GENEVA/JOHANNESBURG—The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières today applauded the new guidelines from the World Health Organization (WHO) that all people be offered antiretroviral treatment immediately after testing positive for HIV. But MSF warned that turning this new recommendation into reality would require dramatically increased support from donors and governments.
"Test-and-treat can turn the tide on HIV, but to work as a tool to control the epidemic it will require drastic changes and greatly increased investment," said Tom Ellman, director of MSF’s Southern Africa Medical Unit. "HIV care has to move out of clinics and into the communities with mobilized, empowered, and engaged people living with HIV that actually are part of the response. This will need effort and money. At the United Nations last week, world leaders agreed to a Sustainable Development Goal to make AIDS history within 15 years, but they are going to need to show that they’re serious about it. Nobody’s going to end AIDS with business as usual.”
The Global Fund to Fight AIDS, TB, and Malaria will hold its replenishment conference next year, which will be the first test of donors’ commitment to using the best science to treat all people living with HIV and further decrease the rates of HIV transmission worldwide.
Experience from MSF’s HIV programs shows that over the last 10 years, one third of people who were diagnosed with HIV, but not eligible to start treatment, never returned to the health facility. Offering such individuals treatment once they test positive could substantially reduce the number of people who may never return.
"In order to reach as many people as possible, as soon as possible, simplified models of care and self-management strategies are needed that allow people to take more control over their own treatment and care," said Marc Biot, MSF’s operational coordinator for HIV. "It’s no longer only a question of when to start people on treatment, but also how to help people stay on treatment for life and to maintain ‘undetectable’ levels of virus in their blood. We need to make sure HIV treatment fits into people’s lives better, just like with any other chronic disease in industrialized countries."
MSF started providing HIV treatment to people in developing countries in 2000, and today more than 200,000 people receive treatment through MSF programs.