With a long term objective to curb 21 million deaths and 28 million new HIV infections, the World Health Organisation (WHO) has strongly recommended to take the antiretroviral treatment route. It says that anyone infected with HIV should begin antiretroviral treatment as soon after diagnosis as possible.
This “treat all” new HIV philosophy of the WHO makes everyone living with the disease including, all populations and age groups, eligible for the treatment. More significantly, this expanded use of antiretroviral treatment is evident of the recent findings from clinical trials. Such trials have confirmed that early use of ART keeps people living with HIV alive, healthier and reduces the risk of transmitting the virus to partners
WHO has made the objective of expanding the treatment target base by 2020-from 28 million people to a massive 37 million people who are living with HIV globally. The broader aim is to pave the way to deal with the epidemic i.e. AIDS and end it by 2030. WHO is hopeful of reaching out to million sof targets spread across the world; statistically put in perspective as 90% of people living with HIV being aware of their HIV infection, 90% of those receiving antiretroviral treatment, and 90% of people on ART having no detectable virus in their blood.
WHO now also recommends that people at “substantial” risk of HIV should be offered preventive antiretroviral treatment. This new recommendation builds on 2014 WHO guidance to offer a combination of antiretroviral drugs to prevent HIV acquisition, pre-exposure prophylaxis (PrEP), for men who have sex with men. Following further evidence of the effectiveness and acceptability of PrEP, WHO has now broadened this recommendation to support the offer of PrEP to other population groups at significant HIV risk. PrEP should be seen as an additional prevention choice based on a comprehensive package of services, including HIV testing, counselling and support, and access to condoms and safe injection equipment.
New recommendations on early use of ART and expanded offer of PrEP are contained in WHO’s “Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV.” The new guideline stresses that, in order to effectively implement the recommendations, countries will need to ensure that testing and treatment for HIV infection are readily available and that those undergoing treatment are supported to adhere to recommended regimens and are retained in care.
The recommendations were developed as part of a comprehensive update of the “WHO consolidated guidelines on the use of antiretroviral drugs for preventing and treating HIV infection”. This early release guideline is shared ahead of the full publication, slated for release later this year, because of their potential for public health impact.
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.