Viewpoint: How you can extend HIV help abroad


Treating HIV patients has always been a passion of mine. At ourpharmacy in the Bronx, N.Y., we've been able to achieve 85% to 90%monthly refill rates on the HIV patients we treat. With thisexperience under our belts, I wanted to apply the techniques I havegained to HIV patients in other countries as well. This was whatbrought me to Rwanda last year.

Out of an estimated population of eight million, 250,000 are living with HIV in this African country. I had learned about the acute need Rwandans have for pharmacotherapy following the 2004 international HIV conference in Bangkok, Thailand, where I gave a poster presentation on the HIV pharmacy adherence program I had set up in New York.

Along with this new technology, I trained a Rwandan pharmacist and pharmacy technician on how to use all this paraphernalia. Fortunately, they were quick studies and the pharmacy became fully operational before long.

While it's too soon to tell whether patient outcomes have improved as a result, all Rx drugs from the pharmacy now carry labels in the patient's native language, explaining how the medications should be taken. There are also patient-refill histories and records on drug usage.

You might ask why our efforts have focused on donating equipment and supplies, rather than drugs, to Rwandans. Unlike TB, HIV has no cure but must be managed through the utilization of chronic antiretroviral medications. If I got involved in supplying drugs but ran out of money, Rwandan patients would be left high and dry. Given that compliance to these medicines is so critical for patient survival, that wouldn't be right.

This is why I deliberately cast a smaller net and strived to develop a pharmacy prototype that is self-sustaining and can be replicated elsewhere. There's a saying, "Give a man a fish, he eats for a day. Teach him how to fish, he eats for a lifetime." This axiom has guided my approach.

My next step is to set up another pharmacy in Rwanda, using the specifications of the first pharmacy. We are now talking with additional organizations such as the United States Agency for International Development to obtain funding and create collaborative arrangements.

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