The statistics are staggering. It is estimated that three-quarters of the world’s AIDS population lives in Sub-Saharan Africa; most have no access to lifesaving drugs, testing facilities or even basic preventative health care. One of the major factors inhibiting medical professionals in Africa from treating this disease is the inability to access vast areas of the continent with adequately equipped medical facilities.
A number of organizations have called for the development of a network of mobile and satellite clinics to provide basic health care and combat the spread of HIV/AIDS in Sub-Saharan Africa. They include Doctors without Borders, The Harvard AIDS Institute, UNAIDS, and the World Health Organization.
A comprehensive review of strategies addressing structural deficiencies commissioned by The World Health Organization’s Commission for Macroeconomics and Health (CMH) revealed that the infrastructure necessary to stem the spread of AIDS do not require the extensive facilities of modern hospitals but can be effectively administered through small clinics and dispensaries. The CMH study, issued in 2002, refers to these as close-to-client systems and suggests that increasing the capacity of these local clinics and dispensaries through stable financing is well within the ability of international efforts.
Community-based approaches to treating and preventing HIV/AIDS have been proven effective in a number of developing countries, including Ghana, Kenya, South Africa and Uganda. With funding from the World Bank, Uganda began investing in local clinics and outreach centers as part of a nationwide initiative to combat the spread of HIV/AIDS in 1994. Since then, the rate of prevalence of HIV/AIDS in Uganda has declined nationwide from 14 percent (and in some urban areas as high as 30 percent) to 5 percent in 2001, according to the Uganda AIDS Commission.
However, even in Uganda, access to care is inadequate in rural areas. In its National Strategic Framework for HIV/AIDS Activities (2000/1-2005/6) the Uganda AIDS Commission cited "inadequate HIV testing and counseling services particularly in rural areas" as one of the major constraints to treating and preventing HIV/AIDS and called for the expansion of voluntary counseling and testing facilities in rural areas.
In May 2003, President George W. Bush signed into law a five-year, $15 billion Emergency Plan for AIDS Relief worldwide. A key component of the plan calls for the development of a layered network of central medical centers that support satellite clinics and mobile units in rural areas. According to the plan, these mobile and satellite clinics would be staffed by lay technicians, possibly rotating nurses, and local healers, who would be trained in standard clinical evaluations and the distribution of medication refills.
The AIDS Research and Family Care Clinic in Mombasa, Kenya, estimates that a single clinic has the potential to provide testing, treatment and care for upwards of 10,000 people. Other medical and relief organizations give higher estimates. Once designed and built, these clinics could be used by relief and community health organizations to create a highly dispersed and effective network of care.
In addition to providing testing, treatment and awareness education to underserved populations, a network of easily deployable mobile clinics equipped with satellite communications systems could provide critical information to central health care centers in order to track prevalence rates in outlying regions, assess the needs of specific communities and deploy limited resources accordingly. In the future, such a network could also play a vital role in distributing antiretroviral drugs and eventually a vaccine.
Implementing Architecture for Humanity’s designs for a Mobile HIV/AIDS Health Clinic for Africa would represent a significant step toward building a dispersed and efficient network of care in Sub-Saharan Africa.