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HMI and International Partners Combat HIV/AIDS Through Education
HMI and International Partners Combat HIV/AIDS Through Education
Through programs developed by Harvey Makadon, vice president of health systems at Harvard Medical International (HMI) and associate professor of medicine at Beth Israel Deaconess Medical Center, HMI is helping to educate people about HIV/AIDS, develop an infrastructure for prevention and care services, and train more health care professionals to address the disease.
Harvey Makadon has led programs against AIDS in India and China. (Photo by Steve Gilbert)
The obstacles run the gamut from the medical challenges facing the providers to the social barriers that distort perceptions of the epidemic and make the work of physicians all the more difficult. Underlying each program is the need to change the way people think about HIV/AIDS by creating an environment that encourages them to be open about risk, compels them to learn about their HIV status, and makes resources for prevention and treatment available.
Training Trainers in India
In the past two years, HMI has pursued this work in poor communities in India and China. In the Indian city of Mumbai, HMI delivers free education programs under the auspices of the nongovernmental organization WHARF (Wockhardt-
| "Counseling and education in the primary care setting is important, but there is a limit to what can be done there. This must be combined with public health and community involvement behind a consistent message." |
HMI is also helping longtime partner Sri Ramachandra Medical College and Research Institute in Chennai, India. Together, they are developing a center of excellence for care in HIV/AIDS and providing education programs to extend the capacity of local providers. Sri Ramachandra is preparing to create a regional network of providers offering outpatient HIV/AIDS programs and plans to develop a care program with clinicians from multiple specialties. An additional goal is to develop community education programs and establish guidelines for HIV/AIDS care to support clinicians. Sri Ramachandra already has in place a voluntary counseling and testing program, a rarity in India.
"We are extremely pleased that Sri Ramachandra, having recognized the growing HIV/AIDS problem in Chennai and the country as a whole, is set to make a real impact," Makadon said. "But it is important to recognize that these programs, related to both care and education, must be integrated into an infrastructure that supports its growth and development."
In China, Focusing on Community
In May, HMI teamed with the China Medical Tribune, AIDS Clinical Care, and The New England Journal of Medicine to lead a training program in Xi'an, in the province of Shannxi, designed to bring the most advanced knowledge in HIV/AIDS diagnosis and treatment to Chinese health care providers.Makadon emphasized the need in China to create a "continuum of care" for the prevention and treatment of HIV/AIDS--an infrastructure supported by coordination of primary care networks, public health efforts, and community-based programs. "Counseling and education in the primary care setting is important, but there is a limit to what can be done there," Makadon said. "This must be combined with public health and community involvement behind a consistent message."
HMI's HIV/AIDS education programs explore the epidemiological impact of the disease at the global and country level and present the latest clinical knowledge, including the principles of antiretroviral therapy, treatment of AIDS complications, prevention of mother-to-child transmission, and HIV virology and its pathogenesis. A cadre of experts in the field have become regular faculty participants in these programs, including Howard Libman, HMS associate professor of medicine at Beth Israel Deaconess Medical Center; Jon Fuller, an associate professor at the Boston University School of Medicine; and Raymond Powrie, an associate professor of medicine and obstetrics at Brown University.
Libman has spoken to many audiences on antiretroviral therapy, a big issue in India and other countries. "These ARVT drugs are being manufactured generically in India and other resource-limited countries, and although they are much cheaper than in the U.S., their costs are still beyond the financial means of much of the population," he said.
Makadon has led programs on HIV/AIDS in Zimbabwe, as well, and has incorporated discussion of HIV prevention and management into HMI programs in the United Arab Emirates and Japan.
--Chris Railey