recipients responded dramatically
to the medication, being able to leave hospital and demonstrate
that indigent families from poorer communities could adhere to
a complex drug regimen in the home. As the Premier of the Western
Cape observed in 2004
"One to One has assisted us in developing
a child treatment model that will be used across the province
and which has potential to be used across South Africa. By developing
a holistic approach to treatment that includes aspects like income
generating projects and education of families, this model has
been very successful in keeping patients on the strict treatment
program".
(Marthinus van Schalkwyk)
In Africa there are now over 2.3 million children
infected with HIV, but currently fewer than 5% have access to
lifesaving medical treatment. The vast majority of children lag
far behind adults in gaining access to the rollout of anti-retroviral
treatment. It's hard to comprehend, but a child dies from an AIDS
related illness every minute of every day. One to One Children's
Fund strives to enhance quality of health care, holistic treatment
and comprehensive support for HIV/AIDS children, their families
and for communities throughout Africa. While progress is being
made in provision of care and treatment for children affected
and infected with HIV, current coverage levels, particularly in
Sub-Saharan Africa remain unacceptably low.
PATA, a One to One Children's Fund initiative
that now links some 50 child HIV clinic teams from more than 20
African countries to develop professional capacity to cope with
the epidemic in a ripple across Africa. It is dedicated to expanding
access to care for children affected and infected with HIV and
their families throughout the African continent. PATA's is also
supported by Kidzpositive, UNICEF, the Clinton HIV/AIDS initiative,
Sidaction.
PATA values and promotes models of care that
address both the medical and psychosocial needs of the child and
that offer high quality, integrated, patient-centred, and affordable
services. The organization works collaboratively with healthcare
teams, serving as a resource to support achievement of their stated
goals. PATA facilitates the development of local capacity for
high quality HIV care through promotion of learning through team
work, sharing of experiences, and spreading of good practice.
The foundation of PATA lies with the PATA teams: multidisciplinary
Treatment Teams of nurses, pharmacists, counsellors and
doctors, who work together at clinics across Sub-Saharan Africa
to form a community of compassionate and committed individuals
who provide treatment and care to children infected with HIV and
their families. Nearly one third of children receiving ARVs are
cared for in PATA affiliated clinics.
PATA believes in the principle of developing
sustainable interventions that are linked to, rather than in parallel
with the work of government and other partners. PATA works to
extend the horizons of care for each of its affiliated clinics
by encouraging Treatment Teams to network with each other through
annual meetings, a newsletter and the PATA website. This enables
PATA teams to share learning and experience and ultimately develop
their own visions for health care improvement. PATA also supports
Treatment Teams to reach out to neighbouring clinics and other
partners to improve quality of care and extend the "PATA
effect" through leadership and mentoring.
The fundamental purpose of PATA is to assist
Treatment Teams to improve the quality of health care they deliver
to their patients. PATA works to build health care capacity in
local communities through support for training, mentoring, increased
access to tools, resources and information, and support for local
initiatives supporting infected and affected children. PATA seeks
to achieve this through fundraising from private and institutional
donors, partnering with individuals and international agencies
and building relationships with other field-based organizations.
It also aims to increase access to essential
health care services for HIV-infected/affected children through
provision of support for increased geographical coverage of clinics
for HIV-infected and affected children as well as assistance in
reaching clinics from remote sites through provision of transportation
subsidies. Furthermore, it is focused on strengthening aspects
associated with psychosocial care and support for children living
with HIV including assistance with disclosure, addressing stigma
and discrimination, management of side effects, and improving
adherence to ART.
PATA's annual conference is held to coincide
with World Aids Day and is a key catalyst in the organisation's
drive to increase the spread of expertise by systematically identifying
(through evaluation) and disseminating examples of replicable
good practice. The report of the 2007 is currently being published
and we will send a copy to the Committee as soon as it is available.
A representative from UNICEF who attended the 2006 event observed:
"PATA is pretty much the best FORUM
I have ever attended and I have been attending them for years".
(Robert Gass, UNICEF)
Crucially, the organisation evaluates the impacts
of its interventions, including impact of performance improvement
activities at PATA clinics on overall child health outcomes including
overall child mortality, and impact of targeted support for HIV
care and support on the delivery of broader health care. Further
information in this regard can be submitted, should the committee
request.
Other key initiatives which are being rolled
out via PATA Clinics are:
(1) Expert patient projects where HIV positive
people are trained to support, counsel and advise newly diagnosed
patients, including children. In the process people with HIV/AIDs
are destigmatised. They also perform vital functions in clinics,
freeing up health care professionals' time, eg taking temperature,
weighing and data recording, counting pills etc.
(2) Focus on adolescents, looking at ways
to educate and stop the spread of HIV in this particularly susceptible
group.
(3) Focus on TB -prevention and treatment.
The opportunistic nature of the diease means that it is inextricably
linked with HIV/AIDS. PATA's 2007 conference had masterclasses
focusing on adolescents and TB.
One To One also funds initiatives in South Africa
linking HIV/AIDS initiatives with football, "KickAids".
Young people are attracted to testing events via football. These
one-day events provide healthy, team participation in the most
popular sport in Africa and use the opportunity to educate about
HIV, counsel for testing and then do simple, accurate tests. Results
are made known, kids are counselled to either remain HIV-free
or are offered medication and counselling to deal with their HIV+
status. A major cross- Africa roll-out of this initiative is planned
for 2010 to coincide with the World Cup in Cape Town, South Africa.
Our vision is for all HIV-infected and affected
children in Africa to have access by 2015 to comprehensive, high
quality health services including ART. We believe that this can
best be achieved by supporting committed health care providers
to enhance, expand and extend their work to impact others through
a ripple effect in the community (the "PATA effect").
We would welcome discussions with the Committee and key policymakers
in the UK and internationally to help us make this a reality,
maximizing value from considered, targeted and evaluated resource
allocation.
21 January 2008
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