The International Association of Physicians in AIDS Care (IAPAC) has long argued that in order for antiretroviral therapies to be properly introduced and scaled up in resource-limited settings, increased attention must be paid to ensuring that physicians and allied health professionals are equipped with a core of knowledge and the minimum infrastructure required to effectively and ethically administer them. From IAPAC's perspective, this would include the guarantee of core clinical competencies via an explicit certification process to accompany HIV management training. Until very recently, this critical rationale -- which lies at the core of IAPAC's Global AIDS Learning & Evaluation Network (GALEN) -- had been most often neglected in global HIV care and drug access planning.

In October 2002, IAPAC made available to key international partners, including the World Health Organization (WHO), the Pan American Health Organization (PAHO), and other international HIV-focused organizations, the first two published modules from within the comprehensive, 15-module GALEN curriculum. In combination, these two modules provide an introduction to antiretroviral therapies, and guidelines and recommendations for their appropriate administration in resource-limited settings. They also provide a framework through which physicians may immediately enhance existing HIV clinical management knowledge.

IAPAC's Southern Africa Regional Office (IAPAC-SARO) this month began to field test the two modules throughout southern Africa, as an appendage to the association's ongoing training of healthcare professionals via the Diflucan Partnership Program. Further, the first two GALEN modules will be incorporated into a comprehensive training partnership program that in November 2002 will see Carol Harris, Director of the Albert Einstein College of Medicine's Global Institute for HIV Medicine (New York, USA), provide two weeks of HIV management training to a select cohort of healthcare professionals in Addis Ababa and Gondar, Ethiopia, at the request and facilitation of the Ethiopian Ministry of Health. Through these various training sessions, IAPAC will be able to determine how best to roll out full-scale training and certification as the entire series of GALEN modules becomes available by year's end.

Of additional significance, IAPAC was recently able to gain important feedback and support from key clinical and policy peers during a WHO consultation convened October 1-2, 2002, in Geneva. The consultation, which explored international strategies and partnerships for scale-up of access to antiretroviral drugs for 3 million people by 2005, was an encouraging sign of positive things to come. As a result of both the serious interest expressed in the field test stage of GALEN and during the course of these and other WHO consultations, IAPAC has reconfirmed commitment to implementing GALEN training and certification on a global scale as soon as remaining materials are finalized. The association continues to welcome and encourage the support and feedback of international partners allied in this struggle to ensure that the laudable goal of scale-up of antiretroviral therapy, as advocated by the WHO, will be achieved.

Development of GALEN materials continues at a quick pace, with additional modules to be made available incrementally over the next three months, following peer-review. Of note, translation of GALEN training modules into Spanish is already underway courtesy of PAHO. As the next few months unfold, IAPAC looks forward to further strengthening its alliances with committed national health authorities, training institutions, global partner organizations, funding agencies, and local care providers in order to quickly empower health professionals who continue to express their collective desire for expanded HIV medical education.

Back to the October 2002 issue of IAPAC Monthly.