Country-Level 90-90-90 Targets, Progress and Experiences...230,000 182,498 164,518 126,596 0 50000...
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Dra. Alethse De la Torre Rosas General Director CENSIDA Country-Level 90-90-90 Targets, Progress and Experiences National HIV/AIDS Program
Transcript of Country-Level 90-90-90 Targets, Progress and Experiences...230,000 182,498 164,518 126,596 0 50000...
Dra. Alethse De la Torre RosasGeneral Director CENSIDA
Country-Level 90-90-90 Targets, Progress and
Experiences
National HIV/AIDS Program
Mexico - overview
http://www.inegi.org.mx
119 million people
10.8% Indigenous population
Inhabitants
Spanish
68 different indigenous languages
Language
32 states
Local government and regulations
Republic
Mexico – Health System snapshot
http://www.scielosp.org/pdf/spm/v53s2/17.pdfOECD -2016
Public
Social Security Ministry of Health (Federal/States)
Private
Government Government StatesEmployer EmployerWorker Households
“Seguropopular”
insurance
Private insurance
ISSSTEPEMEX
SEDENAMARINA
IMSSFederal MH
State MHIMSS
“Bienestar”
Hospitals, clinics, HCW
Hospitals, clinics, HCW
Hospitals, clinics, HCW Private Hospitals and clinics
WorkersWorker’s
familyRetiree
People who can afford private
insuranceSelf-employed and unemployed
Sector
Funds
Buyers
Providers
Users
Ministry of Health(Federal/States)
Social Security
230,000
182,498164,518
126,596
0
50000
100000
150000
200000
250000
People living with HIV PLWH that know their status ARV treatment Viral Supression
100%
79%
72%55%
73%26%<1% 64%36%
HIV Continuum of Care estimates: Mexico 2018
Diagnosis
✓ Simplification of diagnosis algorithms.✓ Publication of HIV Screening Guideline.✓ Projection of needs for diagnosis test.✓ Purchase of central government of HIV diagnosis test (MH).✓ Coordination between CENSIDA and DGE to update epidemiological
surveillance manuals (diagnosis algorithms), and update the registry.✓ HIV Detection Bulletin: monitoring of the detection (MH).
Treatment
✓ Consolidated purchase of ARV medicines.✓ Needs estimation and centralized
purchase of ARV for MH (62% of peoplein ART).
✓ SALVAR system (operating more than 10years ago).
✓ Face-to-face and distance training(Edusida).
Viral Suppression
✓ Needs estimation and centralizedpurchase of monitoring tests (viral loadand CD4).
✓ Criteria for application of monitoring tests(saving).
✓ Resistant committee (CORESAR).✓ Bulletin Attention of people living with
HIV and Sector information monitoring.
Source: SS/Censida.
62%
Private Social Ministry of HealthSecurity
58%41%<1%
Private Social Ministry of HealthSecurity
Social Security Ministry of Health
There is regional variation that we need to understand and address
Source: SS/Censida.
Mexico 11 000 [7900 - 14 000] 11 000 [7600 - 14 000]
Strengthening treatment options: New paradigm
The need of new treatment options was identified
Co
llab
ora
tio
n
Pu
blic
Hea
lth
Sec
tor
Researchers
Clinical leads
Activists
Ministry of Finance
Ministry of Health
Access to same ARV treatment options for patients
across public health sector
Drive down procurement costs, improve terms and decrease product prices
Altering purchasing
patterns
Product Patent
Pro
cure
me
nt
savi
ng
pro
po
sal
Consolidating procurement
Being able to buy new treatment options
(e.g. Biktarvy®)
Three months
Strengthening treatment options: New paradigm
The need of new treatment options was identified
Co
llab
ora
tio
n
Pu
blic
Hea
lth
Sec
tor
Researchers
Clinical leads
Activists
Ministry of Finance
Ministry of Health
Pro
cure
me
nt
savi
ng
pro
po
sal
Three months
The clinical treatment guideline required an official update
A fast track drug registry approval was required (Biktarvy®)
31 ARV medicines – Estimated reduction of 55% from the baseline costs
23 (72%) regions with initial training
ARV Distribution to regions for the next three months
Achievements so far
Standardization of the ARV Distribution process
Training, dissemination of information, continue engagement with communities, advocates
Challenges faced
Person centered registry – to follow up the outcomes that matter to people living with HIV/AIDS
PREVENTION, DETECTION, EARLY TREATMENT
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