Guatemala City/Geneva — In late December 2006, after four years of treating people living with HIV/AIDS in Coatepec, Guatemala, MSF transferred that responsibility to the country's public health agencies. Preparation for the handover had been underway for more than a year.

The transfer was implemented gradually, concluding only when the agencies taking responsibility were ready to ensure continuity of care. MSF continues to provide treatment to people living with HIV/AIDS in Puerto Barrios and Guatemala City.

"For us at MSF, this transfer of responsibility to the public health authorities is a very positive sign," said Dr. Markus Lüthi, MSF Switzerland's medical coordinator in Guatemala. "The medical staff at the Coatepec hospital now has sufficient technical ability to ensure appropriate treatment of a steadily growing number of patients.

"The protocols are well known and we are reasonably optimistic that anti-retroviral drugs will continue to be available now that 'The Global Fund to Fight AIDS, Tuberculosis and Malaria' has committed to supporting the Ministry of Health's acquisition of these supplies through the end of 2009."

The management of the Coatepec hospital strongly supports this program and MSF hopes that the September 2007 elections will not change that. Despite all these precautions, MSF will closely monitor the situation, particularly in the area of medical supplies, and is prepared to provide direct support to patients in the event that medications fall short in the coming months.

In addition, MSF continues to provide technical support in managing the national HIV/AIDS program's drug supplies. Delays may still occur as a result of failures to properly manage orders and supplies and problems may still arise due to slow disbursements of funds. MSF will thus maintain an inventory of medications on site until mid-2007 to deal with any eventualities.

At the end of 2006, 781 people benefited from antiretroviral treatment at the former MSF clinic in Coatepec, which has been incorporated into the hospital. On average, 48 new patients enter the program every month - 27 of whom require immediate antiretroviral treatments. These patients often come from areas far from the city of Coatepec.

"The encouraging handover of this project in Coatepec should not, however, hide the fact that such developments in managing the treatment of AIDS patients remain limited at the national level," says Frank Doerner, managing physician for MSF in Guatemala, based in Geneva.

"For the second consecutive year, national budgets allocated to AIDS have not increased. There are only five medical centers in the country - two in the capital (Roosevelt and San Juan de Dios hospitals), one in Quetzaltenango, one in Puerto Barrios and the Coatepec center - where AIDS patients can be treated. Patients who need treatment must make long and costly journeys to find treatment. While the expertise may exist in Coatepec today, the political will to commit to mass treatment still lags far behind."

MSF has been working in Guatemala for more than 20 years. In 2000, after caring for victims of the civil war and, later, working with extremely disadvantaged populations in urban areas, MSF began gradually developing programs for treating people living with HIV/AIDS. Today, MSF is also treating victims of violence, reflecting the acute reality in this Central American country, and is treating people with Chagas disease, a parasitic illness endemic in parts of Guatemala.