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Lecture - Anna Marzec-Bogusławska - Elements of humanisation in HIV/AIDS system solutions

10 December 2022

I warmly welcome the Internet users. Today my guest is Dr Anna Marzec Boguslawski, Director of the National AIDS Centre. In her presentation, Dr Marzec Boguslawski mentioned the Minister of Health's programme on RSV treatment, which ends in 2021. An important part of this programme is the provisions that allow for the humanisation of the patient-doctor relationship. We wonder what the continuation of this programme will look like. Dr March Boguslawski, can you tell us more about this?
Thank you for your question regarding the viral therapy programme. This is important both for the patient-doctor relationship and for facilitating patient access to this type of therapy. The current edition of the programme is coming to an end, but thanks to cooperation with the Ministry of Health and a team of experts, the next edition has already been finalised. The programme has already been submitted for approval to the Ministry of Health and the Agency for Health Technology Assessment, so we hope that viral therapy will continue to be available without interruption.

The new edition of the programme contains all the important provisions and some of them have even been made more specific, especially regarding the possibility of covering uninsured persons with viral therapy. This applies to both Poles and non-Poles. It is sometimes possible to be granted temporary therapy, but no one will be left behind.

UNESCO and the UN often emphasise that effective action against the epidemic requires ensuring access to therapy for all those in need. Therefore, the new edition of the programme takes into account these requirements and allows for the continuation of viral therapy for patients.
In our programme, we leave no one behind and try to help everyone in the difficult situation they find themselves in. That is why we have also clarified the elements of the programme regarding the change of treatment centre. Patients have the option to change treatment centre if they change their place of residence or their situation requires it.

In addition, the programme allows for the introduction of new antiretroviral drugs that may be helpful for patients who have developed resistance to existing drugs. The programme lasts for five years, so we will introduce new drugs as needed during the programme. This is a very important aspect of the programme as it allows for flexibility to tailor therapies to patients' needs.

The care of patients with HIV and AIDS requires a specialised approach and appropriate legal solutions. Dr Chmielewska mentioned that in the beginning it was well regulated, but there was also a group of passionate people who consistently implemented certain solutions. This ensured that the patient with HIV or AIDS was always in the spotlight. How was this achieved? Can this be considered a model example of care for these patients?

The Organising Centre has the pleasure and honour to continue the work that was previously started and developed by people who worked with great passion for the HIV-infected community in the difficult situation that this infection undoubtedly became at the beginning of the epidemic. I did not intentionally comment on this, but emphasised that it is the people who are most important in the whole process of humanising medicine and creating individual, patient-friendly solutions in the support process.

Patients need antiviral therapy, which is a life-saving treatment that allows them to function normally, but they also need the support of their NGO colleagues and often external support. The role of authority figures in social and public life cannot be overestimated, and the celebrities who support this HIV and AIDS support movement and clinicians play an important role in this.
A group of passionate healthcare professionals is essential to ensure patients receive the right level of care. Research has shown that more than 80 patients in 2007 had the telephone number of their doctor, which means that the doctor becomes the patient's partner in the treatment process. Such a doctor not only prescribes medication, but also supports the patient in his or her therapeutic process.

HIV disease is very serious and requires an appropriate approach. Anonymity and patient safety are key, especially in the early years of the epidemic. At that time, many people experienced alienation and stigmatisation. That is why it is so important to ensure anonymity at testing sites so that patients are more willing to be tested and receive appropriate treatment. A network of testing points for HIV-infected people was established as early as the 1990s and is still being developed. It provides patients with the opportunity to test anonymously and receive appropriate treatment. The current principle is 'test and treat', which means that viral treatment starts as soon as HIV infection is detected.

Patients in Poland have the option of being tested for HIV in a special system that gives them a sense of security. Before the outbreak of the coronavirus pandemic, nearly 40 000 people per year used this option. However, the pandemic has now caused this number to drop significantly, as the restrictions put in place have prevented many patients from going to the points performing these tests. In addition, the pandemic has diverted attention away from the issue of HIV and AIDS. This is a dangerous phenomenon, as there is an increase in the number of infections not only with HIV, but also with other sexually transmitted diseases. This is why NGOs and doctors are appealing to patients to return to HIV testing sites or use other forms of testing, such as self-testing available at some sites. The HIV testing system is still being developed, but already offers patients the opportunity to be individualised and humanised in the testing process.

Seem insignificant, but the sense of anonymity and safety of patients with HIV/AIDS is very important. The activities of the National Centre for HIV/AIDS have contributed to humanising social attitudes towards these people. It has removed many of the negative connotations associated with HIV/AIDS. This is important because people with HIV/AIDS are also people who deserve respect and support.

The Ministry of Health created the National AIDS Centre to better manage the state policy on HIV and AIDS. Father Arkadiusz Nowak was the Minister's plenipotentiary for HIV, AIDS and the creation of this institution. The National AIDS Centre monitors the implementation of the state policy in this area and supports organisations obliged to implement the national programme of the National HIV/AIDS Strategy. This institution is important not only during the pandemic, but also in other situations, as it coordinates nationwide health activities.