The United Nations health agency changed its guidelines Wednesday, now allowing any patient who has tested positive for HIV to get immediate treatment.
Earlier guidelines had limited treatment eligibility only to sufferers whose immune systems were affected to a certain extent, with the patient showing certain symptoms within a given period of time. However, recent studies had proven that immediate treatment can extend a patient’s life, even if they do not show the aforementioned symptoms. Research has also shown that this could reduce the chance of people transmitting HIV to others.
In a statement, the U.N.’s World Health Organization announced that it will be removing “all limitation on eligibility for antiretroviral therapy among people living with HIV,” adding that all populations and age groups would be able to receive treatment. This means that all of the world’s HIV patients – all 37 million of them – should qualify for immediate treatment. This is, however, not a plausible recommendation in poorer nations, where most patients don’t even have decent access to medication. Prior to the new recommendation, at least 28 million people were eligible for anti-HIV treatment.
“The new guideline stresses that in order to effectively implement the recommendations, countries will need to ensure that testing and treatment for HIV infection are readily available,” the WHO added in its statement.
The WHO’s guidelines also state that preventive antiretroviral treatment be given to any and all people who have a “substantial” risk of acquiring HIV. This is a change from the previous guidelines that had recommended such treatment only to men who have sex with other males. The WHO noted that the change was made following “further evidence of the effectiveness and acceptability” of pre-exposure prophylaxis as a preventive measure.
The WHO’s expanded scope, to be specific, also includes sex workers, intravenous drug users, and those who may have HIV-infected partners. And the operative word in the revisions is “substantial” – this is a downgrading of the risk needed in the previous guidelines to justify antiretroviral medication. Men who have sex with men have long been classified under this “high risk” category.
All in all, the UN believes that the more comprehensive guidelines could save up to 21 million lives and prevent 28 million new cases from taking place by 2030.
Although the WHO’s move has been lauded by anti-HIV/AIDS advocates as a move long overdue, they also acknowledged that a lot of funding would be needed, and education, among other tools, would also be required to make things work properly. “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,” said Doctors without Borders director Dr. Tom Ellman. “Nobody’s going to end AIDS with business as usual.”
The issue of funding does appear to be a touchy one, considering the premium prices of most pre-exposure prophylaxis (PrEP) drugs, such as Truvada. These drugs typically cost about $13,000 per year, and aren’t covered by all state Medicare programs. However, HIV and AIDS activists have been working hard to come up with ways to make these drugs more affordable to the average sufferer.