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New approach to HIV treatment
UNAIDS
July 13, 2010

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Everyone wants to do things smarter, faster and better but the reality is that treatment today is complicated. From starting HIV treatment to maintenance, the treatment process works, but each step is cumbersome and expensive.

Up to 80% of the cost of treatment isn't for the medication but for the systems to get it to a person and to keep him or her on it.

Globally, only one third of people who need treatment are on it. HIV testing is underutilized-most people still find out that they are HIV-positive when they develop clinical symptoms of AIDS. Antiretroviral therapy is not homogenous in cost, effectiveness or tolerability. And resistance can build up, making it necessary to maintain costly labs to monitor each person on treatment.

To get smarter, to get faster and to save more lives, the world will need to shift resources and thinking

Today, an estimated 5 million people living with HIV in low- and middle-income countries are receiving treatment, up from about 400 000 in 2003, a more than 12- fold increase in six years.

Despite progress, the global coverage of Antiretroviral therapy remains low. For every two people newly on treatment, five more become newly infected. A majority of people living with HIV are unaware of their HIV status. And although easily preventable, rates of mother-to-child transmission of HIV in many countries remain high. In many settings, HIV prevention and treatment are provided through a sophisticated delivery system requiring specialist doctors who tend to focus on HIV only. This system is often over-stretched, due to an increasing number of patients, a shortage of trained medical personnel and financial constraints. Many in need of treatment live in rural settings, far from specialized care.

With competing global priorities and an economic crisis, a longer-term sustainable solution is needed to ensure that world leaders can keep their commitments to achieve the goal of universal access to HIV prevention, treatment, care and support. The most recent World Health Organization (WHO) guidelines for Antiretroviral therapy call for earlier initiation of treatment and the use of simpler, better drug regimens- recommendations that will further decrease morbidity and mortality as well as vertical and horizontal transmission.1 However, there is still a long way to go.

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