Azeredo Thiago Botelho, Oliveira Maria Auxiliadora, Santos-Pinto Cláudia Du Bocage, Miranda Elaine Silva, Osorio-de-Castro Claudia Garcia Serpa
Observatório de Vigilância e Uso de Medicamentos, Faculdade de Farmácia, UFRJ. Av. Carlos Chagas Filho 373, Cidade Universitária. 21941-170 Rio de Janeiro RJ Brasil.
Departamento de Política de Medicamentos e Assistência Farmacêutica, Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2017 Aug;22(8):2581-2594. doi: 10.1590/1413-81232017228.29472016.
The provision of ARVs is central to HIV/AIDS programs, because of its impact on the course of the disease and on quality of life. Although first-line treatments costs have declined, treatment-associated expenses are steeper each year. Sustainability is therefore an important variable for the success of treatment programs. A conceptual framework on sustainability of ARV provision was developed, followed by data collection instruments. The pilot study was undertaken in Brazil. Bolivia, Peru and Mozambique, were visited. Key informants were identified and interviewed. Investigation of sustainability related to ARV provision involved implementation and routinization events of provision schemes. Evidence of greater sustainability potential was observed in Peru, where provision is implemented and routinized by the National HIV/AIDS program and expenditures met by the government. In Mozambique, provision is dependent on donations and external aid, but the country displays a great effort to incorporate ARV provision and care in routine healthcare activities. Bolivia, in addition to external dependence on financing and management of drug supply, presents problems regarding implementation and routinization. The conceptual framework was useful in recognizing events that influence sustainable ARV provision in these countries.
抗逆转录病毒药物（ARV）的供应是艾滋病毒/艾滋病项目的核心，因为它会影响疾病进程和生活质量。尽管一线治疗成本有所下降，但每年与治疗相关的费用却更高。因此，可持续性是治疗项目成功的一个重要变量。我们制定了一个关于抗逆转录病毒药物供应可持续性的概念框架，随后又制定了数据收集工具。在巴西进行了试点研究。访问了玻利维亚、秘鲁和莫桑比克。确定并采访了关键信息提供者。对抗逆转录病毒药物供应相关可持续性的调查涉及供应计划的实施和常规化事件。在秘鲁观察到了更大的可持续性潜力的证据，该国由国家艾滋病毒/艾滋病项目实施供应并使其常规化，费用由政府承担。在莫桑比克，供应依赖捐赠和外部援助，但该国在将抗逆转录病毒药物供应和护理纳入常规医疗活动方面付出了巨大努力。玻利维亚除了在药物供应的融资和管理方面依赖外部外，在实施和常规化方面也存在问题。该概念框架有助于识别影响这些国家抗逆转录病毒药物可持续供应的事件。
