STANFORD, Calif. - When there are millions of patients clamoring for anti-AIDS drugs and precious little to go around, who decides which patients go to the front of the line? The answer, says Stanford AIDS researcher Dennis Israelski, MD, is relatively simple: the affected community.
Israelski, clinical professor of infectious diseases at the School of Medicine, is medical director of the nongovernmental organization, AIDS Empowerment and Treatment International, or AIDSETI, a network of 23 associations in 14 sub-Saharan African and Caribbean countries, whose mission is to support the scale-up of sustainable systems of HIV/AIDS health care through community empowerment.
"I believe if you give the affected communities the necessary resources, appropriate tools and training, it will do a better job in providing care and treatment than approaching the problem from the top-down," said Israelski, who is also the medical director of the AIDS Program in San Mateo County, Calif.
AIDSETI's cohort is estimated to be 100,000 people living with HIV/AIDS. In a new, small-scale study, to be presented Aug. 17 at the International AIDS Conference in Toronto, Israelski and his colleagues found that the group has been effective in distributing antiretroviral drugs to the patients who need them most.
"What we found in our initial evaluation indicates an equitable distribution of medications, based on gender and severity of illness," said Seble Getachew Kassaye, MD, a postdoctoral scholar in infectious disease at Stanford and first author of the study. Moreover, patients who received drugs showed substantial increases in their CD4 counts, a measure of immune system function, the researchers found.
Given the results, researchers believe the program could be a model for scaling up antiretroviral treatment in more poor nations, alongside other treatment programs.