| Summary |
The use of antiretroviral drug therapy (ART) has led to a marked reduction in AIDS-related
mortality and morbidity. However, the cost of the required combination of antiretroviral
(ARV) drugs has been prohibitive to most developing countries. Recently, the cost of ARV
drugs has decreased significantly as drug manufacturers agreed to sell their products at large
discounts and as a number of developing countries began to manufacture their own ARV
drugs. This cost reduction combined with the creation of the Global Fund for HIV/AIDS,
Tuberculosis and Malaria, which added significant financial resources, gave many developing
countries, especially those hardest hit by the AIDS epidemic, the hope to implement largescale
ART programs.
Despite this hope, caution is required as the cost to implement the full range of services
necessary for large-scale ART programs, especially laboratory services, is still too high for most
developing countries. Resource-limited countries have inadequate health systems
infrastructure and human resources. Available ART regimens are very demanding and require
full patient adherence for life. ARV drugs have unpleasant and sometimes dangerous side
effects, and may interact negatively with drugs needed to treat opportunistic infections
commonly associated with AIDS. Inadequate adherence can lead to treatment failure and
widespread ARV drug resistance. In addition, unless communication to health care providers
and the public is effective, the availability of ARV drugs may undermine HIV prevention
messages.
This paper provides program planning and management guidance to resource-limited
countries that seek to implement expanded ART services. It includes specific guidance on
setting criteria for receiving ART and deciding on treatment protocols, laboratory, clinical,
counseling and pharmaceutical services. In addition, this paper includes guidance for
estimating program costs, human resources and training requirements, and examples of
communication messages specific to ART programs. It suggests components for a national
ART program and topics for key operations research requirements specific to resource-limited
countries. |
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| Keywords |
This Item is associated with the Following
Keywords: ART, ARV Treatment Monitor. |
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