The Regional Expansion of Antiretroviral Therapy (TREAT)

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JCRC TREAT PROGRAM

Timetable for Regional Expansion of Antiretroviral Therapy (TREAT)

JCRC implemented the highly successful the Timetable for Regional Expansion of Antiretroviral Therapy (TREAT) Program, funded by USAID under PEPFAR. TREAT was a seven year project with a Budget of US $69.4 Million. The project started in December 2003, and closed on 30th September 2010. The overall TREAT program aimed at providing universal ART for all in need through an equitable, high quality and sustainable national program based on the ministry of health policy and guidelines. The specific objectives were as follows:

  • To build capacity and establish a framework for quality ART program, develop essential infrastructure mainly through renovation and expansion of existing space, within the selected health facilities
  • To set up ART centres in partnership with private and public sectors including regional referral hospitals, faith based hospitals, health centres.
  • To establish logistics for efficient and accountable provision of ART
  • To train key care providers in provision of ART and later provision of services
  • To set and improve laboratory monitoring in the provinces
  • To establish a quality assurance program
  • To establish develop partnerships with key stakeholders in the area of HIV/AIDS treatment

For the first time in Uganda, TREAT managed to reach a number of remote and difficult to reach areas with high HIV prevalence. ART sites were established in IDP camps in Gulu and Pader districts; the marginalized communities of Batwa in Bwindi; the fishing community in Kalangala and Sesse islands; and hard to reach areas like Kaabong, Kisoro and Moyo hospitals. Other HIV/AIDS partners were able to carry this work forward. 25 outreach sites were established in key regions of Uganda.

USAID/Uganda amended its cooperative agreement with JCRC to extend TREAT program activities from a three Year, to a seven Year program. This was due to   the JCRC great success in expanding ART services nationally, from four sites in 2003 to 52 sites by September 2010.   Over 90,000 people received life saving HIV/AIDS treatment through the program, and the program greatly exceeded expectations for expansion of quality ART nationally.

TREAT was implemented in Seven Regional Centers of Excellence (Kakira, Mbale, Gulu, Fort Portal, Mubende, Mbarara, Kabale), that worked closely with the Regional Referral hospitals in their respective locations. The TREAT program successfully expanded access to ART, increasing the number of people on ART from less than 10,000 in 2003 to over 90,000 by 30th September 2010.

Key TREAT Project achievements;  

  • Rapidly scaled up and expanded quality HIV/AIDS care and treatment services to 52 ART sites and 25 outreaches in all regions of Uganda, as early as December 2003, before ART services became available outside Kampala.Initiated over 90,000 Ugandans on ART, and saved thousands of Ugandan lives. Saved children from being orphans, families  were able to see their children grow into adulthood.
  • Patients prevented from repeated TB attacks, and other OIs.
  • Greatly improved quality of life of HIV positive patients
  • Provided advanced care and state of the art laboratory services in urban and rural hard to reach areas of Uganda.
  • Introduced DNA PCR capacity in Uganda and greatly supported MOH EID Project, and all PMTCT partners in the country relied on the JCRC laboratory capacity. Therefore many Infants were born HIV free.
  • Pioneered and strengthened laboratory specimen referral system from lower health centres to the Regional Centres of Excellence, and all HIV/AIDS partners relied on this system for provision of quality laboratory services.
  • Greatly contributed to health system strengthening of ministry of health facilities through renovations and extensions of health facilities. Over 30 HIV/AIDs clinics were renovated, provided furniture and clinical equipment.
  • Trained over 2,000 health care providers in all the regions of Uganda, focusing on ART management, data management, psycho social support and community involvement.
  • Introduced a robust community based adherence strategy, and best practices in community mobilization and engaging PLHIV as peer support groups to reduce stigma, encourage disclosure and behavior change communication. Strategies include edutainment, thematic music, dance and drama, and community mobilization to raise awareness, and engaged the private sector to support unfunded activities.
  • Introduced ART and Pediatric IEC materials that were adopted by MOH and other partners in the East African region.
  • Successfully carried out a Pediatric HCT and ART campaign in the divisions of Kampala in 2008, and was tested in the slums of Namuwongo and Kireka barracks, in collaboration with USAID and Health communication Partnership.
  • Due to the success of TREAT, USAID designed follow on programs for Ugandan patients, including THALAS and SUSTAIN.