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Resource | Publications,
New data adds to a growing body of evidence that as well as saving lives, treating HIV can also help prevent HIV transmission, making the scale-up of treatment all the more urgent. In May 2011, a study called HPTN 052 supported by the US National Institutes of Health found a 96% reduction in transmission when HIV-positive persons in a relationship with an HIV-negative person were started early on antiretroviral therapy compared to people whose treatment was deferred.9 Early treatment also significantly reduced the development of tuberculosis, which remains the number one killer of people living with HIV/AIDS.
If HIV treatment and prevention interventions are ambitiously expanded, according to UNAIDS, twelve million infections and more than seven million deaths can be averted by 2020. The number of new infections could be reduced by more than half by 2015.
Resource | Publications,
The World Health Organization (WHO), with support from the Pangaea Global AIDS Foundation and funding from the Bill & Melinda Gates Foundation, convened a meeting of experts in HIV treatment from around the world to establish short-term treatment optimization priorities for preferred first- and second-line regimens recommended in 2010 WHO guidelines for adults and paediatrics. The list of attendees is attached at Annex A.
For this meeting, short-term drug optimization was defined as a three-year window (2011-2013), and discussion focused on preferred first- and second-line regimens for adults and paediatrics recommended in the 2010 WHO Guidelines.
The meeting’s objective was to refine the recommendations of the Conference on Anti-Retroviral Drug Optimization (CADO) held in June, 2010, and the recommendations made by the Medicines Patent Pool, UNITAID and WHO, endorsed by a number of global partners working on the Treatment 2.0 initiative, to the WHO Expert Committee on Essential Medicines in March, 2011.
Resource | Publications,
In 2005, the predecessor of this Committee, Scientific Committee on AIDS, published its set of recommended principles of antiretroviral therapy to provide general guidance for the use of antiretrovirals in Hong Kong. The document stated nine major principles of antiretroviral use.
Since then, progress has been made in the realm of HIV management. There have also been corresponding changes in local practice. This Committee therefore undertook to re-examine the document with a view to updates where appropriate. As before, the effort focussed on major principles rather than details of antiretroviral use.
Resource | Publications,
This Regional Issues Brief has been written to provide an overview of an area of enquiry that the Global Commission on HIV and the Law is examining – issues of laws pertaining to intellectual property rights and access to medicines. It has been undertaken through a literature review of laws and documentation of their enforcement in the context of Asia and the Pacific. It serves as an information resource and complements the report of the Regional Dialogue for Asia and the Pacific that was held under the auspices of the Global Commission on HIV and the Law in Bangkok on 16 and 17 February 2011.
Significant advances in treatment access in the Asia Pacific region have resulted from the work of activists who have campaigned to ensure that intellectual property laws do not impose unreasonable constraints on access to HIV medicines. Activists have achieved a number of successes through campaigning and litigation in Thailand and India. The focus of campaigning has been on challenging overbroad patents and trade agreements that block production and importation of affordable generic versions of HIV medicines. The legal response to access to medicines in the region continues to be influenced by heated policy debates between consumer activists and the mainstream pharmaceutical industry.
Resource | Guidelines,
The main causes of death among children under 5 years of age are acute respiratory infection (17%) and diarrhoeal disease (16%), and children infected with human immunodeficiency virus (HIV) have greater morbidity and mortality related to these conditions (WHO, 2008).
The World Health Organization (WHO) departments of Child and Adolescent Health and of HIV/AIDS reviewed the evidence on management of diarrhoea and pneumonia in HIV-infected children, because of the substantial effects of these conditions on morbidity and mortality, potential differences in etiological agents (and thus in recommended empirical regimens) from those for uninfected infants and children, potential changes in the susceptibility of pathogens to co-trimoxazole prophylaxis in these children, and the lack of specific recommendations for this high-risk group. These guidelines are part of a comprehensive set of normative documents being prepared by WHO for the prevention and treatment of common conditions affecting HIV-infected and -exposed infants and children.
Resource | Publications,
Hong Kong, located in Asia the new burning place of HIV infection, is still having a relatively low prevalence of HIV infection. While sexual transmission is the predominant route of transmission in Hong Kong, an upsurge of infection in injecting drug users is a concern from the experience in other Asian localities. Various public health measures in Hong Kong have kept the HIV prevalence of drug users at low level, as compared with neighbouring cities.
Resource | Publications,
Over the past ten years, there has been a remarkable and virtually unprecedented global scaleup of a life-saving medical technology: antiretroviral therapy for people with advanced HIV infection. This therapy not only prolongs life for most patients, it keeps people healthy enough to work, to continue their lives in families and as parents, and to contribute to their communities and countries. We now know that antiretroviral therapy also lowers the amount of HIV in the bloodstream, thus making people less infectious and contributing to HIV prevention goals as well.
The successes of the past ten years are directly linked to the drastic fall in the price of these drugs. The cost of first generation antiretrovirals has decreased from over ten thousand US dollars to as low as 67 dollars per person per year. This amazing reduction has been achieved largely thanks to competition from generic manufacturers, which, for millions of people worldwide, has been the difference between life and death. Such competition has in large part been made possible by countries' utilization of the public health flexibilities in the World Trade Organization's TRIPS Agreement.
The Good Practice Guide analyses each of the public health flexibilities in the TRIPS Agreement
and provides examples where and how have they been used by national governments. The Guide
also provides some examples on the effect of adopting intellectual property protection measures,
which exceed the minimum requirements of TRIPS and which are often introduced through bilateral trade instruments.
Resource | Guidelines,
Significant obstacles remain to scaling up paediatric care, including limited screening for HIV, a lack of affordable, simple diagnostic testing technologies for children less than 18 months of age, a lack of human resources with the capacity to provide the care that is required, insufficient advocacy and understanding that ART is efficacious in children, limited experience with simplified, standardized treatment guidelines, and limited availability of affordable and practical paediatric ARV formulations. Health-care systems remain unable to meet the demands of national paediatric ART coverage. Consequently, far too few children have been started on ART in resource-limited settings. Moreover, the need to treat an increasing number of HIV-infected children highlights the primary importance of preventing transmission of the virus from mother to child in the first place.
The WHO guidelines Antiretroviral therapy for HIV infection in infants and children are based on a public health approach to HIV care. Updated in 2010, these guidelines are harmonized with the treatment guidelines adopted for adults, pregnant women, and for prevention of mother- to- child transmission (PMTCT).
The present guidelines are part of WHO’s commitment to achieve universal access to the prevention, care and treatment of HIV infection in infants and children.
Resource | Guidelines,
Since the publication in 2006 of Antiretroviral therapy for HIV infection in adults and adolescents: Recommendations for a public health approach, new evidence has emerged on when to initiate ART, optimal ART regimens, the management of HIV coinfection with tuberculosis and chronic viral hepatitis and the management of ART failure. This evidence formed the basis for the recommendations contained in the 2010 update, which outlines a public health approach to the delivery of ART for adults and adolescents in settings with limited health systems capacity and resources. The recommendations were based on the preparation GRADE evidence profiles, systematic and targeted reviews, risk-benefit analyses, consultations with PLHIV, technical reports, and assessments of impact, feasibility and cost.
This guideline revision was conducted in accordance with procedures outlined by the WHO Guidelines Review Committee and is based on the GRADE approach to evidence review. The process involved four separate working groups: the Internal WHO ART Guideline Working Group, the ART Guideline Drafting Group, the external ART Peer Review Panel and the full ART Guideline Review Committee.
Resource | Publications,
The latest studies show that a reduction in new HIV infections of up to a third could be achieved globally if there is a radical overhaul of the way that the world provides antiretroviral therapy and if global leaders meet their commitments of ensuring that all people in need of treatment are on it.
It's called treatment as prevention and it is one of the five pillars of the new Treatment 2.0 platform. In an effort to maximize the value of antiretroviral therapy, a radically simplified approach is needed. This includes the development of better combination treatment regimens, cheaper and simplified diagnostic tools, and a low-cost community-led approach to delivery.