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

Obama: I Will Do 'Everything I Can' to Close Guantanamo

US president says prison continues 'to inspire jihadists and extremists around the world' More

Sierra Leone Educates on Safe Ebola Burials

Also, country is improving at rapid response to isolated outbreaks, but health workers need to be even faster, officials say More

Religion Aside, Christmas Gains Popularity in Communist Vietnam

Increasingly wealthy Vietnamese embrace holiday due to its non-religious glamor, commercial appeal More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
US Decision on Cuba Underscores Divisions Among Miami Cubansi
X
Sharon Behn
December 19, 2014 9:34 PM
For decades, older, more conservative Cubans have been gathering at Café Versailles on the corner of Calle Ocho to eat Cuban food and talk politics. After hearing of President Barack Obama’s decision, a number of them gathered in front of the café with posters to protest. VOA's Sharon Behn reports on the situation.
Video

Video US Decision on Cuba Underscores Divisions Among Miami Cubans

For decades, older, more conservative Cubans have been gathering at Café Versailles on the corner of Calle Ocho to eat Cuban food and talk politics. After hearing of President Barack Obama’s decision, a number of them gathered in front of the café with posters to protest. VOA's Sharon Behn reports on the situation.
Video

Video Three Cities Bid for Future Obama Presidential Library

President Barack Obama still has two years left in his term in office, but the effort to establish his post-presidential library is already underway. The bid for the Obama Presidential Library is down to four locations in three states -- New York, Hawaii, and Illinois. As VOA’s Kane Farabaugh reports, each of them played an important part in the president’s life before he reached the White House.
Video

Video Cuba Deal is Major Victory for Pope’s Diplomatic Initiatives

Pope Francis played a key role in brokering the US-Cuba deal that was made public earlier this week. It is the most stunning success so far in a series of peacemaking efforts by the pontiff. VOA religion reporter Jerome Socolovsky has more.
Video

Video Fears of More Political Gridlock in 2015

2014 proved to be a difficult year politically for President Barack Obama and a very good year for the U.S. Republican Party. Republican gains in the November midterm elections gave them control of the Senate and House of Representatives for the next two years -- setting the stage for more confrontation and gridlock in the final two years of the Obama presidency. VOA National Correspondent Jim Malone has a preview from Washington.
Video

Video Sudan School Becomes Target of Aerial Attacks

The school dropout rate is at an all-time high in Sudan's South Kordofan state because many schools have been destroyed during the three-year civil war between the government and SPLA-N rebel forces. Adam Bailes visited Sudan's Nuba Mountains' region and reports many children are simply too scared to go to school
Video

Video VOA Reporter Tours Devastated Peshawar School

Islamist militants wearing military uniforms and strapped with explosives attacked a military run school Tuesday in the northwestern Pakistani city of Peshawar. At least 141 people were killed in the horrific attack, most of them young students. VOA reporter Ayaz Gul visited the devastated school and attended the funeral of the principal who courageously tried to save her students from the deadly attack.
Video

Video Nigerians Fleeing Boko Haram Languish in Camp Near Capital

In its five-year effort to impose Islamic law in northeastern Nigeria, the Boko Haram extremist group has killed thousands of people and forced hundreds of thousands to flee. Some of those who ran for their lives now live in squalor on the edges of the capital, Abuja. Chris Stein reports for VOA.
Video

Video Aceh Rebuilt Decade After Tsunami, But Scars Remain

On December 26, 2004 there was an earthquake in the Indian Ocean so powerful it caused the Earth’s axis to wobble a few centimeters. Onshore on the island of Sumatra, the resulting tsunami was devastating. A decade later, VOA Correspondent Steve Herman reports from Banda Aceh, Indonesia, where although there is little remaining evidence of the physical devastation, the psychological scars among survivors remain.

All About America

AppleAndroid