Early use of ARVs extends life for those living with the HIV/AIDS virus and also cuts down the risk of disease transmission to their partners, the World Health Organisation said yesterday. This was contained in a statement setting out the new goals for its 194 member states after findings from recent clinical trials. Previous WHO guidelines, limited treatment of HIV to those whose immune cell counts had fallen below 500 CD4 cells and 28 million people worldwide were deemed eligible for anti-retroviral therapy (ART). But now the WHO suggests that all people at ‘substantial’ risk of contracting HIV should also be given preventive ART, and not just men who have sex with men. The recent Rwanda HIV/AIDS Incidence Health Survey, indicates that 3 out of 100 individuals have the AIDS virus whereas three out of 1000 individuals are infected every year. Dr Sabin Nsanzimana the head of HIV/AIDS programme at Rwanda Biomedical Centre told The New Times in an earlier interview that the test and treat method would reduce the spread of the disease. “The way we operated before meant that you are tested for HIV now, then you wait until your immunity level of CD4 is less than 500. But two big studies presented this year, one called ‘stat study’ and another ‘temprano’ have provided results to prove that early treatment instead improves the situation,” Nsanzimana said. He also said that when people are tested and treated early enough, they are less likely to die because of opportunistic infections. “One study found that 96 per cent of people who are HIV positive, once treated early enough, will not transmit the virus to other people,” he added. Since everyone with HIV should be given anti-retroviral drugs as soon as possible after diagnosis, 37 million people worldwide should be on treatment, according to the World Health Organisation. New guidelines at the central plank of the United Nations agency aim to end HIV/ AIDs epidemic by 2030. “Everybody living with HIV has the right to life-saving treatment. The new guidelines are a very important step towards ensuring that all people living with HIV have immediate access to anti-retroviral treatment,” said Michel Sidibe, the executive director of UNAIDS. UNAIDS also estimates that expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030. According to experts, early treatment will lead to a sharp increase in demand for ART medicines, which are typically given as a three-drug cocktail to avoid the risk of the virus developing resistance. Major suppliers of HIV drugs include Gilead Sciences (GILD.O), ViiV Healthcare, which is majority-owned by GlaxoSmithKline (GSK.L), and multiple Indian generic manufacturers. The medical charity Medecins Sans Frontieres (Doctors Without Borders) welcomed the WHO’s “treat-all” plan, which it says will prevent many HIV-positive people in poorer countries from falling through the treatment net. MSF says that a third of people who were diagnosed with HIV, but not eligible to start treatment, never returned to the clinic. The charity also warned that making the new recommendation a reality would require dramatically increased financial support from donors and governments. Meanwhile, the WHO estimates that by 2020 low- and lower-middle income countries will need $18.4 billion annually for the expanded HIV fight although fast tracking the response should yield economic returns of $15 per dollar invested, based on improved health and infections averted. AIDS has killed around 40 million people worldwide since it began spreading 30 years ago. editorial@newtimes.co.rw
