The ESTHER hospital partnership initiative: a powerful levy for building capacities to combat the HIV pandemic in low-resource countries

Partnerships between hospitals in high income countries and low resource countries are uniquely capable of fulfilling the tripartite needs of care, training, and research required to address health care crises in low resource countries. Of particular interest, at a time when the EBOLA crisis highlights the weaknesses of health systems in resource-poor settings, the institutional resources and expertise of hospitals can also contribute to strengthening health systems with long-term sustainability. We describe a partnership network between French Hospitals and hospitals/health structures in 19 countries that demonstrates the power and efficacy of health partnership in the response to the HIV/AIDS pandemic in sub-Saharan Africa and south East Asia. Through the ESTHER initiative, the partnership network currently provides capacity development, care and treatment to over 165,000 HIV-positive patients at 87 urban and 92 peripheral sites in 17 countries and enrolls 19,000 new HIV positive patients, delivers psychosocial services to 120 000 people and tests more than 35,000 pregnant women for HIV annually. It also, engages communities and assists with the development of a robust electronic information system. Launched in 2002, the ESTHER (Ensemble pour une Solidarite Therapeutique Hospitaliere En Reseau) initiative has grown from small projects with a focus on access to antiretroviral treatment in a limited number of West African countries at its outset into a large and comprehensive HIV/AIDS-control system in Western and Central Africa. The partnership's rapid achievements in the fight against HIV/AIDS, combined with the comprehensive and long-term approach to countries' health care needs, suggest that this twinning and medical mentoring model can and should be duplicated and developed to address the ever more pressing demand for response to global health needs in low resource countries.