3 million HIV/AIDS sufferers could receive anti-retroviral therapy by 2005
New hope for those in developing world.
BARCELONA, 8 July 2002 - In response to the urgent need to scale up access to HIV/AIDS treatment, the World Health Organization (WHO) is joined by the International AIDS Society at the XIVth International AIDS Conference to formally launch new international guidelines for a public health response to the treatment of AIDS in resource-poor settings.
The guidelines represent a major breakthrough. For the first time, highly complex anti-retroviral (ARV) therapy has been simplified so that it can be used in settings that don't have highly trained medical staff and sophisticated laboratories available to initiate and supervise treatment. The move lowers the technical barriers to HIV/AIDS treatment, potentially benefiting millions of people currently unable to access it.
WHO estimates that today nearly six million people living with HIV/AIDS need equitable access to care and support, including anti-retrovirals (ARVs). Currently, fewer than 5% of those who require treatment in developing countries can access these medicines - with an estimated 230,000 people currently receiving ARV therapy in the developing world. Half of these people live in only one country, Brazil. Africa, the continent that has been hardest hit by the HIV/AIDS pandemic, is even less well served, with fewer than 50,000 people estimated to be currently receiving ARV therapy. This coverage represents less than 2% of the people that need access to this life saving therapy.
WHO believes that potentially, at least three million people needing care could get ARVs by 2005 - a more than ten-fold increase in the developing world.
"For the first time we now have the chance to apply a simplified, easy-to-follow public health approach to AIDS treatment rather than complex individual treatment regimes," says Dr Gro Harlem Brundtland, WHO Director-General. "This, combined with the falling costs of medicines, means it should be possible to extend the life-span of those living with HIV in resource-limited settings."
WHO sees wider access to safe and practical treatment as an important element of an overall strategy to fight HIV/AIDS, bringing together prevention, improved diagnostics and effective treatment so that these elements mutually reinforce each other.
The new guidelines resulted from a year long process with input from over 120 scientists, researchers, clinicians as well as representatives of civil society and people living with HIV/AIDS from over 60 countries. The guidelines take advantage of the dramatic progress in the medical management of HIV/AIDS that has taken place over the last few years in the developed world and apply the latest evidence and experience to develop simplified, standardized, easier-to-use treatment regimens. In a move to enable wider use of ARV treatment, WHO also included 12 ARV drugs in its Model List of Essential Medicines in April 2002.
"By simplifying and limiting the number of combination ARV regimens and laboratory monitoring we have been able to reduce the complexity of ARV treatment", said Dr Tomris Türmen, Executive Director of WHO?s Family and Community Health cluster. "But this technical progress must be translated into scaled-up action. There is an urgent need for funds to build up the human resources and infrastructure to deliver the treatments. Moreover, mobilization of the health sector for HIV/AIDS care will not be enough. More than ever, we need a broad-based partnership to achieve greater equity between rich and poor countries in terms of the quality of care offered. "
In high-income countries, an estimated 1.5 million people live with HIV, many of them productively because they receive highly active ARV therapy. In the USA, the introduction of triple combination ARV therapy in 1996 led to a decline of 70% in deaths attributable to HIV/AIDS. In developing countries with access to ARV therapy the same profound effects have been documented: in Brazil, AIDS deaths have decreased by 73% since the introduction of highly active ARV therapy.
Development of the guidelines was supported by a grant from the U.S. National Institutes of Health Office of AIDS Research.
The World Health Organizations HIV/AIDS Department, is part of the Family and Community Health Cluster, with headquarters in Geneva, Switzerland. The department co-ordinates an organization-wide response to the HIV/AIDS epidemic, develops reference materials and tools to assist countries in key health sector interventions such as HIV Prevention, Care, and Support. It also works to strengthen global HIV surveillance systems, promotes partnerships and conducts advocacy to end the HIV/AIDS epidemic.