Antiretroviral (ARV) toolkit

About this toolkit

Lack of access to antiretroviral (ARV) treatment has perpetuated HIV/AIDS-related stigma and discrimination in many countries. The cost of medicines, poor infrastructure and the lack of skilled healthcare workers are frequently cited as obstacles to scaling up ARV treatment in resource-limited settings. In the face of these challenges, pilot ARV treatment programmes in resource-limited settings have shown that people with HIV can be successfully treated, achieving clinical outcomes that are similar to those seen in highly resourced settings. These pilot projects have also shown that the availability and accessibility of ARV treatment is accompanied by significant reduction in stigma and discrimination.

There is a growing consensus that a public health approach is the way forward for scaling up access to ARV treatment in resource-limited settings. This aims to provide treatment for as many people as possible, while working towards universal access to ARV treatment. More specifically, the public health approach is based on standardized first- and second-line treatment regimens with simplified laboratory monitoring. The public health approach for scaling up ARV treatment also calls for early involvement of a range of stakeholders, including people with HIV and other community members.

A successful ARV treatment programme involves far more than getting pills into the mouth of the patient. ARV treatment is not a cure; for optimal outcomes, ARV treatment must always be linked strongly with prevention and care efforts. This will include testing and counselling for prevention and adherence, systems for follow-up and referral, meaningful involvement of people with HIV and measures to address stigma and discrimination. Scaling up ARV treatment will also mean scaling up testing and counselling and prevention efforts.

The aim of the toolkit is:

  • to address issues arising from planning and implementing ARV treatment programmes in resource-limited settings; and
  • to provide user-friendly technical guidance on planning and implementing ARV treatment programmes in resource-limited settings.

Who is the toolkit for? The toolkit is for a target audience of programme managers, implementers and their partners in the public and private sectors, including nongovernmental organizations (NGOs), community-based organizations (CBOs) and businesses.


  • a user-friendly approach;
  • easy reference and access to its various components; and
  • regular updates.

To ensure the broadest possible access and use, the toolkit will be available in several formats, including hard copy, CD-ROM and an Internet version.

To make it possible to learn from and contribute to rapidly evolving experience of ARV treatment delivery, the toolkit is structured as a ‘living document’.

The toolkit will have a user-feedback facility, which will enable regular monitoring of the use of the toolkit. Feedback will be utilized to make improvements to the toolkit and ensure that it continues to respond to emerging and changing needs.