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Interview with Dr. Adrienne Chan, Medical Coordinator for Dignitas in Zomba, Malawi
 
November 29, 2009
 
As Dignitas and partners make strong advances to fight HIV in Malawi, increasing the number of people living with HIV/AIDS starting antiretroviral treatment, expanding prevention of mother-to-child transmission and integrated HIV/TB care, training healthcare workers and much more, a crisis loomed in April until recently. Malawi (and other African countries) experienced a shortage of medicines. While many worked collaboratively to avert a crisis, the experience was harrowing and our Medical Coordinator, Dr. Adrienne Chan, waves a red flag. Funding must continue to flow so the medicines and services we know are making a difference continue to reach people in need.
 
Carol Devine: When was it clear to you that there was going to be a stock out problem? Did you have warning signs or proactive messages from suppliers?
 
Dr. Adrienne Chan: Since 2004 when the Ministry of Health (MOH) in Malawi first rolled out antiretroviral treatment (ART), we have not yet had any stock outs of antiretroviral (ARV) drugs. Malawi has had an impressive and successful government-led ART scale up program, and 180,000 patients are currently on ART, being provided at well over 200 public sites. Some of the larger programs are supported by NGO partners (including Dignitas International and Médecins Sans Frontières-MSF amongst many others). By World AIDS Day 2009, we will have enrolled almost 12,000 patients on ARVs (10 per cent are children) in Zomba District alone through the support of Dignitas International. 
 
However, since April 2009, we have had some harrowing times of near stock outs of ARVs that have been averted only through the ongoing hard work of the MOH and their partners. The current issue of near stock outs has recently been acknowledged in the Malawi news media by Dr. Mary Shawa, Principal Secretary for the Department of Nutrition, HIV and AIDS in the Office of the President and Cabinet (OPC), to be related to a delay at the Global Fund to Fight AIDS, TB and Malaria (Global Fund), and approval for disbursement of funds for ARV drugs.  

The majority of financial support for Malawi’s ART program and the country’s successful response to HIV/AIDS has come from the Global Fund. Starting with its first round of funding in 2002, the Global Fund disbursed over US$465 million to the country, and the country has been acknowledged internationally to have managed these funds and their ART program extremely well and with good accountability. The Department of HIV and AIDS at the MOH and implementers on the ground have been aware of a potential risk for stock outs while we have waited for emergency deliveries (via UNICEF) of bridging ART since April 2009. We have been working together since that time, to try our best to ensure no stock outs occur for patients.   

>>Continued on Next Page 

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Dr. Adrienne K. Chan has been working as Dignitas’s Medical Coordinator in Zomba since 2007.

Carol Devine is an AIDS activist and a Board Member of Dignitas International.

If you have any questions or would like to learn more, we can be reached at:

info@dignitasinternational.org