News / Africa

    WHO: Better HIV Antiretroviral Strategies Needed

    Gilead Science's Truvada combination antiretroviral pill that's taken once daily.Gilead Science's Truvada combination antiretroviral pill that's taken once daily.
    x
    Gilead Science's Truvada combination antiretroviral pill that's taken once daily.
    Gilead Science's Truvada combination antiretroviral pill that's taken once daily.
    Joe DeCapua
    The World Health Organization says comprehensive HIV treatment strategies are needed in developing countries to overcome stigma and discrimination. It says there are a number of vulnerable groups unable to get full access to antiretroviral drugs.

    Recent studies have shown that antiretroviral drugs not only extend the lives of people infected with HIV, but can also prevent infection in the first place. It’s a strategy known as “treatment as prevention.” It now means countries have the potential to greatly slow the spread of HIV by using the drugs as a prophylaxis. However, often those in need of HIV treatment and prevention are unable to receive them because of their social status.

    “We’ve seen in many countries that there remains stigma against certain population groups. And in some countries these behaviors of these groups are criminalized. Being a sexworker in many African countries is criminal behavior. Being an MSN in some countries is criminalized and obviously injection drug use is,” said Dr. Gottfried Hirnschall, director of the WHO’s HIV/AIDS Department.

    MSM is an acronym for men who have sex with men, one of the WHO’s and UNAIDS’ official groups of vulnerable people.



    “We see barriers for these individuals to access services. And we obviously see that as a consequence in many places these groups have higher infection rates. They have higher mortality, etcetera,” he said.

    Another part of a comprehensive strategy includes the question of when to start treatment. In the early days of antiretrovirals, the drugs were usually given to people when their immune systems had collapsed and were being attacked by opportunistic infections. The state of health is measured by the CD4 count. That is the number of particular immune cells a person has.

    Hirnschall says, in recent years, the recommendation has been to start people on treatment much earlier.

    “If you start as soon as possible – and that’s what’s happening now in the U.S. with the policy change that just took place – you may have a benefit to the patient. WHO now recommends initiation of treatment below a CD4 cell count of 350, which means that the immune system has already some signs of weakening, but that the patient is still not very sick yet,” he said.

    By providing earlier treatment, many opportunistic infections could be avoided.

    Two recent studies have proven the treatment as prevention strategy. One looked at discordant couples, where one person is HIV positive and the other is not. The drugs were 96 percent effective in preventing the HIV negative person from being infected.

    Another study indicated the effectiveness of PrEP or preexposure prophylaxis.

    “Even if you give drugs prior to exposure – in other words to HIV negative persons – referred to as preexposure prophylaxis – you may also protect this person from becoming infected. So the whole field of the use of antiretrovirals has become more and more exciting, but at the same time more complex,” said Hirnschall.”

    The WHO official says it would cost more in the short-term to get more people on antiretrovirals sooner, probably billions more. However, he says in the long-term, the cost will drop and lives will be saved.

    “You will have quite impressive reductions of both mortality and new infections. So we estimate over a period until 2020 more than 12 million new infections could be averted and 7.4 million deaths could be also averted. So in other words, yes, you need to invest. You need to front-load the resources, but you’re buying something for it,” he said.

    Dr. Hirnschall says the World Health Organization is developing what are called consolidated guidelines. The aim is to help developing countries form care and treatment strategies for vulnerable groups.

    You May Like

    Former US Envoys Urge Obama to Delay Troop Cuts in Afghanistan

    Keeping troop levels up during conflict with both Taliban and Islamic State is necessary to support Kabul government, they say

    First Lady to Visit Africa to Promote Girls' Education

    Michele Obama will be joined by daughters and actresses Meryl Streep and Freida Pinto

    Video NYSE Analyst: Brexit Will Continue to Place Pressure on Markets

    Despite orderly pricing and execution strategy at the New York Stock Exchange, analyst explains added pressure on world financial markets is likely

    By the Numbers

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Brexit Vote Plunges Global Markets Into Uncharted Territoryi
    X
    June 24, 2016 9:38 PM
    British voters plunged global markets into unknown territory after they voted Thursday to leave the European Union. The results of the Brexit vote, the term coined to describe the referendum, caught many off guard. Analysts say the resulting volatility could last for weeks, perhaps longer. Mil Arcega reports.
    Video

    Video Brexit Vote Plunges Global Markets Into Uncharted Territory

    British voters plunged global markets into unknown territory after they voted Thursday to leave the European Union. The results of the Brexit vote, the term coined to describe the referendum, caught many off guard. Analysts say the resulting volatility could last for weeks, perhaps longer. Mil Arcega reports.
    Video

    Video Orlando Shooting Changes Debate on Gun Control

    It’s been nearly two weeks since the largest mass shooting ever in the United States. Despite public calls for tighter gun control laws, Congress is at an impasse. Democratic lawmakers resorted to a 1960s civil rights tactic to portray their frustration. VOA’s Carolyn Presutti explains how the Orlando, Florida shooting is changing the debate.
    Video

    Video Tunisian Fishing Town Searches for Jobs, Local Development Solutions

    As the European Union tries to come to grips with its migrant crisis, some newcomers are leaving voluntarily. But those returning to their home countries face an uncertain future.  Five years after Tunisia's revolution, the tiny North African country is struggling with unrest, soaring unemployment and plummeting growth. From the southern Tunisian fishing town of Zarzis, Lisa Bryant takes a look for VOA at a search for local solutions.
    Video

    Video 'American Troops' in Russia Despite Tensions

    Historic battle re-enactment is a niche hobby with a fair number of adherents in Russia where past military victories are played-up by the Kremlin as a show of national strength. But, one group of World War II re-enactors in Moscow has the rare distinction of choosing to play western ally troops. VOA's Daniel Schearf explains.
    Video

    Video Experts: Very Few Killed in US Gun Violence Are Victims of Mass Shootings

    The deadly shooting at a Florida nightclub has reignited the debate in the U.S. over gun control. Although Congress doesn't provide government health agencies funds to study gun violence, public health experts say private research has helped them learn some things about the issue. VOA's Carol Pearson reports.
    Video

    Video Trump Unleashes Broadside Against Clinton to Try to Ease GOP Doubts

    Recent public opinion polls show Republican Donald Trump slipping behind Democrat Hillary Clinton in the presidential election matchup for November. Trump trails her both in fundraising and campaign organization, but he's intensifying his attacks on the former secretary of state. VOA National Correspondent Jim Malone reports.
    Video

    Video Muslim American Mayor Calls for Tolerance

    Syrian-born Mohamed Khairullah describes himself as "an American mayor who happens to be Muslim." As the three-term mayor of Prospect Park, New Jersey, he believes his town of 6,000 is an example of how ethnicity and religious beliefs should not determine a community's leadership. Ramon Taylor has this report from Prospect Park.
    Video

    Video Internal Rifts Over Syria Policy Could Be Headache for Next US President

    With the Obama administration showing little outward enthusiasm for adopting a more robust Syria policy, there is a strong likelihood that the internal discontent expressed by State Department employees will roll over to the next administration. VOA State Department correspondent Pam Dockins reports.
    Video

    Video Senegal to Park Colorful ‘Cars Rapide’ Permanently

    Brightly painted cars rapide are a hallmark of Dakar, offering residents a cheap way to get around the capital city since 1976. But the privately owned minibuses are scheduled to be parked for good in late 2018, as Ricci Shryock reports for VOA.
    Video

    Video Florida Gets $1 Million in Emergency Government Funding for Orlando

    The U.S. government has granted $1 million in emergency funding to the state of Florida to cover the costs linked to the June 12 massacre in Orlando. U.S. Attorney General Loretta Lynch announced the grant Tuesday in Orlando, where she met with survivors of the shooting attack that killed 49 people. Zlatica Hoke reports.
    Video

    Video How to Print Impossible Shapes with Metal

    3-D printing with metals is rapidly becoming more advanced. As printers become more affordable, the industry is partnering with universities to refine processes for manufacturing previously impossible things. A new 3-D printing lab aims to bring the new technology closer to everyday use. VOA's George Putic reports.
    Video

    Video Big Somali Community in Minnesota Observes Muslim Religious Feast

    Ramadan is widely observed in the north central US state of Minnesota, which a large Muslim community calls home. VOA Somali service reporter Mohmud Masadde files this report from Minneapolis, the state's biggest city.

    Special Report

    Adrift The Invisible African Diaspora