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While scaling up access to all treatment and prevention options that currently exist is essential, it is not sufficient. There remains a critical need for additional options. In addition to the introduction of oral-TDF based PrEP and the open-lable extension studies of the vaginal dapivirine ring, there are a number of efficacy trials planned or underway. They're tackling virtually every intervention—from next-generation PrEP in the form of F/TAF, a drug that will soon be tested for efficacy as daily oral PrEP, to long-acting injectables, vaccines and antibody-mediated prevention.
In 2013, viral hepatitis was a leading cause of death worldwide (1.46 million deaths, a toll higher than that from HIV, tuberculosis or malaria, and on the increase since 1990). More than 90% of this burden is due to the sequelae of infections with the hepatitis B virus (HBV) and hepatitis C virus (HCV).
Prevention can reduce the rate of new infections, but the number of those already infected would remain high for a generation. In the absence of additional efforts, 19 million hepatitis-related deaths are anticipated from 2015 to 2030. Treatment now can prevent deaths in the short- and medium term.
With increasing global use of antiretroviral therapy (ART) to both treat and prevent HIV, and increasing global trends in HIV drug resistance ( HIVDR), efforts to improve HIV programme quality and prevent the emergence and transmission of drug-resistant HIV must be strengthened.
This global report is based on 59 countries that reported data from more than 12 000 clinics from cohorts of patients receiving ART between 2004 and 2014. The report includes the most recent clinic-level data reported to WHO in 2015 –2016 and reflects a lag due to the 12 month cohort reporting period.
Given the higher rates of acquisition seen across so-called key populations—members of highly burdened and underserved groups—it is critical to provide access to the research process such that they can participate and reap more immediate benefit of scientific progress. Greater efforts must be made to include key populations in this crucial process for the HIV prevention response to be truly impactful.
Excerpted from Px Wire.
ART is being rapidly scaled up in Myanmar, led by National AIDS Programme (NAP) and supported by many partners.
Keywords: HIV, ART, PLHIV, NGO, services
The publication presents cascade of HIV testing, care and treatment services, 2014–2015 for Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor Leste.
There has been a rapid increase in the number of people living with HIV in Myanmar over the last decade, the majority of who are eligible for treatment. Alongside this increase has been an effort by the ministry of health to rapidly scale up provision of treatment in order to reduce HIV-related illnesses and deaths.
However, Myanmar has an ambitious national strategic goal of providing ART to 106,058 people by the end of 2016. The health system in Myanmar is already stretched, and to achieve this goal, innovation in ART delivery will be required in-order to ensure that ART is provided close to communities, without compromising quality.
The report finds that prices of older HIV drugs continue to decline, while newer drugs remain largely priced out of reach. This is in large part because pharmaceutical corporations maintain monopolies that block price-lowering generic competition.
Today, the lowest available price for a quality-assured, World Health Organization-recommended first-line one-pill-a-day combination is US$100 per person per year (tenofovir/emtricitabine/efavirenz). This is a decrease of 26 per cent since MSF last recorded the lowest price for first-line treatment at US$136 in 2014. For a WHO-recommended second-line regimen, the lowest available price is now US$286 per person per year (zidovudine/lamivudine + atazanavir/ritonavir) – an 11 per cent decrease from US$322 two years ago.
Greatly expanded access to routine viral load testing will be a game-changer in the global response to AIDS. Routine viral load tests improve treatment quality and individual health outcomes for people living with HIV, contribute to prevention, and potentially reduce resource needs for costly second- and third-line HIV medicines.
2015 confirmed a significant recent trend in the flagship WHO Model List of Essential Medicines with groundbreaking new treatments for hepatitis C and a variety of cancers included in the list despite their high prices. The list also included five new medicines for multidrug resistant tuberculosis (TB), among other updates. Traditionally considered a tool for developing countries to use as a guide for national medicines selection, the WHO Essential Medicines List is increasingly seen as a tool to increase access globally.