Dr.Jolly : Policies and processes to make effective drugs available to people in society at an affordable price must be developed urgently. This effort needs unique commitment from governments, multilateral agencies and the pharmaceutical industry, and the participation of communities and NGOs.
• Reduced prices are an essential element of increasing access to drugs, but this alone will not ensure access to the best treatments for the poorest people. Improved and properly financed delivery systems are essential and can only be achieved through partnerships between communities, NGOs, the private sector, and governmental organizations.
•Antiretroviral drugs (ARVs) are currently the most effective long-term treatment for HIV infection. But other drugs including antibiotics, antifungals and treatment for TB improve both quality and length of life PLWHA. Work to increase the accessibility and affordability of
drugs such as these should not be compromised by efforts to provide ARVs. In India government is providing support for opportunistic Infections but how many people are aware about this support.
• Ensure that every country has at least one care and support unit as a reference centre and for nationwide training in diagnostics, treatment (including ARVs), standards of care and monitoring of HIV and HIV-related diseases for doctors and Para medical professionals in government and
private health systems.
• Establish an international HIV/AIDS drug and commodity procurement fund at global level that could leverage the buying power of developing countries and donors. Resources demarcated for the procurement of HIV/AIDS drugs, related commodities and the development of new products such as vaccines must include a strategy to strengthen related health systems infrastructure
including necessary personnel training.
• Continue to work with both the research-based and generic pharmaceutical industries to dramatically lower the prices of all relevant drugs and diagnostics, while maintaining incentives for investment in research and development.
•Urgent support is needed for families and communities that include children affected by HIV/AIDS. Call for urgent attention to the needs of all children in affected countries and particularly for those made most vulnerable by the epidemic. Actively support community
mobilisation efforts to address the needs of affected children and actively develop polices to ensure resources to enable all affected children to have full access to education, health and other essential services.
•Strengthen existing health, education and welfare services to cope with the additional problems experienced by unsupported PLWHA and design new services in such a way that they decrease stigma and discrimination.
•Openly and vehemently challenge discriminatory attitudes and enact laws and policies that reduce the vulnerability of PLWHA and enforce their rights/duties as human beings.
• Encourage the participation of PLWHA in the development of services and programmes for them.
• Prevention, care, rehabilitation and impact mitigation initiatives must all be scaled up and better integrated. While prevention must be the mainstay of our global response, care and impact alleviation are both essential in and of themselves and are crucial for effective prevention.
• Providing care and support to PLWHA in the society can increase condom use, decrease risk behaviour and increase disclosure of HIV status to partners, even if prevention promotion is not included in the care programmed. All these positive results can be further increased by
explicitly addressing prevention alongside care.
• Providing care and support to PLWHA also increases planning and provision for children affected by HIV/AIDS, increases children’s understanding of HIV/AIDS, and increases the number of orphans who are immediately placed in a loving and supportive environment after
their parents die.
• Action to alleviate the impact of HIV/AIDS, such as caring for orphans and vulnerable children, in turn contributes to both prevention and care. One of the most effective methods to mobilize community action on all aspects of HIV/AIDS is to focus on the needs of affected children.
•Involving PLWHA in prevention campaigns both increases safe behaviour by the PLWHA themselves and more effectively catalyses safe behaviour among people who are not infected.
Ultimately, the focus of prevention, care, rehabilitation and impactmitigation work is mostly with individuals, families and their communities. Community mobilization and support is thus central to effective responses to HIV/AIDS and to effective linkages among these issues. Increasingly support the development and implementation of integrated prevention, care and impact alleviation efforts delivered at the community level. Call for special programmed and policy efforts focused on and involving children orphaned by AIDS, who need ongoing love and support until their adult years, may themselves need HIV/AIDS care, or otherwise may be particularly vulnerable to HIV infection