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Conference
"Determinants of Treatment Success" Dr. Robert Hogg (biography) English - 2003-03-29 - 38 minutes
Summary : Recent epidemiological data point to certain parts of the world where HIV prevalence is increasing beyond the 10-15% rate. Sub-Saharan Africa is one such region. India and the Caribbean are also seeing high infection rates, and sadly, injection drug use seems to be driving the jump in new cases in Eastern European countries. Thailand is one of the few countries that seems to have controlled of the spread of AIDS throughout its population, and this in turn seems to be attributed to the direct involvement of the government in the early assessment of the epidemic and subsequent carrying out of extensive prevention activities. The goal of antiretroviral therapy in the absence of a cure remains to achieve long-term remission, and the decision of when to begin antiretroviral therapy is now based on the CD4 count. There are currently less than one million people on antiretroviral therapy, these being mostly in North America, Europe and Oceania. Access to care is notably poor in sub-Saharan Africa, where less than 10, 000 people are on antiretroviral therapy, and the HIV/AIDS death rate is over two million per year. Brazil provides a good example of how the estimated number of new HIV infections can be drastically reduced by increasing the number of patients on antiretroviral therapy. Additional benefits of the Brazilian access policy have been significantly reduced mortality and morbidity rates, reduced hospitalization and cost savings. Finally, AIDS is not only a global epidemic of an infectious disease, but a human security issue, affecting the fundamental conditions that are needed for people to live safe, secure, healthy and productive lives.
Learning objectives : The participant will review the epidemiological data indicating countries with a high prevalence of HIV, and be able to compare the high prevalence region of sub-Saharan Africa directly with countries which have gained a measure of control over the epidemic, such as Thailand and Brazil, where government involvement and better access policies have taken effect.
Bibliographic references : Access to antiretroviral treatment in Latin American countries and the Caribbean.
OBJECTIVES: To assess the access to antiretroviral therapy in the Latin America and Caribbean region and the main issues involved. METHODS: A review of National AIDS Programmes reports, published studies on HIV access to antiretroviral drugs, and personal communications from National AIDS Programmes in the region. RESULTS: Most countries have, or are in the process of developing, laws and regulations to ensure better access to antiretroviral drugs for people in need. However, there are still many countries that either have not implemented policies or do not have policies. There has been an important decrease in the cost of drugs, but prices are still too high for all countries to afford them. The benefits in decreased mortality and hospitalizations in the countries with high coverage are significant. The number of people receiving antiretroviral therapy has been estimated to be close to 170,000 individuals; however, this figure only represents a fraction of the people in need in the region. Some different strategies will have to be implemented in order to increase coverage. CONCLUSION: Renewed efforts are needed from both governments and international community organizations to strengthen the health services and increase access to antiretroviral drugs.
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