The practice of charging user fees at the point of service delivery for HIV/AIDS treatment and care

WHO discussion paper

Reference number: WHO/HIV/2005.11

The global movement to expand access to antiretroviral treatment for people living with HIV/AIDS as part of a comprehensive response to the HIV pandemic is grounded in both the human right to health and in evidence on public-health outcomes. However, for many individuals in poor communities, the cost of treatment remains an insurmountable obstacle. Even with sliding fee scales, cost recovery at the point of service delivery is likely to depress uptake of antiretroviral treatment and decrease adherence by those already receiving it. Therefore, countries are being advised to adopt a policy of free access at the point of service delivery to HIV care and treatment, including antiretroviral therapy. This recommendation is based on the best available evidence and experience in countries. It is warranted as an element of the exceptional response needed to turn back the AIDS epidemic.