Bristol-Myers Squibb's SECURE THE FUTURE(R) Program Offers New Approach to Replicate Successful HIV Treatment Support Model

Bristol-Myers Squibb's SECURE THE FUTURE(R) Program Offers New Approach to Replicate Successful HIV Treatment Support Model

July 23, 2007

    SYDNEY, Australia, July 23 /Xinhua-PRNewswire/ -- Today
Bristol-Myers Squibb announced a new approach to expand its
SECURE THE FUTURE(R) program in the developing world
through replicating its most successful HIV treatment
support programs in partnership with governments, community
groups and other funders. The initiative will provide a
practical, step-by-step guide and the expertise of SECURE
THE FUTURE staff to create effective HIV treatment support
programs based on methods proven successful even in the
poorest, most remote areas of Africa. The program is
already being replicated in Mali, Namibia, South Africa and
Swaziland.

    The aim is to enable others to take advantage of the
lessons learned by SECURE THE FUTURE from eight years of
work fighting HIV/AIDS in some of the most resource
constrained areas of Africa. The experiences of a five-site
demonstration project coordinated by SECURE THE FUTURE in
partnership with governments, district hospitals and civil
society in Botswana, Lesotho, Namibia, Swaziland and South
Africa are documented in the manual.

    Higher CD4 counts, better adherence to drug regimens,
reduced hospital bed occupancy, reduced in-hospital
AIDS-related deaths and better quality of life are all
documented outcomes of the treatment support program.
Closely monitored and rigorously evaluated, the program
paired medical care and treatment with a variety of
community support programs including home-based care,
targeted and broad-based community mobilization and
education, psychosocial supports, nutritional resources,
income generating projects and buddy programs.

    "With community support, a patient is more likely
to seek testing and treatment, will be better prepared to
begin and adhere to antiretroviral therapy, is less likely
to default on treatment and is more likely to have a better
clinical outcome," said Phangisile Mtshali, director of
the Bristol-Myers Squibb Foundation, who oversaw
implementation of the SECURE THE FUTURE program in southern
Africa through 2006. The program, launched by Bristol-Myers
Squibb in 1999, has grown to a $150 million commitment in
12 African countries with special emphasis on community
treatment support programs, care for children and building
infrastructure.

    At the International AIDS Society conference in Sydney,
SECURE THE FUTURE representatives offered a public health
tool entitled SECURE THE FUTURE Manual: Seven Steps to
Involve the Community in HIV/AIDS Treatment Support
Programs (First Edition). The guide shows how to establish
antiretroviral treatment programs that integrate community
supports to assure that the patient receives assistance at
home and in the community as well as at the clinic. It
provides field-tested tools to help communities adapt and
implement the model of care and monitor and evaluate its
impact on the patient. The manual includes full case
studies from communities that implemented the model. 
   
    "This manual is a practical, how-to guide to
integrate efforts of clinicians and community workers. It
shows how each can add value to the other's work, sharing
information about clients' progress and needs through case
management tools," said Patricia Doykos Duquette,
director of the Bristol-Myers Squibb Foundation and
co-author of the manual. "For example, home-based care
workers can be alerted when a patient fails to appear for a
scheduled clinic visit. When a clinic nutritionist
identifies a malnourished patient, the community partnering
program can provide food parcels so important to successful
treatment." The manual is available online at
www.bms.com/foundation or by sending an email request to
[e-mail].

    Bristol-Myers Squibb and SECURE THE FUTURE staffs are
available to consult with governments and community groups
on replication of the model. They will provide technical
support to groups seeking to develop their own programs.

    Since 2003, SECURE THE FUTURE has operated five
community-based treatment support sites. By April 2007, the
sites had enrolled more than 17,000 patients, with over
8,000 on antiretroviral treatment. The model places equal
emphasis on supporting the needs of patients receiving
antiretroviral treatment and patients whose disease has not
yet progressed to warrant treatment.

    A rigorously conducted evaluation of the five sites by
Family Health International showed that HIV-positive
patients who received integrated medical care and
broad-based community support achieved and sustained
improved clinical outcomes. For instance, at the sites,
community mobilization led to a rapid uptake of clinical
services, an improved community response to HIV/AIDS, a
reduction in stigma surrounding the disease and better
adherence with treatment. 

    Zengani Chirwa, M.D., chief medical officer for
Mapilelo, the SECURE THE FUTURE funded community-based
treatment support center in Caprivi, Namibia, said,
"The provision of support programs by community groups
greatly enhances clinical treatment outcomes. For example,
the SECURE THE FUTURE demonstration centers recorded higher
CD4 counts in patients who received medical treatment and
community supports. Monitoring shows that those who were
receiving community supports recorded a CD4 count after 12
months averaging 326 compared to 268 for those who did not
receive the supports. That measurement is a very important
indicator of a person's health status, with higher counts
indicating a greater ability to fight infection."

    At both the Caprivi and Bobonong centers, Chirwa noted
that the hospital bed occupancy rate was reduced by 50
percent with the combination community supports to medical
care. 

    Governments and community groups are already
spearheading efforts to replicate the SECURE THE FUTURE
centers. The first replication program was created by
SECURE THE FUTURE in the Koulikoro region of Mali at the
request of local experts in partnership with the national
government in 2005. To date, over 5,000 people have been
tested, with 374 HIV-positive patients enrolled in the
program and 214 receiving antiretroviral treatment. The
Koulikoro Reference Health Center offers community outreach
and education, food programs and home-based care through
local non-governmental organizations (NGOs),
community-based organizations and association of People
Living with HIV/AIDS.

    In Namibia, the Mapilelo Project, in partnership with
the national government and local community-based
organizations, opened a new center this April in Kavango,
Nankudu, Namibia. The Nankudu District Hospital and four
primary health clinics offer medical treatment and
community support to approximately 900 patients.

    In Bambisana in the Eastern Cape Province of South
Africa, the Bambisanani NGO began partnering with the local
district hospital in February to provide community support,
including home-based care and food security to 1,400
HIV-positive patients on antiretroviral medicines. With
SECURE THE FUTURE funding, Bambisanani has also opened two
centers to assist 50 orphans and vulnerable children in the
district, because of the escalating number of children
negatively impacted by the disease. 
      
    In Swaziland, the national government, in partnership
with SECURE THE FUTURE, is replicating the PORECO model of
Prevention-of-Mother-to-Child Transmission Program Plus
that has been validated in Mbabane. The replication
project, in the Northern Hhohho region, will serve up to
3,000 pregnant women, their newborn children and their
partners by providing community support and intensive
patient tracking throughout pregnancy, delivery and
postnatal care.  The continuum of care continues after the
child's birth with pediatric care for the newborn
facilitated by the Pediatric AIDS Corps doctors, a program
funded through the SECURE THE FUTURE and Baylor College of
Medicine collaboration. 

    The SECURE THE FUTURE manual was co-authored by
Sebastian Wanless, M.D.,  medical director of SECURE THE
FUTURE, Duquette and Mtshali, the project managers who
implemented the programs, along with assistance of the
Bristol-Myers Squibb Foundation staff, and I-TECH, the
International Training and Education Center on HIV. I-TECH
is a joint project of the University of Washington and the
University of California San Francisco. I-TECH was
established in 2002 as part of the President's Emergency
Plan for AIDS Relief (PEPFAR) by the Health Resources and
Services Administration in collaboration with the U.S.
Centers for Disease Control and Prevention and USAID.  

    Bristol-Myers Squibb is a global pharmaceutical and
healthcare products company whose mission is to extend and
enhance human life. Visit Bristol-Myers Squibb at
http://www.bms.com . 


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