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.

Multimedia

Audio
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

Mood Tense Ahead of Scotland Independence Vote

As race to persuade undecided voters continues, No voters say they believe life in Scotland will slowly improve and do not want to take a risk by endorsing independence More

South Africa’s 'Open Mosque' Admits Everyone, Including Critics

Open Mosque founder plans to welcome gay worshipers and allow women to lead prayers More

Ukrainian Activist in Despair About Future of Her Country

IrIna Dovgan, accused of being a spy and tortured by pro-Russian separatists, is appealing to UN Human Rights Council to support her country More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
NASA Picks Boeing, SpaceX to Carry Astronauts Into Spacei
X
September 17, 2014 4:20 AM
The U.S. space agency, NASA, has chosen Boeing and SpaceX companies to build the next generation of spacecraft that will carry U.S. astronauts to the International Space Station by the year 2017. The deal with private industry enables NASA to end its dependence on Russia to send space crews into low Earth orbit and back. Zlatica Hoke has more.
Video

Video NASA Picks Boeing, SpaceX to Carry Astronauts Into Space

The U.S. space agency, NASA, has chosen Boeing and SpaceX companies to build the next generation of spacecraft that will carry U.S. astronauts to the International Space Station by the year 2017. The deal with private industry enables NASA to end its dependence on Russia to send space crews into low Earth orbit and back. Zlatica Hoke has more.
Video

Video Future of Ukrainian Former President's Estate Uncertain

More than six months after Ukraine's former President Viktor Yanukovych fled revolution to Russia, authorities have yet to gain control of his palatial estate. Protesters occupy the grounds and opened it to tourists but they are also refusing to turn it over to the state. VOA's Daniel Schearf reports from Mezhigirya, just north of Kyiv.
Video

Video China Muslims Work to Change Perceptions After Knife Attacks

China says its has sentenced three men to death and one woman to life in prison for a deadly knife attack in March that left more than 30 dead and 140 injured. Beijing says Muslim militants from China's restive western region of Xinjiang carried out the attacks. Now, more than six months after the incident, residents in the city are still coping with the aftermath. VOA's Bill Ide has more from Kunming.
Video

Video Enviropreneur Seeks to Save the Environment, Empower the Community

Lorna Rutto, a former banker, is now an ‘enviropreneur’ - turning plastic waste into furniture and fences discusses the challenges she faces in Africa with raw materials and the environment.
Video

Video West Trades Accusations Over Ransoms

As world leaders try to forge a common response to the threat posed by Islamic State militants in Iraq and Syria, there is simmering tension over differing policies on paying ransoms. In the past month, the jihadist group has beheaded two Americans and one Briton. Both countries refuse to pay ransom money. As Henry Ridgwell reports for VOA from London, there is uncertainty in the approach of some other European nations.
Video

Video Scotland Independence Bid Stokes Global Interest

The people of Scotland are preparing to vote on whether to become independent and break away from the rest of Britain, in a referendum being watched carefully in many other countries. Some see it as a risky experiment; while others hope a successful vote for independence might energize their own separatist demands. Foreign immigrants to Scotland have a front row seat for the vote. VOA’s Henry Ridgwell spoke to some of them in Edinburgh.
Video

Video Washington DC Mural Artists Help Beautify City

Like many cities, Washington has a graffiti problem. Buildings and homes, especially in low-income neighborhoods, are often targets of illegal artwork. But as we hear from VOA’s Julie Taboh, officials in the nation's capital have come up with an innovative program that uses the talents of local artists to beautify the city.
Video

Video US Muslim Leaders Condemn Islamic State

Leaders of America's Muslim community are condemning the violent extremism of the Islamic State group in Iraq and Syria. The U.S. Muslim leaders say militants are exploiting their faith in a failed effort to justify violent extremism. VOA correspondent Meredith Buel reports.
Video

Video Bedouin Woman Runs Successful Business in Palestinian City

A Bedouin woman is breaking social taboos by running a successful vacation resort in the Palestinian town of Jericho. Bedouins are a sub-group of Arabs known for their semi-nomadic lifestyle. Zlatica Hoke says the resort in the West Bank's Jordan Valley is a model of success for women in the region.


Carnage and mayhem are part of daily life in northern Nigeria, the result of a terror campaign by the Islamist group Boko Haram. Fears are growing that Nigeria’s government may not know how to counter it, and may be making things worse. More

AppleAndroid