Affordable ART and the Third World: difficulties to overcome

Abstract

A coherent strategy is required, donors to cover the costs of a business plan and personnel to provide advice and training and the country must be chosen. An urban environment is preferred with a local link, ideally a University Department with an existing ART programme and a willingness to be involved. Premises, a clinician and an embryologist must be identified, appropriate training arranged and excellent communication systems put in place. Apart from arranging equipment and servicing supplies, management systems and transparent data collection processes must be established. The protocol and local variations have to be agreed. The clinic needs to be related to the local health system, referral patterns must be created and screening processes set up to develop a waiting list of suitable patients. The nature of prior treatments must be defined. At some point, there needs to be a visit of an agreed scientific adviser with or without a donor representative. The number of patients treated in an initial cohort and review details should be determined. A longer term programme, the creation of a local professional network and clear relations with the state health system need to be explored. Any of these stages may constitute difficulties to be overcome.