Background & Mission

In 1998, Harvard University and the Merck Company Foundation established the Enhancing Care Initiative (ECI) to improve the clinical care of people living with HIV and AIDS in resource-constrained settings. The key strength of ECI is the Initiative’s multisectoral and multi-disciplinary AIDS Care Teams that lead analysis of HIV and AIDS care, design locally appropriate solutions in challenging contexts, and generate new evidence and best practices applicable in diverse settings. Through ECI, local care experts based in São Paulo and Santos, Brazil, in Dakar, Senegal, in KwaZulu Natal, South Africa, in Northern Thailand and in Western Puerto Rico, work locally to address the status of AIDS care in specific communities and regions. ECI was created five years ago, when funding and attention to programs attempting to improve care and treatment for people living with HIV and AIDS in resource-constrained settings were virtually non-existent.

ECI is coordinated by the Harvard AIDS Institute in close collaboration with the François-Xavier Bagnoud Center for Health and Human Rights and the Department of Population and International Health at the Harvard School of Public Health. The initial grant from The Merck Company Foundation, was supplemented by a grant from the United States Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB), which supports the ECI Puerto Rico AIDS Care Team.

When the Enhancing Care Initiative began five years ago, ECI represented a new way of conceptualizing AIDS care. That is, first, that HIV infection and its consequences can be treated in resource-constrained settings. Second, that local solutions to the difficulties of HIV care and treatment are best determined by local care experts. And, finally, that HIV care can and must occur throughout the course of one’s infection- from the time of discovering one is infected to the time of need for palliative care.

The Enhancing Care Initiative is based on the beliefs that concrete, practical improvements in care for people with HIV can and must be developed—and that these improvements will be most effective when developed and implemented by local experts who understand the challenges and possibilities intrinsic to their regions. Thus the heart of ECI lies in its AIDS Care Teams that are formed by, composed of, and led by people from the countries involved.