Call for urgent scale up of access to treatment

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Call for urgent scale up of access to treatment

23 April 2013

L to R: UNAIDS Executive Director, Michel Sidibé, United States Global AIDS Coordinator, Ambassador Eric Goosby and chair of the International HIV Treatment as Prevention Workshop, Julio Montaner. Credit: British Columbia Centre for Excellence in HIV/AIDS.

Vancouver, 1996: Researchers electrify the International AIDS Conference with news of a stunning scientific breakthrough. Using a combination of medicines, they have been able to reduce the amount of virus in the blood of people living with HIV to virtually undetectable levels. In what became known as the “Lazarus Effect,” people once near death were suddenly well again and able to live normal, healthy lives.

This discovery transformed the course of the AIDS response forever and more than 8 million people around the world today have access to the lifesaving treatment.

This week, HIV experts are once again gathering in Vancouver. This time to discuss another important scientific breakthrough—recent research showing that HIV treatment not only protects the health of people living with HIV, it also dramatically reduces the likelihood of transmitting the virus to others.

On the opening day of the conference the Executive Director of UNAIDS Michel Sidibé, together with the United States Global AIDS Coordinator Eric Goosby, led roundtable discussions on the theme ‘What will it take to end AIDS?’

“If we have the evidence that antiretroviral therapy can help someone living with HIV to stay alive and protect their sexual partners from infection by up to 96%, then we have a moral obligation to make it available,” said Mr Sidibé. “Providing HIV treatment as soon as possible is ethically and morally correct, economically and programmatically feasible and consistent with what we have learnt about clinical best practice over the last decade.”

If we have the evidence that antiretroviral therapy can help someone living with HIV to stay alive and protect their sexual partners from infection by up to 96%, then we have a moral obligation to make it available.

UNAIDS Executive Director Michel Sidibé

Mr Sidibé was referring to results announced in May 2011 by the United States National Institutes of Health which showed that if an HIV-positive person adheres to an effective antiretroviral therapy regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%.

The Prime Minister of St Kitts and Nevis Denzil Douglas made a bold statement on the potential impact of combination HIV prevention. He said, “Using treatment as prevention in combination with other prevention interventions can end AIDS in the Caribbean countries.”

Malawi, a country which has been severely affected by HIV, radically scaled up its response to HIV in recent years resulting in a 73% drop in the rate of new HIV infections since 2001. Talking about the impact of antiretroviral therapy on her country’s epidemic, the Minister of Health of Malawi, Catherine Hara said, “In part due to the rapid treatment expansion, HIV infections in Malawi have decreased to 46,000 per year and annual deaths are going down and are now less than 50,000 per year whereas before the number of deaths was nearly 100,000.” She also added “My country pioneered Option B+* in antenatal care services for women and the number of pregnant women living with HIV that are accessing treatment increased by over 700%.”

The Prime Minister of St Kitts and Nevis Denzil Douglas speaking at the Vancouver conference. Credit: British Columbia Centre for Excellence in HIV/AIDS.

Emphasizing the need to start treatment early Marvelous Muchenje, of Women’s Health in Women’s Hands said, “Many people associate starting treatment with illness or even death—we need to change that conception as starting treatment earlier prevents illness, death and HIV transmission.”

Wrapping up the session, chair of the International HIV Treatment as Prevention Workshop, Julio Montaner, stressed the need to turn evidence into action. "We know enough about the science for treatment as prevention. It is now time to act."

The Workshop will continue until Thursday 25 April as researchers, implementers and policy makers involved in treatment as prevention continue to share data, protocols and findings, and foster an open collaborative environment regarding research into treatment as prevention. They will be looking to identify areas of potential synergy and possible gaps, where further targeted research efforts may be needed.

*Option B+ is an option that gives women living with HIV the possibility of starting lifelong antiretroviral therapy immediately for their own health as well as to protect their children.