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In this issue brief we first review trends in generic competition and intellectual property (IP) licensing for key antiretroviral drugs. We then outline seven momentous decisions to be made in 2015 that will largely determine whether ART will be affordable, available and robust for the next 15 years of treatment scale-up to all people living with HIV. This includes opportunities for greatly improved treatment regimens based on WHO guidelines on when to start treatment, and what first- and second line regimens should include.
Keywords: HIV/AIDS, Global Fund, medicines, treatment, ART
The present document aims to review the progress of the HIV response in the Asia-Pacific region, with a view to identifying the opportunities for further action afforded by the 2011 Political Declaration. In doing so, it also draws on the expressed commitments undertaken by ESCAP member States to address the HIV epidemic, including those reflected in resolutions 66/10, Regional call for action to achieve universal access to HIV prevention, treatment, care and support in Asia and the Pacific (19 May 2010) and 67/9, Asia-Pacific regional review of the progress achieved in realizing the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS (25 May 2011).
Keywords: IGM, 2015, HIV, prevalence, treatment, care, prevention, gender, violence, ART, children, women
Developed by Southern African AIDS Trust, with the support of WHO and UNAIDS, the summary of the the WHO’s New Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection is now available.
Among many new recommendations is that antiretroviral therapy (ART) should be initiated in everyone living with HIV at any CD4 cell count. Another is that the use of daily oral pre-exposure prophylaxis (PrEP) is recommended as a prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches.
In support of the United Nation's Millennium Developtrieht Goal Number 6 to halt or reverse the incidence of Human Immuno-deficiency Virus (HIV)/Acqnired' Immune Deficiency Virus (AIDS) by 2015, PhilHealth through Board Resolution No. 1331, series of 2009 has approved the implementation of an outpatient HIV/AIDS treatment package. This benefit aims to increase the proportion of the population having·access to effective HIV/AIDS treatment and patient education measures.
Surveillance of transmitted HIV drug resistance (TDR) in individuals recently infected with HIV was performed following WHO-suggested methods. The prevalence of transmitted HIV drug resistance (TDR) in recently infected antiretroviral drug naïve individuals in PNG has not been fully characterised.
The objective of this report is to provide an analysis of the provisions in the proposed TPPA in order to obtain a clearer understanding of their implications. It is hoped that the report will also be a useful resource for other stakeholders in the public health field.
The report analyses the key negotiating issues in the USA’s proposals (widely considered to be the basic negotiation text for the TPPA) which are likely to have an impact on access to medicines and public health.
HIV Drug Resistance emerges when HIV replicates in the presence of antiretroviral drugs. If HIV drug resistance becomes widespread, the drugs currently used to treat HIV infection may become ineffective. To date, levels of HIV Drug Resistance in countries scaling up ART remain manageable. However, resistance is slowly increasing: in East Africa, resistance rates of 10% to non-nucleoside drugs (such as nevirapine and efavirenz) have been recently described.
To maximize the long-term effectiveness of first-line ART regimens, and ensure the sustainability of ART programmes, it is essential to minimize the further spread of HIV drug resistance. Even in settings with optimal ART programme management, some degree of HIVDR is expected to emerge in populations on ART and some HIVDR is expected to be transmitted to previously uninfected individuals. Therefore, WHO recommends that HIV treatment scale-up should always be accompanied by a robust assessment of drug resistance emergence and transmission.
The action plan sets out a vision of a world in which there are no preventable deaths of newborns or stillbirths, where every pregnancy is wanted, every birth celebrated and women, babies and children survive, thrive and reach their full potential. Nearly 3 million lives could be saved each year if the actions in the plan are implemented and its goals and targets achieved. Based on evidence of what works, and developed within the framework for Every Woman Every Child, the plan enhances and supports coordinated, comprehensive planning and implementation of newborn specific actions within the context of national reproductive, maternal, newborn, child and adolescent health (RMNCAH) strategies and action plans, and in collaboration with stakeholders from the private sector, civil society, professional associations and others. The goal is to achieve equitable and high quality coverage of care for all women and newborns through links with other global and national plans, measurement and accountability.
The study was conducted with objectives to explore the barriers to access and utilization of PMCT services by pregnant key populations and describe the factors of not accessing PMTCT services. Because of non-availability of pregnant key populations other than FSWs for participation in the study, the study exploration focused only on the FSWs. An exploratory qualitative research design was applied where Round Table Discussions with Key Informants and Individual Depth Interviews (IDIs) with FSWs. During IDIs, short quantitative questions were also posed to this non-random sample to be able to quantify some of the key variables of interest.
Keywords: prevention, condom, anti-retroviral therapy (ART), unwanted pregnancy
Access to appropriate antiretroviral therapy (ART) is vital to prevent HIV morbidity and mortality, and high ART coverage also promotes HIV prevention by lowering the amount of virus circulating in people within a particular setting or population. The World Health Organization (WHO) released new treatment recommendations in June 2013 that raise the CD4 cell count threshold for ART initiation for most people (from 350 to 500 cells/mL) and expand the number of populations that should receive treatment irrespective of their immune status. These changes have substantially increased the number of people eligible for ART. At the end of 2012, almost 10 million people were receiving ART in low- and middle-income countries, or about 34% of the total eligible population under the 2013 WHO treatment guidelines (28.6 million). The access level in children was falling behind at an estimated 20% of the total paediatric population in need of ART; while 647 000 children were receiving ART as of December 2012, an additional 2.6 million children were eligible for ART under current WHO treatment guidelines, but not receiving it.