The Strategic Use of Antiretrovirals to Help End the HIV Epidemic. WHO (2012)

The strategic_use_of_ARV_to_help_end_the_HIV_epidemic

This document is a discussion paper, prepared for the 2012 InternationalAIDS Conference in Washington DC, United States of America. It highlights key issues that confront the global community, policy-makers and national programme planners as they seek to make optimal use of antiretroviral drugs (ARVs) as part of the broader response to HIV. It also discusses how ARVs could contribute to eventually ending the HIV epidemic. The paper does not in itself constitute a World Health Organization (WHO) guidance document, even though it summarizes existing WHO guidelines related to ARV use, highlights progress in the Treatment 2.0 initiative, and summarizes the next steps in WHO’s normative work related to ARV use.


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Programmatic Update: Antiretroviral Treatment as Prevention (TASP) of HIV and TB. WHO (2012)

TASP of_HIV_and_TB

In 2010, an estimated 34 million people were living with the human immunodeficiency virus (HIV), around 70% of them in sub-Saharan Africa. By the end of 2010, 6.6 million people, or 47% of those in need (CD4+ cell count <350 cells/mm3), were on antiretroviral therapy (ART), and an estimated 7.5 million people were still in need of treatment. While considerable progress has been made in extending ART coverage, there continue to be critical gaps. In the same year, coverage for children was reported to be less than 23%, there were 2.7 million new infections and more than 20 million people were not yet treatment-eligible (as most of them did not know their HIV status). There were an estimated 1.1 million new cases of HIV-associated tuberculosis (TB), which led to 24% of HIV-related deaths. HIV is the strongest risk factor for developing TB, and people living with HIV have a 20–37 times higher risk of developing TB than those who do not. ART has a significant secondary prevention benefit for both HIV and TB, and expanded access to ART has probably averted millions of HIV infections and cases of TB.

 

 

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Untangling the Web of Antiretroviral Price Reductions - 15th Edition July 2012. Medecins Sans Frontieres. (2012)

ART price_reductions_15th_2012-1

Now is a critical time to ensure widest possible access to ART: a landmark scientific breakthrough in 2011 showed that treatment with antiretroviral medicines (ARVs) not only saves lives, but can also stop HIV from being transmitted by up to 96%.4 In response to this evidence, in 2012 the World Health Organization (WHO) issued guidance supporting immediate treatment – regardless of a person’s immune system’s status or CD4 count – for HIV-positive people who have HIV-negative partners, in order to help prevent transmission of the virus.5 At the same time, guidance was also issued suggesting the possibility of offering full antiretroviral therapy for life to all pregnant women living with HIV for prevention of mother-to-child transmission of the virus (PMTCT).

 

 

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Issue Brief: The Potential Impact of Free Trade Agreements on Public Health. UNDP and UNAIDS (2012)

Potential impact_of_FTA_on_public_health

Over the past ten years, an increasing number of countries are initiating, negotiating and agreeing new trade agreements between two countries or amongst a group of countries. These are commonly known as free trade agreements or “FTAs”1, and they are promoted as providing significant economic benefits to signatory countries through the removal or reduction of barriers to trade in goods and services.


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Discussion Paper - Anti-counterfeit Laws and Public Health: What to Look Out for. UNDP (2012)

Anti-counterfeit Laws_and_Public_Health

The purpose of the Discussion Paper is to facilitate the UNDP consultation on enforcement of intellectual property rights, in particular anti-counterfeit measures and access to HIV treatment and other essential medicines in sub-Saharan Africa. The Discussion Paper summarizes the developments in intellectual property rights enforcement in the world and in the region. It elaborates on the public health impact of anti-counterfeit laws and discusses whether they are an adequate solution to the legitimate concerns about the quality, safety and efficacy of medicines.


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Programmatic Update: Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants. WHO (2012)

Use of_ARV__for_Pregnant_Women

Recent developments suggest that substantial clinical and programmatic advantages can come from adopting a single, universal regimen both to treat HIV-infected pregnant women and to prevent mother-to-child transmission of HIV. This streamlining should maximize PMTCT programme performance through better alignment and linkages with antiretroviral therapy (ART) programmes at every level of service delivery. One of WHO’s two currently recommended PMTCT antiretroviral (ARV) programme options, Option B, takes this unified approach.

 

 

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When and How to Use Assays for Recent Infection to Estimate HIV Incidence at a Population Level. WHO and UNAIDS (2011)

who when how

The document reviews the public health importance of estimating the HIV incidence in populations, and the various methods that have been used for this purpose. It provides guidance on the way in which laboratory tests for recent HIV infection may be used to estimate HIV incidence in populations, particularly with regard to sampling designs, sample size and the statistical analyses that should be employed.


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Forecasting the Population-Level Impact of Reductions in HIV Antiretroviral Therapy in Papua New Guinea. Gray RT, Zhang L, Lupiwa T, et al (2011)

Forecasting the Population-Level Impact of Reductions in HIV Antiretroviral Therapy in Papua New Guinea. Gray RT, Zhang L, Lupiwa T, et al (2011) Papua New Guinea (PNG) recently did not secure external funding for the continuation of its antiretroviral treatment (ART) programs meaning that supplies of HIV drugs for the estimated 38,000 people living with HIV in PNG could be completely depleted during 2010. Using a mathematical model of HIV transmission calibrated to available HIV epidemiology data from PNG, we evaluated the expected population-level impact of reductions in ART availability.

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Regional Issues Brief: Intellectual Property Rights and Access to Medicines. Global Commission on HIV and the Law UNDP, HIV/AIDS Practice (2011)

Intellectual property_right

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 Pacifi c. It serves as an information resource and complements the report of the Regional Dialogue for Asia and the Pacifi c that was held under the auspices of the Global Commission on HIV and the Law in Bangkok on 16 and 17 February 2011.


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Untangling the Web of Antiretroviral Price Reductions - 14th Edition July 2011. Medecins Sans Frontieres. (2011)

ART price_reductions_14th_2011-1

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.

 

 

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