Re: NACO Treatment Guidelines

[Guest guest]

Dear FORUM,

The following letter, sent last week by the European AIDS Treatment Group

(EATG) to the Russian National AIDS program, also reflects many of the issues

confronting the Indian National Program. For this reason I am reposting this

excerpt from the letter.

...The published standards show a number of serious shortcomings threatening

treatment outcomes and patient safety. The European AIDS Treatment Group appeals

to the Government of the Russian Federation and its Health and Social

Development Ministry, to collaborate with Russian scientists, clinicians, civil

society and people living with HIV, the WHO, UNAIDS and the medical community in

Europe in addressing the following problems with utmost urgency:

Treatment guidelines should not depend on specific care delivery structures.

Differentiation should be based on the patients’ treatment experience (naïve or

experienced) and reflect the different disease stages.

Treatment guidelines need to recommend proven first line, second line and

salvage regimens.

Treatment guidelines must include recommendations for the monitoring of

patients, such as CD4, viral load and resistance testing at baseline; CD4, viral

load and other parameters while on treatment and resistance testing on failure

or in case of interruptions.

Drugs recommended by the guidelines should reflect international standards and

be approved by the FDA/EMEA or prequalified by the WHO.

The Government of the Russian Federation must commit to observe proven standards

of care and ensure universal access to quality treatment. Treatment centres must

be established and enough medical staff trained to address the specific needs

and requirements of injecting drug users in need of treatment, as they represent

80% of all HIV cases in Russia. This includes access to substitution treatment

and healthcare in prisons according to WHO guidelines.

National healthcare budgets must be adjusted to treat all patients in need. The

treatment programmes run under the auspices of the Global Fund against AIDS,

Tuberculosis and Malaria, must be complementary to the national programme and

follow the same guidelines.

Effective and appropriate treatment must be provided for co-infections, in

particular hepatitis C, tuberculosis and multi-drug resistant TB and

opportunistic infections in line with internationally accepted guidelines....

Sincerely,

Stern, Ph.D.

Director

Agua Buena Human Rights Association

San , Costa Rica

e-mail: <rastern@...>