HIV Update: Antiretroviral therapy

Antiretroviral therapy

By Lucy Stackpool-Moore (IPPF)

A record 10 million people living with HIV now have access to antiretroviral therapy but now is not the time to become complacent

The latest scientific results were presented by the leading thinkers and scientists at the 7^th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) in Kuala Lumpur at the end of June. At this conference, the World Health Organization (WHO) released new international guidelines on the use of antiretroviral (ARV)drugs to inspire more and better access to treatment for people around the world.

The new guidelines call for increased access to ARVs for many people – earlier initiation of treatment for people living with HIV (by increasing the recommended CD4 count to 500 cells/mm3), treatment for life for pregnant mothers living with HIV and any infants born with HIV, and provide operational guidance for programmers and planners to adopt the guidelines. These recommendations are ambitious in a time when pediatric treatment remains unacceptably low and funding to guarantee access to treatment risks being inadequate and unsustainable. Complacency, or so-called ‘AIDS fatigue’, and fears of global financial hardship are all factors that may jeopardize the success of the uptake of the new WHO guidelines. Strong leadership is critical within such a moment in time.

Enhanced access to treatment will not be the panacea for meeting all needs, but it is a good start. It can catalyze a great deal through enhancing comprehensive prevention efforts, ensuring lifesaving and health promoting treatment, and reducing the likelihood of HIV transmission. But even with enhanced access, stigma remains; as do many of the structural determinants that fuel HIV and render people vulnerable to ill-health. New challenges will also emerge in terms of treatment adherence for more people and potential risks of increased drug resistance.

Colleagues from across IPPF have recently responded to a question about the need for an exceptional response to HIV. The responses overwhelmingly affirmed that such a response is still necessary – to consolidate hard-won gains of the last 30 years, to innovate and catalyze strengthening in health systems, to protect human rights of the most marginalized people around the world (who are often also the most vulnerable to HIV), and to continue to tackle wider structural determinants of health. As one colleague said, quite simply, “stigma still remains as a great obstacle in many senses: cultural, and political. People that need treatment, don´t have it yet.”

Visionary leadership for HIV is as critical now as ever before. People matter, and every person’s life is important. Now and for the foreseeable future, HIV is part of life – as is living with HIV – for individuals, families, communities, societies and countries around the world.

Download the full issue of the IPPF HIV Update newsletter: http://ippf.org/resource/HIV-Update-Antiretroviral-therapy