Israeli and International Programs

Introduction

Hadassah's AIDS Center (HAC), is an integral part of the Department of Clinical Microbiology & Infectious Diseases at Hadassah University Hospital. HAC operates in two locations in Jerusalem, that are run by Hadassah's Jerusalem office. HAC's international programs are focused mainly on Ethiopia.

Jerusalem Activities
HAC treats over 350 adult patients at the AIDS Clinic located in the main building of Hadassah Ein Kerem hospital. Hadassah Hospital also runs a small Pediatric AIDS program. All anti-retroviral drugs (ARVs), which are commercially available and FDA-approved, are available at the clinic. These ARVs are supplied by each of the four Israeli Healthcare Funds. Additionally, the AIDS Clinic provides testing for viral load, viral resistance and CD4 levels.

More than half of the patients seen at HAC are Ethiopian immigrants.

HAC also runs the Jerusalem Voluntary Counseling and Testing (VCT) clinic. The clinic offers both anonymous and confidential HIV testing. The clinic is also the only government-funded HIV testing clinic in the Jerusalem area.

Staff
HAC is comprised of 4 MDs, Infectious Diseases specialists, 2 nurses, 2 social workers, 2 Ethiopian coordinators, 3 counselors and a technician.

HAC International Programs

Ethiopia
Since 1995, HAC has partnered with EHNRI (Ethiopian Health and Nutrition Research Institute), as well as several hospitals and clinics in Addis Abeba, to study and work in the field of HIV/AIDS and associated sexually transmitted infections (STI's). The project is funded through private donations and small grants from the Israeli Ministry of Foreign Affairs.

With the start of US AIDS control programs in Ethiopia in 2004, in addition to the introduction of ART (antiretroviral treatment) under PEPFAR (President Emergency Plan for AIDS Relief), the collaboration between Hadassah and Ethiopian AIDS clinics has entered a new phase, which has welcomed its new US partners. New collaborative programs, which emphasize the proper training Ethiopian medical personnel in AIDS medicine, building infrastructure for delivery of anti-retroviral drugs, the development of HIV drug resistance in Ethiopia, and tuberculosis control. HAC has established a viable collaborative program in each of these areas.

- Education in AIDS Medicine
HAC is a subcontract of ITECH (International Training & Education Center on HIV), a program run by the University of Washington, Seattle. Through this program, HAC has become part of University of Washington's PEPFAR program in Ethiopia. HAC, together with other Israeli programs (Israeli Consortium on AIDS Medicine of the Tel Aviv AIDS Center and the Central HIV laboratory at Tel Hashomer hospital) has launched advanced courses in AIDS Medicine to Ethiopian doctors and nurses, emphasizing the multidisciplinary approach to AIDS care as an indispensable component to AIDS. These perceptorship-based training courses are run in Israel, 2 or 3 times a year.

- HIV Resistance
In 1996 HAC participated in the first HIV drug resistance survey in Ethiopia, conducted together with the US-CDC and the EHNRI. HAC has also organized a laboratory training program in HIV resistance technology for Ethiopian technicians at the Central Virology Lab for Israel. A team from the Israel Central Virology Laboratory conducted a workshop on the technical aspects of HIV resistance testing in Addis Ababa.

- Advanced Clinical Monitoring (ACM)
With the help of private contributions, HAC has developed an advanced clinical monitoring program for AIDS patients on ART in Addis Ababa (the St. Paul Cohort). The program is in it's third year and has recruited so far over 200 patients.

- Tuberculosis Control
HAC, in collaboration with John Hopkins University Bloomberg School of Public Health, has been active in introducing the MODS (Microscopic Observation Drug Susceptibility) assay to Ethiopia. The assay, a culture based technique for fast identification and resistance of M. tuberculosis in culture, carries the potential of revolutionizing the diagnosis of tuberculosis in developing countries. In 1996, HAC has run the first course in the diagnosis of tuberculosis using MODS. HAC collaborates with the Clinical Microbiology Department at Hadassah.

Involvement in Other Countries
Early approaches towards the involvement of the HAC in program related to AIDS control in Kazakhstan and Russia are under way.