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Geneva, Switzerland, UNAIDS, 2017. 198 p. (UNAIDS/JC2900E)Since they were launched at the 20th International AIDS Conference in Melbourne, Australia, in 2014, the 90-90-90 targets have become a central pillar of the global quest to end the AIDS epidemic. The targets reflect a fundamental shift in the world’s approach to HIV treatment, moving it away from a focus on the number of people accessing antiretroviral therapy and towards the importance of maximising viral suppression among people living with HIV. This shift was driven by greater understanding of the benefits of viral suppression -- not only does treatment protect people living with HIV from AIDS-related illness, but it also greatly lowers the risk of transmitting the virus to others.
New York, New York, UNICEF, 2016 Dec. 92 p.Despite remarkable achievements in the prevention and treatment of HIV, this report finds that progress has been uneven globally. In 2015, more than half of the world’s new infections (1.1 million out of 2.1 million) were among women, children and adolescents, and nearly 2 million adolescents aged 10-19 were living with HIV. In sub-Saharan Africa, the region most impacted by HIV, three in four new infections in 15-19-year-olds were among girls. The report proposes strategies for preventing HIV among women, children and adolescents who have been left behind, and treating those who are living with HIV.
Geneva, Switzerland, UNAIDS, 2016.  p.Efforts to reach fewer than 500 000 new HIV infections by 2020 are off track. This simple conclusion sits atop a complex and diverse global tapestry. Data from 146 countries show that some have achieved declines in new HIV infections among adults of 50% or more over the last 10 years, while many others have not made measurable progress, and yet others have experienced worrying increases in new HIV infections.
Geneva, Switzerland, UNAIDS, 2016.  p.This report highlights best practices and provides examples of countries that are already coming close to achieving the 90–90–90 targets, which are that 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads. The report outlines steps that are needed to expedite gains towards each of the three 90s. Technological and service delivery innovations rapidly need to be brought to scale, communities must be empowered to lead the push to end the epidemic, new resources must be mobilized to reach the final mile of the response to HIV and steps must urgently be taken to eliminate social and structural barriers to service access.
[New York, New York], United Nations General Assembly, 2016 Apr 1.  p. (A/70/811)This new report warns that the AIDS epidemic could be prolonged indefinitely if urgent action is not implemented within the next five years. The report reveals that the extraordinary acceleration of progress made over the past 15 years could be lost and urges all partners to concentrate their efforts to increase and front-load investments to ensure that the global AIDS epidemic is ended as a public health threat by 2030. The review of progress looks at the gains made, particularly since the 2011 United Nations Political Declaration on HIV and AIDS, which accelerated action by uniting the world around a set of ambitious targets for 2015. The report outlines that the rapid treatment scale-up has been a major contributing factor to the 42% decline in AIDS-related deaths since the peak in 2004 and notes that this has caused life expectancy in the countries most affected by HIV to rise sharply in recent years. The report underlines the critical role civil society has played in securing many of the gains made and the leadership provided by people living with HIV. Community efforts have been key to removing many of the obstacles faced in scaling up the AIDS response, including reaching people at risk of HIV infection with HIV services, helping people to adhere to treatment and reinforcing other essential health services.
Geneva, Switzerland, UNAIDS, 2015.  p.This document, released on the World AIDS Day 2015, provides an update on the global status of the HIV epidemic. According to the press release, the epidemic has been forced into decline. New HIV infections and AIDS-related deaths have fallen dramatically since the peak of the epidemic. The document cites a 35 percent decrease in new HIV infections; a 42 percent decrease in AIDS-related deaths since the peak in 2004; a 58 percent decrease in new HIV infections among children since 2000; and an 84 percent increase in access to antiretroviral therapy since 2010. Additionally, the global response to HIV has averted 30 million new HIV infections and 7.8 million AIDS-related deaths since 2000. While acknowledging these achievements, the report also emphasizes that accelerating the AIDS response in low-and middle-income countries could avert 28 million new HIV infections and 21 million AIDS-related deaths between 2015 and 2030, saving US$24 billion annually in additional HIV treatment costs. The next phase of the global response must accommodate new circumstances, opportunities, and evidence, including a rapidly shifting context and a new, sustainable development agenda. The single priority of the HIV response for the next 15 years is to end the epidemic by 2030.
Geneva, Switzerland, UNAIDS, 2013.  p.The 2013 report on the global AIDS epidemic contains the latest data on numbers of new HIV infections, numbers of people receiving antiretroviral treatment, AIDS-related deaths and HIV among children. This report, which follows the endorsement of the 2011 United Nations Political Declaration on HIV and AIDS outlining global targets to achieve by 2015, summarizes progress towards 10 key targets and reviews commitments and future steps. While recognizing significant achievements, UNAIDS warns of slowing progress in meeting some targets. In 2012, there were 35 million people living with HIV (PLHIV), and 2.3 million new infections-a 33 percent decrease from 2001, including significant reductions in new infections among children. More people than ever are on antiretroviral therapy (ART). Twenty-six countries have achieved the global target of halving sexual HIV transmission by 2015, but other countries are not on track to meet this target, hence the need to enhance prevention efforts. Globally, countries have made limited progress in reducing HIV transmission by 50 percent among people who inject drugs. While ART coverage is high, and approaching the target of 15 million PLHIV on treatment, coverage in low- and middle-income countries represented only 34 percent of 28 million eligible PLHIV in 2013. Stigma, discrimination and criminalization towards PLHIV continue; specifically, 60 percent of countries report laws that inhibit access to HIV services by key populations. The results of this report should be used by countries to refocus and maintain their commitments. The authors urged strengthened global commitment to achieve the goal of zero new HIV infections, discrimination, and AIDS-related deaths.
Geneva, Switzerland, UNAIDS, 2010.  p. (UNAIDS/10.11E ; JC1958E)The 2010 edition of the UNAIDS Report on the global AIDS epidemic includes new country by country scorecards on key issues facing the AIDS response. Based on the latest data from 182 countries, this global reference book provides comprehensive analysis on the AIDS epidemic and response. For the first time the report includes trend data on incidence from more than 60 countries.
Geneva, Switzerland, WHO, 2011.  p.In June 2010, the UNAIDS Secretariat and WHO launched Treatment 2.0, an initiative designed to achieve and sustain universal access and maximize the preventive benefits of antiretroviral therapy (ART). Treatment 2.0 builds on '3 by 5' and the programmatic and clinical evidence and experience over the last 10 years to expand access to HIV diagnosis, treatment and care through a series of innovations in five priority work areas: drugs, diagnostics, costs, service delivery and community mobilization. The principles and priorities of Treatment 2.0 address the need for innovation and efficiency gains in HIV programmes, in greater effectiveness, intervention coverage and impact in terms of both HIV-specific and broader health outcomes. Since the launch of Treatment 2.0, the UNAIDS Secretariat and WHO have worked with other UNAIDS co-sponsoring organizations, technical experts and global partners to further elaborate and begin implementing Treatment 2.0. The Treatment 2.0 Framework for Action outlines the five priority work areas which comprise the core elements of the initiative and establishes a strategic framework to guide action within each of them over the next decade. The Framework for Action reflects commitments outlined in Getting to Zero: 2011 - 2015 Strategy, UNAIDS and the WHO Global Health-Sector Strategy on HIV, 2011 - 2015, the guiding strategies for the multi-sectoral and health-sector responses to the HIV pandemic. (Excerpt)
Bangkok, Thailand, UNAIDS, Regional Support for Asia and the Pacific, 2011.  p. (UNAIDS / 11.05E)This report provides the most up to date information on the HIV epidemic in the region in 2011. While the region has seen impressive gains -- including a 20% drop in new HIV infections since 2001 and a three-fold increase in access to antiretroviral therapy since 2006 -- progress is threatened by an inadequate focus on key populations at higher risk of HIV infection and insufficient funding from both domestic and international sources.
Eastern Mediterranean Health Journal. 2008; 14 Suppl:S90-6.Now, 28 years after acquired immune deficiency syndrome (AIDS) was first recognised, it has become a global pandemic affecting almost all countries. WHO/UNAIDS (Joint United Nations Programme on HIV/AIDS) estimate the number of people living with human immunodeficiency virus (HIV) worldwide in 2007 at 33.2 million. Every day 68 000 become infected and over 5700 die from AIDS; 95% of these infections and deaths have occurred in developing countries. The HIV pandemic remains the most serious of infectious disease challenges to public health. Sub-Saharan Africa remains the most seriously affected region, with AIDS the leading cause of death there. Although percentage prevalence has stabilized, continuing new infections (even at a reduced Estimated number of people living with HIV globally, 1990-2007, data from UNAIDS rate) contribute to the estimated number of persons living with HIV, 33.2 million (30.6-36.1 million). A defining feature of the pandemic in the current decade is the increasing burden of HIV infection in women, which has additional implications for mother-to-child transmission. In sub-Saharan Africa, almost 61% of adults living with HIV in 2007 were women. The impact of HIV mortality is greatest on people in their 20s and 30s; this severely distorts the shape of the population pyramid in affected societies. Globally, the number of children living with HIV increased from 1.5 million in 2001 to 2.5 million in 2007, 90% of them in sub-Saharan Africa. HIV/AIDS also poses a threat to economic growth in many countries already in distress. According to the World Bank analysis of 80 developing countries, as the prevalence of HIV infection increases from 15% to 30%, the per capita gross domestic product decreases 1.0%-1.5% per year. The powerful negative impact of AIDS on households, productive enterprises and countries stems partly from the high cost of treatment, which diverts resources from productive investments, but mostly from the fact that AIDS affects people during their economically productive adult years, when they are responsible for the support and care of others. This crisis has necessitated a unique and truly global response to meld the resources, political power, and technical capacity of all UN organizations, developing countries and others in a concerted manner to curb the pandemic. AIDS often engenders stigma, discrimination, and denial, because of its association with marginalized groups, sexual transmission and lethality, hence it requires a more comprehensive and holistic approach. During the past 10 years, many developments have occurred in response to this pandemic. WHO has played an important role in this response. This article reviews the major developments in treatment and prevention and the role of WHO in response to these developments.
Teddington, United Kingdom, Tearfund, 2008 Jul. 44 p.This report provides an overview of PMTCT and is an attempt to explore what is working, and why, in scaling up access. The report captures innovative examples of successful programming and partnerships, while identifying challenges and bottlenecks that must be overcome if these countries are to meet their nationally set universal access targets by 2010. The research methodology used for this report was based on a desk review, interviews with key global informants (see Acknowledgements) and country case studies in Malawi, Nigeria and Zambia in early 2008. The in-country study included semi-structured interviews with representatives of government and nongovernmental organisations as well as focus group discussions with community representatives, participatory and observational methodologies. The main objectives of the research were to: 1) identify and conduct interviews with the key international and national stakeholders and explore the structure, components, implementation, co-ordination, financing, policies, and guidelines and monitoring system of the PMTCT programmes; 2) determine what was working well and why; and 3) identify specific bottlenecks, challenges and recommendations for progress. This report provides an overview of the perceptions of key experts and communities on PMTCT interventions and approaches, current global action and country progress.
Lancet Infectious Diseases. 2007 Nov; 7(11):705.An expert advisory group, convened by the European Centre for Disease Prevention and Control (ECDC), has concluded that it would be inadvisable to embark on a widespread pre-pandemic H5N1 vaccination programme in European countries at the present time. Pre-pandemic vaccines, currently being developed by several pharmaceutical companies, can be made ahead of the emergence of pandemic influenza virus, unlike "true" pandemic vaccines. However, experts have concluded that there remains too much uncertainty as to whether the H5N1 avian influenza virus, on which pre-pandemic vaccines currently under development are based, will ever be responsible for a pandemic. According to Johan Giesecke (ECDC, Stockholm, Sweden), "If there is an H5N1-based pandemic, the strategy of having stockpiled pre-pandemic H5N1 vaccines, even if the vaccines incompletely match the pandemic virus, may prevent more infections and deaths than waiting for specific "true" pandemic vaccines...however, there is no guarantee that the next human influenza pandemic will evolve from the current H5N1 avian influenza virus". (excerpt)
Global progress in PMTCT and paediatric HIV care and treatment in low- and middle-income countries in 2004 -- 2005.
Reproductive Health Matters. 2007 Sep; 15(30):179-189.A growing number of countries are moving to scale up interventions for prevention of mother-to-child transmission (PMTCT) of HIV in maternal and child health services. Similarly, many are working to improve access to paediatric HIV treatment. This paper reviews national programme data for 2004-2005 from low- and middle-income countries to track progress in these programmes. The attainment of the UNGASS target of reducing HIV infections by 50% by 2010 necessitates that 80% of all pregnant women accessing antenatal care receive PMTCT services. In 2005, only seven of the 71 countries were on track to meet this target. However PMTCT coverage increased from 7% in 2004 (58 countries) to 11% in 2005 (71 countries). In 2005, 8% of all infants born to HIV positive mothers received antiretroviral prophylaxis for PMTCT, up from 5% in 2004, though only 4% received cotrimoxazole. 11% of HIV positive children in need received antiretroviral treatment in 2005. In 31 countries that had data, 28% of women who received an antiretroviral for PMTCT also reported receiving antiretroviral treatment for their own health. Achieving the UNGASS target is possible but will require substantial investments and commitment to strengthen maternal and child health services, the health workforce and health systems to move from pilot projects to a decentralised, integrated approach. (author's)
Geneva, Switzerland, WHO, 2005. 64 p.In an effort to keep abreast of rapid changes in the landscape of the HIV pandemic, WHO and UNAIDS report semiannually on progress toward "3 by 5". The first update was presented at the XV International AIDS Conference in Bangkok, Thailand, in July 2004. This second report measures progress made by countries and describes how international partners are supporting their efforts. In addition, it summarizes how the building blocks of antiretroviral (ARV) therapy programmes are being put into place and how issues beyond treatment are being addressed. It provides examples of country progress and a global estimate of the number of people receiving ARV therapy, and it assesses how well the therapy is working. It also identifies some of the challenges faced in resource-constrained settings and how these are being met by improving health care systems, links between prevention and treatment and providing equal access to quality care. This report is based on reports and updates provided by dozens of international, national and community organizations involved in scaling up ARV therapy. We thank everyone who has contributed to this progress report. WHO departments at the headquarters, regional and country levels worked with national governments and nongovernmental organizations to gather the latest information on the scaling up of ARV therapy. The UNAIDS Secretariat and the UNAIDS Cosponsors gathered information on how United Nations agencies and international nongovernmental organizations are translating the rapidly expanding commitment to "3 by 5" into action. (excerpt)
UNAIDS and WHO Consultation on Progress in Prevention and Care in the Context of the "3 By 5 Initiative" and the Perspective of Universal Access in the Western Pacific Region, 12-16 December 2005, Manila, Philippines. Report.
Manila, Philippines. WHO, Regional Office for the Western Pacific, .  p. ((WP)HSI/ICP/HSI/3.5/001; Report Series No. RS/2005/GE/45(PHL))The WHO Western Pacific Regional Office, in collaboration with the Joint United Programme on HIV/AIDS (UNAIDS), organized the four-day UNAIDS and WHO Consultation on Progress in Prevention and Care in the Context of the "3 by 5" Initiative and the Perspective of Universal Access in the Western Pacific Region with the general objective that, by the end of the consultation, the participants would have: (1) reviewed progress made on prevention and care scale-up in the context of the "3 by 5" Initiative; (2) shared experiences among countries on the current performance of monitoring and evaluation systems related to HIV/AIDS care, treatment and support: (3) identified ways to strengthen the integration of HIV/AIDS prevention and care: and (4) defined the conditions and terms of reference of a partners technical working group on HIV/AIDS prevention and care scale-up in the Western Pacific Region. (excerpt)
Washington, D.C., World Bank, Knowledge and Learning Center, 2005 Nov.  p. (Findings Infobriefs No. 118; Good Practice Infobrief)The Mali Multi-sectoral AIDS Project (MAP) began implementation in late 2004 and is in the preliminary phases of the project cycle. This project has been commended by the World Bank's Board for its innovation and the involvement of the private sector to address HIV/AIDS. Mali is one of the poorest countries in the world due to factors such as its limited resource base, land-locked status and poor infrastructure. According to the 2001 Demographic and Health Survey (DHS) published by the Ministry of Health, Mali's HIV/AIDS prevalence rate is estimated at 1.7% in 2001. The project objective is to support the Government of Malis efforts to control the spread of the HIV/AIDS epidemic and provide sustainable access to treatment and care to those infected with or affected by HIV/AIDS. While Mali currently has a low HIV prevalence rate by Sub-Saharan African standards, it runs a high risk of experiencing an increase in prevalence rates. (excerpt)
Bulletin of the World Health Organization. 2007 May; 85(5):325-420.In 1991, the 44th World Health Assembly set two key targets for global tuberculosis (TB) control to be reached by 2000: 70% case detection of acid-fast bacilli smear-positive TB patients under the DOTS strategy recommended by WHO and 85% treatment success of those detected. This paper describes how TB control was scaled up to achieve these targets; it also considers the barriers encountered in reaching the targets, with a particular focus on how HIV infection affects TB control. Strong TB control will be facilitated by scaling-up WHO-recommended TB/HIV collaborative activities and by improving coordination between HIV and TB control programmes; in particular, to ensure control of drug-resistant TB. Required activities include more HIV counselling and testing of TB patients, greater use and acceptance of isoniazid as a preventive treatment in HIV-infected individuals, screening for active TB in HIV-care settings, and provision of universal access to antiretroviral treatment for all HIV-infected individuals eligible for such treatment. Integration of TB and HIV services in all facilities (i.e. in HIV-care settings and in TB clinics), especially at the periphery, is needed to effectively treat those infected with both diseases, to prolong their survival and to maximize limited human resources. Global TB targets can be met, particularly if there is renewed attention to TB/HIV collaborative activities combined with tremendous political commitment and will. (author's)
Geneva, Switzerland, World Health Organization [WHO], 2006 Mar 30.  p.This independent formative evaluation was conducted by a team of six international consultants between August 2005 and January 2006 to appraise WHO's contributions and roles in implementing the "3 by 5" Initiative. Funded by the Canadian Government, and as a requirement for its grant to WHO, the evaluation investigated all three levels at which WHO operates (headquarters, regional offices and country offices), placing particular emphasis on Africa. This included seven country assessments and an extensive consultation of international and country-level partners and stakeholders. A number of focused technical studies were also commissioned. The evaluation reviewed how effectively WHO provided technical, managerial and administrative guidance and support pursuant to the "3 by 5" goals and target. An assessment was also made of the extent to which WHO has mobilized, sustained and contributed to this major global partnership through improving harmonization between United Nations agencies and working with other stakeholders and partners. Key lessons from "3 by 5" have been documented, including those on how the initiative contributed to health systems strengthening and HIV prevention, as well as the ways with which equity and gender concerns were dealt. Potential opportunities for future collaboration between WHO, main donors and partners were identified and recommendations have been provided for future plans and the way forward for WHO and its partners. (excerpt)
The continuum of care for people living with HIV / AIDS in Cambodia: linkages and strengthening in the public health system. Case study.
Manila, Philippines, World Health Organization [WHO], Regional Office for the Western Pacific, 2006. 30 p.HIV/AIDS is a multifactorial disease requiring life-long treatment. In 2003, Cambodia released its plan to meet this need -- the comprehensive Continuum of Care (CoC) -- which is an integrated provision of treatment for people living with HIV/AIDS (PLHA). In three short years, Cambodia's National Center for HIV/AIDS and STI (NCHADS) has started and expanded this country-devised and country-led activity. By the end of 2005, it was reaching 20 out of the country's 68 operational districts (ODs), including free antiretroviral treatment (ART) for 11,284 PLHA out of the estimated 19,184 adult Cambodians who currently need it. Additionally 1,071 children are receiving ART. This case study provides a snapshot of the CoC as it is in the middle of this rapid expansion. It is also an investigation of possible health system strengthening effects achieved by the CoC. In general, the four provinces included in the study had a common understanding of the multiple elements that make up the CoC, despite their varying levels of outside support from non-governmental organizations (NGOs) and donors for implementation. (excerpt)
Lancet. 2006 Jun 10; 367(9526):1876.In the past few weeks, India made headlines for two very different reasons. The good news was that India's economy grew at the fastest pace in more than 2 years, surpassed only by China. The bad news soon followed, however. India has overtaken South Africa as the country with the highest number of people living with HIV/AIDS, according to the latest figures from the Joint United Nations Programme on HIV/AIDS (UNAIDS). In its 2006 Report on the Global AIDS Epidemic, released ahead of the UN General Assembly Special Session on HIV/AIDS in New York, UNAIDS estimated that India now has 5.7 million HIV-positive people. India's government disagrees with these figures, which for the first time include estimates of children younger than 15 years and adults older than 50 years. (excerpt)
Bulletin of the World Health Organization. 2006 May; 84(5):337-424.Developing countries are failing to make full use of flexibilities built into the World Trade Organization's (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to overcome patent barriers and, in turn, allow them to acquire the medicines they need for high priority diseases, in particular, HIV/AIDS. First-line antiretroviral (ARV) drugs for HIV/AIDS have become more affordable and available in recent years, but for patients facing drug resistance and side-effects, second-line ARV drugs and other newer formulations are likely to remain prohibitively expensive and inaccessible in many countries. The problem is that many of these countries are not using all the tools at their disposal to overcome these barriers. Medicines protected by patents tend to be expensive, as pharmaceutical companies try to recoup their research and development (R&D) costs. When there is generic competition prices can be driven down dramatically. The TRIPS Agreement came into effect on 1 January 1995 setting out minimum standards for the protection of intellectual property, including patents on pharmaceuticals. Under that agreement, since 2005 new drugs may be subject to at least 20 years of patent protection in all, apart from in the least-developed countries and a few non-WTO Members, such as Somalia. Successful AIDS programmes, such as those in Brazil and Thailand, have only been possible because key pharmaceuticals were not patent protected and could be produced locally at much lower cost. For example, when the Brazilian Government began producing generic AIDS drugs in 2000, prices dropped. AIDS triple-combination therapy, which costs US$ 10 000 per patient per year in industrialized countries, can now be obtained from Indian generic drugs company, Cipla, for less than US$ 200 per year. This puts ARV treatment within reach of many more people. (excerpt)
Shock therapy in Brazil. By combining prevention campaigns and free access to drug treatment, Brazil has successfully curbed the AIDS epidemic. [Tratamiento de shock en Brasil. La combinación de campañas de prevención con el libre acceso al tratamiento con fármacos ha permitido a Brasil frenar exitosamente la epidemia de SIDA]
New Courier. 2004 Oct; 46-47.Explosive. That was the word to describe the AIDS epidemic in Brazil. In 1992, the World Bank predicted that the number of cases would exceed one million in the year 2000. The demographic growth of Brazil, a country of nearly 170 million people, heightened fears of an epidemic comparable to that sweeping Africa. But while Brazil is one of the countries in Latin America that has been hardest hit by the disease, with more than 600,000 people living with HIV, the numbers are far below the catastrophic forecasts made 10 years ago. The country has even become a point of reference for numerous developing countries in the throes of the epidemic. The daring policy adopted by the authorities in Brasilia - based on active prevention campaigns and, since 1996, the free distribution of anti-retroviral drugs to those who are sick - has turned out to be particularly effective. Currently, 140,000 Brazilians, or nearly all of those who are aware that they have the disease, are receiving free medication. Result: the AIDS related death rate has been cut in half since 1997. And contrary to what some people feared, the widespread access to treatment has not had an adverse effect on prevention. The number of new HIV infections stood at 22,000 in 2003, down from 25,000 in the 1990s. In addition, the incidence of high-risk behavior has dropped. For example, the percentage of soldiers who use a condom when having sex with a paid partner increased from 69 percent in 1999 to 77 percent in 2002. (excerpt)
Odessa workshop helps build capacity among Ukrainian clinicians who care for people living with HIV / AIDS.
Connections. 2004 Jan;  p..A recent Anti-retroviral Therapy Training Workshop held in Odessa, Ukraine, marked the start of an ongoing collaboration between AIHA and the Los Angeles-based AIDS Healthcare Foundation (AHF). It was the first training hosted under the aegis of the newly established World Health Organization Regional HIV/AIDS Care and Treatment Knowledge Hub for which AIHA is the primary implementing partner. This Knowledge Hub was created in response to the burgeoning HIV/AIDS pandemic in Eastern Europe and Central Asia to serve as a crucial capacity-building mechanism for reaching WHO's "3 by 5" targets for the region. (excerpt)
WHO consultation on technical and operational recommendations for scale-up of laboratory services and monitoring HIV antiretroviral therapy in resource-limited settings.
Geneva, Switzerland, WHO, 2005. 42 p.The aim of the consultation was to obtain clear and realistic guidelines as to which diagnostic and monitoring schedules were optimal and how they could be delivered in order to assist decision-making on treatment and facilitate the implementation of strategies and necessary actions for scaling up diagnosis and monitoring at the local, regional and global levels, with particular emphasis on resource-constrained settings. It was required that the resulting recommendations would provide useful tools for the rational implementation of scaling-up processes, taking into consideration variations between developing countries in human resources, health structures and socioeconomic contexts. (excerpt)