World Health Organization report focuses on AIDS
Delivery of treatments for AIDS and the implementation of disease prevention initiatives will help strengthen health systems in the world's poorest countries, providing long-term health benefits for everyone, according to a new report from the World Health Organization.
Published earlier this week, “The world health report 2004 — changing
history” calls for a comprehensive HIV/AIDS strategy that links
prevention, treatment, care and long-term support. WHO suggests that,
until now, treatment has been the most neglected element of HIV/AIDS
strategies in developing countries. “Yet among all possible HIV-related
interventions, it is treatment that can most effectively drive health
systems strengthening, enabling poor countries to protect their people
from a wide range of health threats,” the report states. It adds
that availability of antiretroviral treatment can enhance prevention
by increasing demand for counselling and testing services, by providing
an opportunity for patients to receive information about HIV-prevention
and by lowering the risk of transmission.
Treatment expansion was first outlined in the WHO “three by five” initiative,
which aims to see three million people in developing countries provided
with antiretroviral therapy by the end of 2005. The new report suggests
how this can be done and highlights the treatment regimens and guidelines
developed by WHO to accelerate the treatment programme. The number of
first-line treatment regimens recommended by WHO has been cut from 35
to four. Nevirapine-based regimens are most suitable for initial therapy
in resource-poor settings, it says. Protease inhibitors are reserved
for second-line therapy.
Drug supply management is also a challenge in many developing countries. “Focusing
on a small number of simplified drug regimens and using fixed-dose combinations
should make it easier,” the report suggests. WHO estimates that
the cost of scaling up AIDS treatment programmes and hitting the three
by five target is likely to reach $5.5bn by the end of 2005. However,
costs could be significantly reduced if drug prices for all developing
countries approached those negotiated for a few.
The report is available on the WHO website |
The
Pharmaceutical Journal
Acrobat
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