Contact: Ken Kostel
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In Rwanda, Clever Use of Technology
Helps a Little Go a Long Way, and Faster
In a country that made headlines for a brutal genocide that left an estimated 800,000 dead, Rwanda now counts itself among several African nations battling with another devastating enemy: AIDS. According to government estimates, about 4 percent of adults living in rural areas and as many as 13 percent in Kigali, the country’s capital, are living with HIV/AIDS. With approximately one doctor per 60,000 people in Rwanda, the number of people waiting for antiretroviral (ARV) treatment is expected to be high for some time.
A major challenge to scaling up AIDS treatment programs has been communications systems that rely on cumbersome data-sharing processes. Hindrances in communication can delay responses to drug shortages, causing disruptions in patient treatment and increasing the probability of drug resistance.
But the government of Rwanda is taking an unusual and very effective step in their plans to scale-up treatment. They are using cellphone technology to streamline and expedite data sharing among health workers using mobile or fixed telephone lines and the Internet, in a project called "TRACnet."
Today 67 clinics and 150 health workers around Rwanda use TRACnet to follow patients’ progress, monitor drug supplies, and share data affecting national policies all within a matter of seconds as opposed to days or weeks.
With this system, health workers can dial ‘3456’ or log onto a bilingual (French and English) Web site and receive patients’ test results as soon as they are processed. Prior to TRACnet, patients waited up to a month for test results.
Having drug information available within seconds also gives officials such as ones at the Ministry of Health, Rwanda's Treatment and Research AIDS Center (TRAC), the National Reference Laboratory, and CAMERWA, a pharmaceutical agency coordinating drug supply for HIV/AIDS patients the tools they need to enhance patient services and reach their treatment coverage goals, helping to avoid life-threatening interruptions in the delivery of drugs.
Rwanda’s antiretroviral (ARV) program currently covers the treatment needs of more than 13,000 HIV-positive citizens, with a target of 101,000 patients by 2007.
According to Josh Ruxin, director of projects at the Center for Global Health and Economic Development (CGHED), and principal investigator on the TRACnet project, building human capacity is the “single greatest factor” to ensuring people with HIV/AIDS have access to the care they need.
“With TRACnet, we’re able to put critical programmatic and patient-level information in the hands of decision-makers and enable them to scale up services more rapidly,” says Ruxin, whose Center is providing ongoing technical assistance to the TRACnet project. “In the history of the AIDS epidemic so far, the disease has far outpaced our systems and capacities to respond; TRACnet is proving to be a critical new tool to react and strategize in real time.”
TRACnet now serves as the national repository for sharing and storing critical data affecting national programs on HIV/AIDS. TRACnet is managed by a dedicated team of trainers and system administrators at TRAC.
TRACnet was launched in January 2005 with funding from the U.S. Centers for Disease Control and Prevention, CGHED (working closely with Rwanda's Treatment and Research AIDS Center (TRAC)), the Ministry of Health, and Voxiva, a U.S.-based technology solutions provider.
The national phone company, RwandaTel, and the country's cell phone provider, MTN-Rwandacell, have set up toll-free numbers and donated network time to support TRACnet.
Ongoing technical assistance is provided by CGHED’s Access Project for the Global Fund, which is supported by a grant from the Glaser Progress Foundation. Since 2002, the Access Project team has been working closely with the Rwandan government in planning and rolling out its HIV/AIDS strategy.
About The Center for Global Health and Economic Development
The Center for Global Health and Economic Development (CGHED) is a collaboration between the Mailman School of Public Health and the Earth Institute at Columbia University. Through partnerships with the United Nations, the World Health Organization, and private donors, existing programs with demonstrated success will be ramped up to reach a broader base, and new programs will be developed to address critical global health issues. Initiatives focus on a wide range of issues, such as AIDS, tuberculosis, maternal mortality, reproductive health, gender equity, sexuality, environmental contamination (arsenic), forced migration and health, assistance and human rights. For more information, visit www.cghed.columbia.edu/.
About The Earth Institute
The Earth Institute at Columbia University is the world's leading academic center for the integrated study of Earth, its environment and society. The Earth Institute builds upon excellence in the core disciplines earth sciences, biological sciences, engineering sciences, social sciences and health sciences and stresses cross-disciplinary approaches to complex problems. Through research, training and global partnerships, it mobilizes science and technology to advance sustainable development, while placing special emphasis on the needs of the world's poor. For more information, visit www.earth.columbia.edu.