Photo: John Nyaga/IRIN

The new programme will help eliminate delays in initiating ART

KIGALI,  – Rwandan nurses will soon be authorized to start HIV-positive patients on life-prolonging antiretroviral treatment (ART), a move Ministry of Health officials say will speed up the rollout of ART in the East African nation.

“Task-shifting will reduce the number of cases requiring the presence of a doctor, thereby reducing the number of treatment-eligible patients that have not initiated ART because they have to wait for the doctor’s visit,” Aimable Mbituyumuremyi from TRAC Plus, the Centre for Treatment and Research on AIDS, Malaria, Tuberculosis and Other Epidemics, told IRIN/PlusNews.

At present, starting on ARVs requires a medical consultation and prescription from a physician. Nurses are responsible for regular patient follow-up and can refill existing ARV prescriptions. Physicians are generally based at district hospitals and visit health centres once a week.

According to officials from TRAC-Plus and the Ministry of Health, the new programme aims to train two nurses from every health centre offering HIV services. By the end of May, 600 nurses will be trained on the theoretical and practical aspects of ART prescription. Training will be followed by a three-month mentorship period, where physicians from district hospitals will conduct follow-up visits to each health centre to guide nurses on patient management.

By September the nurses will be authorized to prescribe ART in uncomplicated cases requiring first-line drugs.

Cases with significant complications that may require second-line ART will continue to be referred to physicians. Doctors and supervisors from the district hospitals will continue to monitor nurses during their quarterly formative supervision visits to health centres.

A 2009 study by the NGO, Family Health International, and the Ministry of Health, evaluating nurse-centred ART in rural health centres in Rwanda found that nurses could “effectively and safely prescribe ART when given adequate training, mentoring, and support”.

Rwanda suffers from a severe shortage of health workers; according to the UN World Health Organization, the country has approximately one physician per 10,000 population and four nurses and midwives per 10,000, compared with 13 physicians per 10,000 globally and 32 physicians per 10,000 in the European region.

The country’s limited number of health workers has been put under enormous stress by the rapid scale-up of ART. According to TRAC, clients on ART increased from approximately 34,000 at end-2006 to more than 75,000 at end-2009 – an increase of 120 percent – while the number of health centres providing ART increased from 133 to 252 during the same period.

The latest Rwanda National Strategic Plan for HIV/AIDS aims to have all health facilities in Rwanda able to provide a full package of HIV services, including ART, by 2012; it also intends to put 90 percent of eligible patients on HIV treatment. The plan envisages task-shifting as critical to achieving these goals.

rj/kr/mw source.irinnews

Photo: Wikimedia Commons

What will we be able to grow in another 40 years?

JOHANNESBURG,  – Temperatures seem set to soar to perilously high levels because of climate change. In another 40 years, would maize still be the staple food in Kenya, already hit by five failed rainy seasons? If not, what could people grow and eat? And if you could grow maize, how much water and fertilizer would it need?

If you live in the remote semi-arid Karamoja region of northeastern Uganda – beset by 14 droughts in 25 years – you might also want to know what your options are for continued food security.

For the first time, a customized regional climate model linked to crop growing and water models, run on a supercomputer at Michigan State University (MSU), will help provide crop breeders in three East African countries – Kenya, Uganda and Tanzania – with detailed answers on crop yields.

Many research institutions have been working on models to predict the impact of climate change on food production in Africa, but in a few months the MSU model will help scientists and breeders to zoom in at a regional level on the possible impact of climate change on a wide variety of crops in these countries.

The research could help produce climate-resilient varieties of food crops, said Jennifer Olson, lead researcher and associate professor at MSU’s College of Communication Arts and Sciences.

In a few months the MSU model will help scientists and breeders to zoom in at a regional level on the possible impact of climate change on a wide variety of crops in these countries

“East Africa is already experiencing the impact of climate change – food crops are experiencing extreme water stress,” she commented. People living in Kenya’s highlands, who have traditionally grown tea and coffee, have begun experimenting with maize and beans as the climate has grown warmer.

Work on the model began 10 years ago with the recording of relevant data, such as the impact of nutrients on a certain food crop, or the impact of water stress on another, which were subsequently fed into the model. “The model is still being perfected,” said Olson.

The model can experiment with the impact of climate change, such as high temperature and water stress on a certain crop variety, saving the time that would have been spent on field trials, “which will help speed up the agricultural research cycle”, she noted.

The researchers intend to launch the model at a workshop in June. Concern about increasing food insecurity in East Africa has prompted two institutions to set up a research grants to encourage innovative solutions.

The New Partnership for Africa’s Development (NEPAD), based in South Africa, and the International Livestock Research Institute (ILRI), in Nairobi, Kenya, announced a US$10.67 million grant from the Swedish International Development Agency (SIDA) to support the establishment of a multidisciplinary competitive funding mechanism for biosciences in Burundi, Ethiopia, Kenya, Rwanda, Tanzania and Uganda.

ILRI’s Bruce Scott said they would be looking for innovative solutions using bioscience to improve crop resilience to climate change, or perhaps to improve the shelf-life of a food product.

jk/he source.irinnews

Norway, Germany, the Netherlands, Belgium and Luxembourg have called on NATO to support efforts to achieve a world without nuclear weapons. “Our aim is to reduce the importance of nuclear weapons in NATO’s security policy,” said Foreign Minister Jonas Gahr Støre.

The foreign ministers of the five countries presented a joint letter to the NATO Secretary General today advocating a comprehensive discussion on NATO’s nuclear policy at the Alliance’s next foreign ministers’ meeting, which will be in Tallinn in April.

“The views expressed in this joint letter correspond closely to those set out in the Government’s disarmament strategy. I am pleased that Norway has such good partners to work with in our efforts to promote disarmament,” said Mr Støre.

The letter is important input to the process on NATO’s new Strategic Concept. Norway hopes to use the review of the concept to reduce the importance of nuclear weapons in the Alliance’s security policy.

“Disarmament and non-proliferation are important security policy tools for reducing the risk of the proliferation of weapons of mass destruction and to ensure a more peaceful and stable world,” said Mr Støre.

source.mfa.norway