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Table of Contents   
LETTER TO THE EDITOR  
Year : 2016  |  Volume : 9  |  Issue : 4  |  Page : 288-289
Responding to the World Health Organization call for ensuring accessibility to antiretroviral therapy for all


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

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Date of Web Publication28-Jun-2016
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Responding to the World Health Organization call for ensuring accessibility to antiretroviral therapy for all. Ann Trop Med Public Health 2016;9:288-9

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Responding to the World Health Organization call for ensuring accessibility to antiretroviral therapy for all. Ann Trop Med Public Health [serial online] 2016 [cited 2019 Oct 18];9:288-9. Available from: http://www.atmph.org/text.asp?2016/9/4/288/184794
Dear Sir,

The human immunodeficiency virus (HIV) infection has been acknowledged as one of the leading global public health concerns accounting for the deaths of 1.2 million people and newer infection among 2 million people worldwide in the year 2014.[1] Even though, no vaccine exists for the disease till date, the antiretroviral therapy (ART) is a crucial tool to reduce the sufferings of people and enhance the quality of life.[2] In fact, the recent global estimates suggest that out of the 37 million people living with HIV/acquired immune deficiency syndrome (AIDS) (PLHA), only 16 million are receiving ART while the remaining 56.7% has no access to it.[1],[2]

It is really commendable that the world has achieved the Millennium Development Goal of reversing the HIV prior to the deadline; nevertheless it has motivated the world leaders and program managers to end the AIDS epidemic by 2030.[2] In fact, the member states of the United Nation in their recently adopted Sustainable Development Goals, have pledged to accomplish the mid-term goal (viz., 90% PLHA are aware about their infection, 90% of them are on ART, and 90% of the people on ART have no detectable virus in their blood) by 2020.[1]

Owing to the results of a trial it is revealed that the initiation of ART immediately on confirmation of the infection, will enable people to stay healthy and reduce the risk of transmission to their partners, the World Health Organization took an historical decision to administer ART to all people living with HIV irrespective of their CD4 count.[3] Even though these global recommendations have been made, the primary challenge for the international stakeholders is to ensure that ART is made accessible to all, so that not only AIDS associated deaths of more than 20 million but also incidence of newer infection among 28 million people is prevented by the end of 2030.[1],[3],[4] Further, it is very important to ensure that people who are started on ART should not discontinue their therapy in between due to any reasons.[5]

A wide range of measures such as sustaining national ownership, encouraging the practice of community or self-testing to increase the number of people who are aware of their HIV status, initiating therapy promptly by bringing ART to the community, increasing the time span between subsequent health center visits for people tolerating ART well, and improving access to viral load testing centers, have been proposed to ensure that nations successfully implement the “treat all” recommendation.[1],[2] At the same time, measures to reduce the incidence of HIV infection, such as undergoing voluntary medical circumcision, initiating prophylactic ART to all people with substantial risk of acquiring HIV infection, practicing behavior-change communication, encouraging for the correct and consistent use of male and female condoms, and prevention of mother-to-child transmission of HIV can also play a significant role.[1],[2],[3]

To conclude, if the stakeholders really wish to end the AIDS epidemic within a generation, they have to focus their attention and efforts toward the missing half of the people living with HIV, who are devoid of HIV testing and ART services.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization. HIV/AIDS - Fact sheet No. 360. 2015. Available from: http://www.who.int/mediacentre/factsheets/fs360/en/. [Last accessed on 2015 Dec 25].  Back to cited text no. 1
    
2.
World Health Organization. Accelerate Expansion of Antiretroviral Therapy to all People Living with HIV. WHO; 2015. Available from: http://who.int/mediacentre/news/statements/2015/antiretroviral-therapy-hiv/en/. [Last accessed on 2015 Dec 1].  Back to cited text no. 2
    
3.
World Health Organization. Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV. Geneva: WHO Press; 2015. p. 1-3.  Back to cited text no. 3
    
4.
Sardashti S, Samaei M, Firouzeh MM, Mirshahvalad SA, Pahlaviani FG, Seyed Alinaghi S. Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa. World J Virol 2015;4:134-41.  Back to cited text no. 4
    
5.
Shankar D, Kumar AM, Rewari B, Kumar S, Shastri S, Satyanarayana S, et al. Retention in pre-antiretroviral treatment care in a district of Karnataka, India: How well are we doing? Public Health Action 2014;4:210-5.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.184794

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