Improving the responsiveness of Kitwe City Council to the needs of the stakeholders

This report is centred on the responsiveness of the KCC to the needs of the stakeholders in the city. It arose from the 2nd SINPA workshop at which a strategy for building capacity within the KCC was developed. Responsiveness was identified at this workshop as a priority area where capacity building was required in the KCC. The report has highlighted the importance of responsiveness in urban governance and the critical role that participatory decision making plays in good urban governance. It has defined responsiveness as the extend to which the KCC operates in a demand oriented manner and also the extent to which KCC performs satisfactorily in the eyes of the stakeholders. Therefore, the core of the work is centered on investigating the extent to which the KCC programmes and activities are rooted in the needs and priorities of the stakeholders. The main stakeholders have been identified as: the residents of the city; the business community and the NGOs. The TORs of the report were: (1) To identify and assess the existing structures vis-a vis responsiveness and to what extent they work in identifying the needs and priorities of the stakeholders and whether these are used in development planning by the KCC and; (2) To formulate recommendations to improve the existing structures or recommend new ones where necessary and to suggest ways in which SINPA Zambia can contribute to follow-up

High treatment uptake in human immunodeficiency virus/ hepatitis C virus-coinfected patients after unrestricted access to direct-acting antivirals in the Netherlands

Background The Netherlands has provided unrestricted access to direct-acting antivirals (DAAs) since November 2015. We analyzed the nationwide hepatitis C virus (HCV) treatment uptake among patients coinfected with human immunodeficiency virus (HIV) and HCV. Methods Data were obtained from the ATHENA HIV observational cohort in which >98% of HIV-infected patients ever registered since 1998 are included. Patients were included if they ever had 1 positive HCV RNA result, did not have spontaneous clearance, and were known to still be in care. Treatment uptake and outcome were assessed. When patients were treated more than once, data were included from only the most recent treatment episode. Data were updated until February 2017. In addition, each treatment center was queried in April 2017 for a data update on DAA treatment and achieved sustained virological response. Results Of 23574 HIV-infected patients ever linked to care, 1471 HCV-coinfected patients (69% men who have sex with men, 15% persons who [formerly] injected drugs, and 15% with another HIV transmission route) fulfilled the inclusion criteria. Of these, 87% (1284 of 1471) had ever initiated HCV treatment between 2000 and 2017, 76% (1124 of 1471) had their HCV infection cured; DAA treatment results were pending in 6% (92 of 1471). Among men who have sex with men, 83% (844 of 1022) had their HCV infection cured, and DAA treatment results were pending in 6% (66 of 1022). Overall, 187 patients had never initiated treatment, DAAs had failed in 14, and a pegylated interferon-alfa–based regimen had failed in 54. Conclusions Fifteen months after unrestricted DAA availability the majority of HIV/HCV-coinfected patients in the Netherlands have their HCV infection cured (76%) or are awaiting DAA treatment results (6%). This rapid treatment scale-up may contribute to future HCV elimination among these patients