ICAP News - April 2008

ICAP Lesotho Recognized with PEPFAR Implementing Partners’ Award for 'Fantastic Job' of Monitoring and Reporting Activities

ICAP Lesotho has been named recipient of the 2007 Implementing Partners’ Award by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in Lesotho. The award recognizes ICAP for “outstanding program planning, monitoring and reporting” and is the first award of its type for a PEPFAR implementing partner in Lesotho.

“We are heartened to be recognized by PEPFAR for our work in Lesotho,” said ICAP-Lesotho Country Director Raphael Ntumy, MD. “We are committed to working closely with our partners to eliminate mother-to-child transmission of HIV and scale up comprehensive HIV services for women, children, and their families.”
Joan Atkinson, former PEPFAR coordinator in Lesotho, commended ICAP for its “fantastic job of monitoring and reporting ICAP activities.” She added, “ICAP truly deserved to win the award because of its contributions to PEPFAR’s accomplishments in Lesotho.”

ICAP has been supporting the implementation of multidisciplinary, family-centered HIV/AIDS prevention, care, and treatment programs in Lesotho since January 2006. Specific goals include: provision of comprehensive services to HIV-infected women, including pregnant women; reducing mother-to-child transmission of HIV; and decreasing HIV-related deleterious effects on women, children, and their families. By the end of December 2007, these programs were providing antiretroviral therapy to approximately one-third of those people who started such treatment in Lesotho.

For more about ICAP Lesotho, visit here.

New International Training Program Launched for Columbia University Students

Columbia University students are gaining practical knowledge and experience in HIV/AIDS prevention, care, and treatment in Africa through a new educational and training program recently launched by ICAP.

Approximately 20 students from Columbia University Medical Center schools and other graduate programs have been selected to take part in the program. Students will work with in-country teams or at ICAP’s New York headquarters where they will develop projects with mentors who will supervise them during training periods.  

Fourth-year medical students Jason Sulkowski and Edward Requenez, the first students to begin their training experiences, joined the ICAP-Tanzania team in late March. They are working in the country’s Kigoma Region where they will learn as well as contribute to ICAP’s ongoing work.

“I'm delighted to have such talented students join our team,” said ICAP-Tanzania Country Director Amy Cunningham. “I am confident their experiences will enrich their educational and professional development.”

Added ICAP’s Jessica Justman, MD, who is overseeing this program, “Experiences such as these can transform lives and inspire students to pursue careers in international health.”

ICAP received more than 90 applications for the limited number of training positions in 2008. To learn more about the student opportunities program, visit http://www.columbia-icap.org/students/index.html.

Photo caption: Columbia University medical students Edward Requenez (left) and Jason Sulkowski (center) learn about laboratory processes from a technician at Kasulu District Hospital in Kigoma.

Tuberculosis Infection Control Program Piloted at South Africa Sites

People living with HIV/AIDS (PLWHA) are at high risk of contracting tuberculosis (TB), which can result in high mortality. Compounding the TB risk to PLWHA is the emergence of drug-resistant strains. To protect HIV patients, health care workers, and others from acquiring TB, ICAP is supporting the piloting of an innovative TB program at two facilities in the Eastern Cape Province of South Africa – Motherwell Community Health Centre and Cecilia Makiwane Hospital.

The program’s approach focuses on screening and early diagnosis of TB in HIV patients receiving care at the facilities with the goals of protecting their health and minimizing the risk of transmission to health care workers, family and community members. The program provides for the development of facility-specific plans for TB infection control that address needs identified in surveys of healthcare workers and assessments of infection control practices already in place at the sites. Elements include TB screening and patient triage, rapid TB diagnosis and initiation of treatment, and increased natural ventilation to reduce transmission. Several novel strategies are also employed to motivate healthcare workers to limit sources of infectiousness and engage patients as “cough monitors” to identify other patients who may be in need of rapid evaluation for TB.

On March 26-27, ICAP supported a workshop for clinicians and managers from the pilot sites to discuss the rationale for the program, introduce the proposed new programmatic components, and discuss plans for their implementation. Based on the recommendations and outcomes of the pilot project, plans will be instituted for expansion to other ICAP-supported sites in South Africa.

Said ICAP Director Wafaa El-Sadr, MD, MPH, “The overarching message is “Think TB! for your sake, your family’s and your community’s sake.”

Photo caption: Working together at the TB infection control workshop were Sister Nompucuko Ngwevela (left), who is responsible for the implementation of the infection control initiative at Motherwell Community Health Center, and Sister Tanda Tobeka, ICAP-South Africa clinical nurse mentor.

For more about ICAP South Africa, visit here.

Revised Nursing Curriculum in Rwanda Addresses Need for More Healthcare Providers to Deliver HIV Services



In early March, representatives from the Rwanda Ministry of Health, the Treatment and Research AIDS Center (TRAC), ICAP, and Intrahealth met to finalize the tools and documents which will form the foundation of a new HIV/AIDS prevention, care, and treatment training component in the national nursing curriculum. The revised curriculum addresses the need to expand the role of nurses in the delivery of specialized HIV services. Focus areas include prevention of mother-to-child transmission of HIV, pediatric care and treatment, opportunistic infections, HIV/tuberculosis co-infection, post-exposure prophylaxis, and psychosocial support services for people living with HIV/AIDS.

After the revised curriculum is finalized, ICAP will help train nursing faculty on the care and treatment sections and provide mentoring for nursing school lecturers in HIV care and treatment. ICAP has been working with Intrahealth, the lead partner on the project, to support the revision of the nursing curriculum since 2005.

Photo caption: Representatives from the Ministry of Health, the Treatment and Research AIDS Center, ICAP, and Intrahealth meet to finalize the HIV/AIDS training component of the national nursing curriculum.

For more about ICAP Rwanda, visit here.

Zanzibar Workshop Highlights Need for Greater Support to Substance Users

In response to the increasing prevalence of HIV infection among injection drug users in Zanzibar, the Tanzania Ministry of Health Department of Substance Abuse, in collaboration with ICAP, held a two-day workshop in March for 28 healthcare workers and other stakeholders focused on substance abuse and the need for greater support to substance users.

In Zanzibar, a group of islands off the Tanzania coast, HIV seroprevalence among substance users is estimated at more than 28 percent. In contrast, among the general population, HIV seroprevalence is less than 1 percent. During the workshop, experts described the physiological and psychological effects of heroin – the most commonly injected drug in Zanzibar – and the risk for HIV transmission from sharing needles and unprotected sex.

ICAP-Tanzania Program Officer Witness Motta, MD, said many heroin users understand the risk of HIV transmission from sharing needles and are determined to quit using if help is offered, such as methadone replacement therapy. “Having the necessary support structures and programmatic components in place can have a major impact on the lives of substance users and their communities,” he said.

Mussa Mahamood, MD, coordinator for the Ministry of Health substance abuse department, praised the workshop for preparing participants to cope with the growing problem of injection drug use in Zanzibar and urged them to continue sharing knowledge on the topic. “Drug abuse is not a crime, but rather a public health problem,” he said. “Families and communities should give drug users the care and support they need and not abandon them.”

In Zanzibar, ICAP supports four healthcare facilities providing HIV care to 212 people, including antiretroviral therapy to 88 individuals.

Photo caption: Zanzibar healthcare workers discuss the risks of HIV infection by injection drug use.

For more about ICAP Tanzania, visit here.

Ethiopia Workshop Surveys Latest Clinical Guidelines for PMTCT and Pediatric HIV/AIDS Care and Treatment

On March 18, more than 70 pediatric healthcare providers and HIV/AIDS program managers from partner organizations participated in a national workshop on the latest clinical guidelines for prevention of mother-to-child transmission (PMTCT) of HIV and pediatric HIV/AIDS care and treatment. The workshop was organized by Ethiopia’s Federal HIV/AIDS Control and Prevention Office (FHAPCO) in collaboration with ICAP.

In addition to discussions of new issues related to PMTCT and pediatric HIV care and treatment, FHAPCO representatives emphasized the need for continued expansion to reach at least 90 percent of pregnant women and 80 percent of children who need such services – goals for which representatives from the U.S. Centers for Disease Control and Prevention (CDC) Ethiopia and ICAP-Ethiopia leadership voiced their support.

"ICAP Ethiopia, as part of the PEPFAR-Ethiopia team, is fully committed to support the scale up of PMTCT and pediatric HIV care and treatment services to achieve the national road map targets,” said ICAP-Ethiopia Country Director Zenebe Melaku, MD.

Attending the workshop were representatives from FHAPCO, CDC Ethiopia, the Ethiopia Ministry of Health, regional health bureaus, and other in-country implementing partners of the U.S. President’s Emergency Plan for AIDS Relief.

For more about ICAP Ethiopia, visit here.