One of IDI’s mandates is to develop models for the care of infectious diseases in low-resource settings. Through the PCT programme, the institute has produced a series of innovative and replicable models of care, such as Task Shifting, Pharmacy Refill Program, and ‘Switch’ Meetings that focus on regimen change for individual patients. Other models include the HIV/TB co-infection clinic, integrated sexual and reproductive health services, care and treatment for key populations (commercial sex workers and long-distance truck drivers). IDI has a wealth of experience and expertise that has been fostered through regular Continuing Medical Education (CME) activities, journal clubs, and a research forum.

Task Shifting: This is an approach to address the shortage of healthcare workers through reallocating human resources. This model gained international recognition in 2008 but was implemented as early as 2006 to address overwhelming numbers of patients during the antiretroviral rollout in the clinic. Task shifting empowers nurses to review patients so that medical doctors can concentrate on treatment and broader clinical care. Nurses are trained in clinical assessment, identification of drug toxicities, management of opportunistic infections, and drug interactions to ensure the quality of care. In addition, the nurses are kept abreast of developments in clinical care through Continuous Nursing Education (CNE). Worthy of note is that nurses at IDI have shifted some of their tasks to the Expert Friends on a voluntary basis, enabling nurses to concentrate on offering quality care to the clients who attend the clinic. Some of the tasks delegated by nurses to the Expert Friends include taking patient vitals, such as weight and height, and the transfer of files. The Friends are trained in basic patient care management and counselling to provide quality care.

Pharmacy Refill Programme: Time is precious, and once lost, it can never be recovered. Aware of this fact, the Pharmacy Refill Programme was conceived as an efficient and cost-effective way of decongesting the IDI clinic. At the time, it was observed that not all the patients who visited the clinic each day needed to see a clinician. The clinician workload was too high for both doctors and nurses because of the high demand for HIV care. The load included patients who were deemed clinically stable. The Pharmacy Refill Programme was created to address this special group of clients. The program, which has been rolled out to other centres of HIV care in Uganda and Africa, has reduced waiting time for patients and enabled nurses, clinicians, and pharmacy staff to pursue other interests due to reduced workload.

Switch Meetings: This is one of the Continuing Medical Education sessions held by IDI’s PCT programme. The purpose is to discuss the care of Friends who are failing on antiretroviral therapy (ART). All cases of Friends that require a switch of medication are discussed by a team of committed clinicians with support from internal and external experts, and necessary recommendations are made to improve the quality of HIV treatment. Additionally, Switch Meetings are a great resource for medical students, visiting clinicians, and other healthcare workers to learn about real-life HIV care in a resource-limited setting.