Description

The statistics are staggering. It is estimated that three-quarters of the world’s AIDS population lives in Sub-Saharan Africa; most
have no access to lifesaving drugs, testing facilities or even basic
preventative health care. One of the major factors inhibiting medical
professionals in Africa from treating this disease is the inability to
access vast areas of the continent with adequately equipped medical
facilities.

A
number of organizations have called for the development of a network of
mobile and satellite clinics to provide basic health care and combat
the spread of HIV/AIDS in Sub-Saharan Africa. They include Doctors
without Borders, The Harvard AIDS Institute, UNAIDS, and the World
Health Organization.

"...a remarkable project with great possibility..."
William J. Clinton, 42nd President of the United States

A
comprehensive review of strategies addressing structural deficiencies
commissioned by The World Health Organization’s Commission for
Macroeconomics and Health (CMH) revealed that the infrastructure
necessary to stem the spread of AIDS do not require the extensive
facilities of modern hospitals but can be effectively administered
through small clinics and dispensaries. The CMH study,
issued in 2002, refers to these as close-to-client systems and suggests
that increasing the capacity of these local clinics and dispensaries
through stable financing is well within the ability of international
efforts.

Community-based
approaches to treating and preventing HIV/AIDS have been proven
effective in a number of developing countries, including Ghana, Kenya,
South Africa and Uganda. With funding from the World Bank, Uganda began
investing in local clinics and outreach centers as part of a nationwide
initiative to combat the spread of HIV/AIDS in 1994. Since then, the
rate of prevalence of HIV/AIDS in Uganda has declined nationwide from
14 percent (and in some urban areas as high as 30 percent) to 5 percent
in 2001, according to the Uganda AIDS Commission.

However,
even in Uganda, access to care is inadequate in rural areas. In its
National Strategic Framework for HIV/AIDS Activities (2000/1-2005/6)
the Uganda AIDS Commission cited 'inadequate HIV testing and counseling
services particularly in rural areas' as one of the major constraints
to treating and preventing HIV/AIDS and called for the expansion of
voluntary counseling and testing facilities in rural areas.

In May 2003, President George W. Bush signed into law a five-year, $15
billion Emergency Plan for AIDS Relief worldwide. A key component of
the plan calls for the development of a layered network of central
medical centers that support satellite clinics and mobile units in
rural areas. According to the plan, these mobile and satellite clinics
would be staffed by lay technicians, possibly rotating nurses, and
local healers, who would be trained in standard clinical evaluations
and the distribution of medication refills.

The
AIDS Research and Family Care Clinic in Mombasa, Kenya estimates that a
single clinic has the potential to provide testing, treatment and care
for upwards of 10,000 people. Other medical and relief
organizations give higher estimates. Once designed and built, these
clinics could be used by relief and community health organizations to
create a highly dispersed and effective network of care.

In
addition to providing testing, treatment and awareness education to
underserved populations, a network of easily deployable mobile clinics
equipped with satellite communications systems could provide critical
information to central health care centers in order to track prevalence
rates in outlying regions, assess the needs of specific communities and
deploy limited resources accordingly. In the future, such a network
could also play a vital role in distributing antiretroviral drugs and
eventually a vaccine.

Implementing
Architecture for Humanity’s designs for a Mobile HIV/AIDS Health Clinic
for Africa would represent a significant step toward building a
dispersed and efficient network of care in Sub-Saharan Africa.