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Resource | Publications,
Although anti-retroviral treatment (ART) is not traditionally considered a central concern in the harm reduction agenda, from a global public health perspective, Asian Harm Reduction Network (AHRN) believes that ART remains a very important service within a comprehensive HIV/AIDS treatment and care model. As such, AHRN’s analysis and experience in national, regional or international initiatives which have operational goals determined and evaluated through the provision of anti-retroviral (ARV) medications to people living with HIV/AIDS (PLWHA), demonstrates that we should applaud such treatment services on the principle that all people, regardless of ethnicity, religion, gender or sexual orientation, should receive quality treatment and health care.
Resource | Publications,
HIV/AIDS is among the greatest health crisis ever faced by humanity. Already this pandemic has killed 20 million people. Today, 40 million people are living with HIV. Each year, 3 million are dying of HIV/AIDS. However, most of these deaths could be prevented if they had access to antiretroviral therapy (ART).
In September 2003, WHO declared that failure to provide antiretroviral therapy to patients in developing countries a global public health emergency. Accordingly, WHO with UNAIDS and partners set a target of providing 3 million people in developing countries with antiretroviral treatment by the end of 2005 (the “3 by 5” initiative). While this is an interim target, long-term goal is of universal access to ART for all those who need it.
The primary objective of the antiretroviral therapy is to prolong the survival as well as improve the quality of life of the people living with HIV/AIDS. By bringing down the HIV viral load to sustained undetectable level, it is expected that ART will contribute also to HIV prevention.
Resource | Publications,
In an effort to keep abreast of rapid changes in the landscape of the HIV pandemic, WHO and UNAIDS
report semiannually on progress toward "3 by 5". The first update was presented at the XV International AIDS Conference in Bangkok, Thailand, in July 2004.
This second report measures progress made by countries and describes how international partners are
supporting their efforts. In addition, it summarizes how the building blocks of antiretroviral (ARV) therapy programmes are being put into place and how issues beyond treatment are being addressed.
It provides examples of country progress and a global estimate of the number of people receiving ARV therapy, and it assesses how well the therapy is working. It also identifi es some of the challenges faced in resource-constrained settings and how these are being met by improving health care systems, links between prevention and treatment and providing equal access to quality care.
Resource | Presentations,
With significant reduction in the cost of antiretroviral (ARV) drugs, access to antiretroviral therapy (ART) has become increasingly real for people in low-resource settings. In many countries, governments have developed national guidelines on ART management to define care standards and establish protocols for such areas as eligibility criteria, drug regimens and monitoring HIV-infected clients on ART.
Standard operating procedures (SOPs) describe processes and provide instructions to maximize ART service delivery at health facilities in accordance with national guidelines. They guide clinicians in providing ART to HIV-infected clients and in evaluating performance, thereby serving as a quality assurance tool for management.
Resource | Publications,
This policy brief reviews the evidence to date on providing antiretroviral (ARV) therapy to HIV-positive injecting drug users. A number of related medical, psychological and social issues are also addressed including the need to manage drug interactions and the benefi t of harm reduction interventions in supporting optimum care for HIV-positive injecting drug users.
Resource | Publications,
This technical assistance (TA) aims to reduce the vulnerability to, and risk of, HIV/AIDS transmission among ethnic minority groups through communication strategies. The TA focuses on ethnic minorities that live in cross-border areas in the GMS. An Asian Development Bank (ADB) regional TA (RETA), begun in 2002 and completed in December 2004, dealt with HIV/AIDS in GMS areas. The proposed TA will build on the achievements of RETA 6083 by (i) scaling-up to address the increased risk of HIV/AIDS due to human trafficking and drug abuse; and (ii) scaling-out to include new ethnic groups prioritized by government partners.5 The TA will build on ADB’s past work in strengthening the human capital of ethnic minorities, including addressing their vulnerability to HIV/AIDS, and will coordinate with ongoing TAs on human trafficking and drug abuse in reducing structural vulnerabilities, for example citizenship and land tenure, among ethnic minorities in cross-border areas of the GMS.
Resource | Publications,
Successful treatment of HIV/AIDS depends on strict adherence by HIV positive patients in taking their medications as instructed and for health care providers to recommend antiretroviral treatment (ART) based on rigorous scientific evidence. The devastating consequences of incorrect or partial HIV treatment are premature death, increased morbidity, development of drug resistant HIV strains, and lack of further treatment options.
The main purpose of these guidelines is to assist health care providers in determining the optimal ART regimen for their HIV positive patients and to provide recommendations for standardized quality of care. We hope that compliance with the guidelines will reduce the risk of treatment failures, prevent ART resistance and in the long term enable Pakistan to successfully contain the HIV/AIDS epidemic.
It is crucial to for health care providers and patients to understand that treatment and care of HIV is an evolving science. While these guidelines contain the latest recommended ART practices, they are a living document. The National AIDS Control Program would like to emphasize that these guidelines will be regularly revised and updated to incorporate new information and best practices.
Resource | Publications,
With national estimated prevalence of between 0.6% and 2.2%, Myanmar is experiencing a generalized epidemic, considered one of the most serious in Asia. The Ministry of Health estimates that 338,911 adults aged 15–49 years old were living with HIV/AIDS in September 2004, of which 96,834 (28.6%) were women, indicating a total adult prevalence rate of 1.3%. HIV infection rates vary across the country, with several regions showing considerable increases in prevalence rates among less vulnerable populations. According to the Ministry of Health, in 2003, 12 of 29 sentinel sites for pregnant women showed a prevalence of HIV infection exceeding 2%. At Pyay and Hpa-an, prevalence rates among pregnant women were as high as 5% and 7.5% respectively.
Resource | Publications,
Since late 2003, when WHO and UNAIDS launched a strategy for ensuring treatment for 3 million people living with HIV/AIDS in low- and middle-income countries by the end of 2005 (the "3 by 5" target), coverage of antiretroviral therapy (ART) in these countries has more than doubled – increasing from 400 000 to approximately 1 million people receiving treatment at the end of June 2005. To date, 14 of these countries are providing ART to at least 50 per cent of those who need it, consistent with the "3 by 5" target.
This interim report on global efforts to increase access to ART focuses primarily on understanding the reasons for the successes and failures of scaling up HIV/AIDS interventions in different settings. The report also makes recommendations concerning the approaches needed to overcome major bottlenecks, as well as the need for sustainable financing mechanisms and greater harmonization of effort by technical and financing partners at country level. A comprehensive report and country-specific analysis of access efforts and obstacles that remain will be released at the end of 2005.
Resource | Publications,
The HIV/AIDS and STDs Prevention and Management Project (HSPMP) aimed to use intensive pilot efforts to achieve two objectives: (a) develop HIV/AIDS and STD institutional mechanisms at the national and provincial levels; and (b) develop interventions capable of reducing transmission of HIV and STDs. The total Project cost of $35.2 million was to be financed with an IBRD loan of $24.8 million and government counterpart funding for the remaining $10.4 million.
The HSPMP represented an effort to address the world-wide AIDS pandemic in Indonesia in the pre-epidemic stage of the disease. Prior to project preparation, in the early-mid 1990s, attention of policy makers in Indonesia and the Bank was gained for early intervention with commercial sex workers through epidemiological projections showing that, with no change in preventive efforts, Indonesia would have 500,000 sexually transmitted HIV infections within four years. These scenarios turned out to be quite inaccurate. Sexually transmitted HIV remains even today at a low level in Indonesia, while HIV transmission associated with drug use has grown rapidly.