NACO Guidelines for a Phased Scale up of Access to ART

[Guest guest]

Programme Implementation Guidelines for a Phased Scale up of Access

to Antiretroviral Therapy for People Living with HIV/AIDS. DRAFT.

National AIDS Control Organization, 9th Floor Chandralok, 36,

Janpath, New Delhi - 110001

The draft publications have been placed on website for your valuable

comments if any, Please forword the comments to NACO prior to 20th

March, 2004 on the following E-mail:- asec-mdg@... after which

the final documents will be sent for printing.

http://www.naco.nic.in/nacp/arvimp.htm

INTRODUCTION

Across India today, HIV/AIDS is seen to be moving from high risk

groups to the more vulnerable segments among the general population.

Political leadership, commitment and has shifted significantly in

favor of providing access to anti-retroviral treatment (ART) for

people living with HIV/AIDS. Treatment is now perceived as a critical

component of a comprehensive program to combat HIV/AIDS, along with

prevention and the improvement of health care infrastructure for the

delivery and monitoring of care and support.

This integration has become recently, more feasible. Earlier,

high costs, demanding treatment regimens, and the absence of basic

health infrastructure were repeatedly cited as potentially

insurmountable barriers.

The Call to Action " at the UN General Assembly Special Session

on HIV/AIDS (June 2001), pushed forward a new global consensus on the

need for ART. This led to a cumulative response from diverse

quarters. It put pressure on pharmaceutical manufacturers, and ever

since, we are witnessing dramatic reductions in drug prices. Brazil's

national ART distribution programme added to the public debate. WHO

released guidelines for anti-retroviral use in resource constrained

settings in April 2002, added 10 ART drugs to its list of " essential

medicines " for all countries, and for the first time qualified a

number of generic manufacturers. WHO declared the lack of access to

ARV treatment for HIV/AIDS a " global health emergency " in September,

2003, and announced that it would release an emergency plan to scale

up access to ARV treatment for at least three million people by the

end of 2005. This joint WHO/UNAIDS announcement popularly came to be

known as the 3 by 5 initiative. The WHO guidelines for anti-

retroviral use in resource constrained settings have since been

revised in June 2003.

Admittedly, antiretroviral therapy is no cure for HIV/AIDS.

Effective antiretroviral regimens inhibit the efficient replication

of the HIV virus, and reduces viremia to undetectable levels. Lower

frequency of opportunistic infections significantly reduces the cost

of management of HIV. This helps people lead more productive lives,

with perceptibly reduced stigma and discrimination. Successes

achieved in terms of ART delaying the onset of AIDS, has now

transformed the common perception about HIV from being an immediately

fatal scourge. HIV is now beginning to be perceived as perhaps a

somewhat more manageable, chronic illness, although devastatingly

debilitating in the long run.

http://www.naco.nic.in/nacp/arvimp.htm