Lifting The Lid On Hiv And Aids

Treat everyone diagnosed with HIV

Treat everyone diagnosed with HIV is the sum of the World Health Organisation (WHO) new guidelines that came out on Wednesday 30 September—meaning that 37 million people worldwide should be on treatment.

Should we bother caring about these new guidelines? What mandate does the WHO have? Is Malawi obligated to endorse these guidelines? All great questions but that is an article for another day. Malawi doesn’t have to endorse and develop policy based on these guidelines but Malawi can—and may—at least critically consider them.

In reading WHO ‘treat-all’ guidelines think what the financial implications, capacity, human resource, infrastructure issues are for a country like Malawi but also think about the real possibility of eradicating HIV.

Recent clinical trials have confirmed that early drug use extends the lives of those with the Aids-causing virus and cuts the risk of disease transmission to partners. Under previous WHO guidelines, which limited treatment to those whose immune cell counts had fallen below a certain threshold, 28 million people were deemed eligible for anti-retroviral therapy (ART).

The new guidelines are an important pillar of the United Nations agency’s aim to end the Aids epidemic by 2030. According to UNAids estimates, expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million Aids-related deaths and 28 million new infections by 2030.

With its “treat-all” recommendation, WHO removes all limitations on eligibility for antiretroviral therapy (ART) among people living with HIV; all populations and age groups are now eligible for treatment.

WHO now also recommends that people at “substantial” risk of HIV—such as men who have sex with men—should be offered preventive antiretroviral treatment.

Expanding access to treatment is at the heart of a new set of targets set for 2020 with the aim to end the Aids epidemic by 2030. These targets include 90 percent of people living with HIV being aware of their HIV infection, 90 percent of those receiving antiretroviral treatment, and 90 percent of people on ART having no detectable virus in their blood.

Imagine in 15 years, we could end the Aids epidemic. n

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