Rouen University Hospital, Epidemiology and Public Health Department, Rouen University Hospital, Hôpital Charles Nicolle. 1, rue de Germont, Rouen cedex, 76 031, France.
BMC Public Health. 2013 May 14;13:470. doi: 10.1186/1471-2458-13-470.
Transmission of HIV from mother-to-child during pregnancy, labor, or breastfeeding is the primary cause of pediatric HIV infection in sub-Saharan Africa. A regimen of single-dose nevirapine administered to both HIV-positive pregnant women and their infants has been shown to lower the risk of mother-to-child transmission (MTCT) of HIV. In an effort to facilitate scale-up of PMTCT programs in low-income countries, Boehringer Ingelheim, the manufacturer of Viramune (branded nevirapine), initiated the Viramune Donation Programme (VDP) in 2000. The aim of this study was to evaluate the impact of the VDP on participating institutions.
A total of 164 institutions in 60 countries were included in the VDP over its 11-year duration. An online quantitative and qualitative questionnaire was submitted to all program managers. The questionnaire collected data on the impact of the VDP on initiation and scale-up of PMTCT services, operational capacity, national PMTCT policies, access to funding, and national and international partnerships. Participants were asked for their opinion of how VDP was perceived by different stakeholders (medical community, patients, government authorities, communities).
Ninety-nine managers (60.4%) in 34 countries responded to the online questionnaire; 89 of institutions (89.9%) were located in Africa The most positive aspects of the VDP identified were: helped to expand PMTCT services (85.9% of program managers), reduced stigma against HIV-positive pregnant women, increased social support mechanisms (78.8%), fostered partnerships with national and international organizations (69.0%), and encouraged access to donor funding (63.0%). Implementation of the VDP triggered improvements in training hospitals and logistical capacity and was associated with changes in policy strategies at the national level.
A drug donation program such as the VDP can act as a catalyst for systemic changes at the institutional and national levels. The VDP provides a model for how private initiatives can have a significant impact on public health issues and foster diverse public-private partnerships among governments, commercial organizations, local institutions, and international NGOs.
在撒哈拉以南非洲，HIV 经妊娠、分娩或哺乳由母亲传播给儿童是小儿 HIV 感染的主要原因。给 HIV 阳性孕妇及其婴儿单次给予奈韦拉平治疗方案已显示可降低 HIV 母婴传播（MTCT）的风险。为了促进低收入国家扩大预防母婴传播规划，奈韦拉平的生产商勃林格殷格翰公司于 2000 年启动了 Viramune 捐赠方案（VDP）。本研究旨在评估 VDP 对参与机构的影响。
VDP 在 11 年期间共覆盖了 60 个国家的 164 个机构。向所有方案管理人员提交了一份在线定量和定性问卷。该问卷收集了 VDP 对启动和扩大预防母婴传播服务、运营能力、国家预防母婴传播政策、获取资金以及国家和国际伙伴关系的影响的数据。调查对象被要求对 VDP 如何被不同利益攸关方（医学界、患者、政府当局、社区）感知发表意见。
来自 34 个国家的 99 名（60.4%）管理人员对在线问卷作出答复；89 个机构（89.9%）位于非洲。VDP 最积极的方面有：帮助扩大预防母婴传播服务（85.9%的方案管理人员）、减少对 HIV 阳性孕妇的污名化、增加社会支持机制（78.8%）、促进与国家和国际组织的伙伴关系（69.0%）以及鼓励获取捐助资金（63.0%）。VDP 的实施改进了医院培训和后勤能力，并与国家一级政策战略的变化相关。
VDP 等药品捐赠方案可以成为机构和国家各级系统变革的催化剂。VDP 为私营部门如何对公共卫生问题产生重大影响并促进政府、商业组织、地方机构和国际非政府组织之间多样化的公私伙伴关系提供了范例。
