The World Health Organization’s latest bulletin is a must-read for experts and advocates working on global AIDS, delving into the hot topic of preventing HIV transmission with antiretroviral drugs and noting upcoming WHO action on this issue in the coming months.
The bulletin, authored by Kevin M De Cock and others in the WHO’s Department of HIV/AIDS, is a great where-we-stand-on-AIDS report that synthesizes everything from the latest science to the current financial crisis, and how those developments may impact the ever-evolving approach to this global epidemic.
“By the end of 2007, approximately 3 million people were accessing ART in resource-constrained settings, an unimaginable achievement a few years previously, yet one whose expansion and sustainability are threatened by resource constraints and competing priorities,” the authors write. “Adding complexity are scientific uncertainties – where is the pandemic going, what is the best way to use ART for individual health and what role can ART play in HIV prevention?”
The bulletin takes note of recent research showing better survival rates among HIV-positive patients who started ART earlier and says that WHO will be “reviewing evidence and revising guidance on ART” later this year. The WHO will also be organizing “a consultation” at the end of 2009 to look at research priorities and a variety of other new questions triggered by the possible use of ART for HIV prevention.
“There is little doubt that ART has preventive effects; what is uncertain is how best to apply it and combine it with other evidence-based prevention interventions for maximal synergy and benefit,” De Cock and others write. “At a time when other avenues of HIV prevention research, including vaccine evaluations, have given discouraging results, how to use ART for the greatest simultaneous therapeutic and prevention benefit is perhaps the most pressing question in HIV research.”
A link to the full WHO bulletin is above and again here.