“When people die who are on drugs, it is assessed if it has anything to do with the fact that they were on drugs,” he said yesterday. “People are going to die, but hopefully they won’t die because of problems with the quality of care.”
Another of the grant’s three program directors, SPH Associate Professor Wafaie Fawzi, head of the efforts in Tanzania, said that many patients who died while awaiting treatment were probably in the critical last stages of the disease.
“If there’s any reason to believe that it is related to the program, it is noted,” Fawzi said. “But in many cases, it’s not the quality of care, but rather that a great many of the people who had initiated treatment were very advanced in the disease.”
Skolnik said that so far, no deaths have been attributed to the quality of care.
But Murphy said yesterday that although the patients on the waiting list were “the sickest patients,” many could have lived longer had they received treatment in March.
“I don’t think [University officials] understood the consequences of delaying this grant,” Murphy said. “I don’t think there was any maliciousness....It’s very unfortunate. That’s how it goes with this disease.”
Murphy said 2,000 to 3,000 additional patients could have been on treatment had it not been for the funding delay.
‘HEART AND SOUL’
Because funding for the program was delayed in March, in-country partners in Nigeria—including doctors, nurses, counselors and community health workers—went without pay for five months, Idako said.
“They were getting stipends from the hospital,” Idoko said. “But Harvard gives them stipends for Harvard-related work, and they weren’t getting that.”
The employees at his clinic began receiving their stipends at the end of July, Idako said, but employees at other Nigerian sites did not begin receiving their pay until last September.
“The only reason they were even willing to start was because of the existing relationship they had with Professor Kanki and myself,” Murphy said. “We’ve been working there for years. It’s amazing that they worked for nothing.”
An oversight committee for the grant, chaired by Harvard Medical School Professor Martin Hirsch, will be meeting next week to begin planning the grant’s first annual audit report, Skolnik said. The audit will be done by independent, outside experts, he added.
The audit report is scheduled to be released next November.
Skolnik stressed the program’s successes in meeting treatment targets in Nigeria and elsewhere.
He also indicated that the AIDS treatment programs would soon save roughly 40 percent of the cost of anti-retroviral drugs, thanks to the recent Food and Drug Administration fast-tracked approval of a generic AIDS drug.
“Harvard should be proud of the work that people have done here,” Skolnik said. “This is a really challenging, difficult, life and death issue. People are giving their heart and soul to this project.”
—Staff writer May Habib can be reached at habib@fas.harvard.edu.