THE TREATMENT, CARE AND SUPPORT (T, C & S) COMPONENT
The T, C & S component is one of the core components of NASCP, which works with the six other functional components of the programme towards ensuring effective delivery of NASCP's mandate. The component has its specified thematic roles and responsibilities. It is headed by a directorate cadre staff, who is accountable to the National Coordinator.
The roles and responsibilities of the T, C & S component are to:
- Design and coordinate the implementation of strategies and interventions for expanded access to comprehensive HIV/AIDS Treatment, Care and Support Services
- Develop guidelines, training manuals and SOPs for the delivery of comprehensive HIV/AIDS Treatment, Care and Support services
- Forge a robust and proactive national partnership for HIV/AIDS Treatment, Care and Support in Nigeria
- Enforce standards and ensure that the activities of all relevant stakeholders conform to national guidelines and protocols and
- Offer technical assistance to states and other relevant stakeholders in areas such as capacity building, development of strategic plans and coordination of state level partnerships
The National ART Programme
The Federal government in 2001 initiated Nigeria's National Antiretroviral (ART) Therapy Programme however, actual implementation started in February 2002 in 25 tertiary institutions with the aim of placing 10,000 adults and 5,000 children on treatment. The programme has evolved over the years, has received funding from a varied implementing and donor agencies, and currently has about 1, 048, 805 PLHIV on ART.
The ART programme is domiciled in the T, C & S component, with an overall goal of reducing HIV related morbidity, mortality, and mitigating the impact of the AIDS epidemic by ensuring all eligible PLHIV receive quality treatment services for HIV/AIDS and opportunistic infections including TB - HIV co-infections. The provision of ART is guided by the following principles:
- Persons with HIV should be treated with respect, and with complete consideration for human rights, ethics, privacy and confidentiality, informed consent, autonomy and dignity
- Active involvement of PLHIV at all levels of programme management
- Compliance with National guidelines for the use of ARV drugs in Nigeria and other treatment protocols based on global and national standards and best practices
- Equitable and universal access to ART
- Implementing ART as an integral part of comprehensive HIV care
- Integration and linkage of ART into other health care services.
- Robust monitoring and evaluation systems to ensure programme effectiveness and quality of services, and
- Public-private partnership for national and international networking
All the activities for the National ART Programme are implemented through the four units of the T, C & S component. These units include
- Adult ART
- Adolescent ART Programme
- Care and Support units.
The provision of Adult, Paediatric and Adolescent ART services across all service delivery points is guided by the National Treatment Guidelines for HIV Prevention, Treatment and Care, and overall it is based on the 90-90-90 targets, which calls for 90% of HIV-infected individuals to be diagnosed by 2020, 90% of whom will be on anti-retroviral therapy (ART) and 90% of whom will achieve sustained virologic suppression.
Routine provision of ART services rests on health facilities, and as part of chronic HIV care, health care providers have the responsibility of ensuring the implementation of the "Test and Start" strategy. Prior to initiating ART, health care providers educate patients about the goals and benefits of ART, ensure adequate adherence preparation and support, provide psychosocial support, ensure the integration of ART into routine clinical services, and ensure viral load monitoring using the Standard of Care PCR laboratory platforms.
The national programme also adapted and adopted the WHO TB/HIV collaborative activities, which is currently been implemented using the National strategic framework across all levels of the health care delivery system, and the communities, in order to reduce the burden of the two diseases. The framework provides a guiding principle for the implementation of the TB/HIV collaborative activities in Nigeria.
Care and support in the context of HIV, involves provision of palliative care and social support to PLHIV and their families; and provision of social protection to children and adolescents. AIDS-related care and support are key elements in the response to the HIV/AIDS epidemic: not only do they directly benefit PLHIV, but they help also help to reduce the social and economic impact of the epidemic and boost HIV prevention. Care and support services are offered to PLHIV, chronically ill people and their families including orphans and vulnerable children to improve the quality and length of their life.