Treatment 2.0: Translating concept into practice to overcome the HIV epidemic
24 March 2011
How to translate the concept of Treatment 2.0 into practice was the topic of discussion at a seminar co-organized by UNAIDS and the World Health Organization (WHO) on 18 March at UNAIDS Headquarters in Geneva. Staff members from both organizations participated in the event together with colleagues from the Global Fund, the International AIDS Society and UNITAID.
“We need to find innovative solutions to overcome the HIV epidemic,” said Dr Bernhard Schwartländer, UNAIDS Director of Evidence, Strategy and Results Department and the seminar’s organizer. “Innovation to improve treatment regimens but also innovation in the way we approach the AIDS response.”
Treatment 2.0 is a concept launched in November 2010 by UNAIDS and WHO that calls for a radically simplified treatment platform. Its viability and implementation at country level will determine the level of success in the response to HIV in the coming years.
Craig McClure, Senior Adviser on Treatment 2.0 at WHO and Mariangela Simao, UNAIDS Chief, Prevention, Vulnerability and Rights, jointly presented on “Catalyzing the Next Phase of Treatment”. They outlined the five pillars on which the Treatment 2.0 initiative is based: optimizing drug regimens, simplifying laboratory platforms for diagnosis and monitoring; reducing costs; adapting delivery systems and mobilizing communities.
We need to find innovative solutions to overcome the HIV epidemic. Innovation to improve treatment regimes but also innovation in the way we approach the AIDS response
Bernhard Schwartländer, UNAIDS Director of Evidence, Strategy and Results Department
Mr McClure recognized that, while some of the innovations in drugs and diagnostics are years away, there are many actions that countries can take now to simplify treatment and make it more efficient,. For example, choosing to purchase one-pill-per-day fixed dose drug combinations, legal reform to use TRIPS flexibilities to reduce costs, integrating HIV treatment with prevention services and other areas of health care where appropriate and involving communities more intensively in designing and delivering HIV services.
On this topic, David Barr from the International Treatment Preparedness Coalition gave specific examples that show how involving communities in managing treatment programmes can improve treatment access and adherence. Community approaches shall also reduce the burden faced by health systems in trying to absorb the number of people newly put on treatment.
Another advantage of scaling up community-based service delivery is that communities can better reach and engage key affected populations. “Community-based approaches have demonstrated to improve the ability of populations at higher risk of HIV to access HIV services and to benefit from antiretroviral therapy and prevent new infections,” said Mr Barr.
Providing a perspective from Latin America, Dr Massimo Ghidinelli, Regional HIV Adviser at the Pan American Health Organization (PAHO) discussed some of the critical issues faced in that region. The need to optimize drug regimens, diagnosis and monitoring tools as well as lowering costs and improving treatment delivery systems were identified as major challenges.
According to UNAIDS, the new treatment approach could also reduce new HIV infections by up to one million annually if countries provide antiretroviral therapy to all people in need. “We cannot treat ourselves out of this epidemic,” said Dr Schwartländer. “But reaching all eligible with effective therapies will not only safe millions of lives, but significantly reduce the number of new infections through lowering the viral load in people living with HIV.”