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JAMA. 2001 Sep 26; 286(12):1444.The 20th anniversary of the first diagnosis of HIV infection has come and gone. So has the razzmatazz surrounding the UN General Assembly's Special Session on AIDS in June. Headlines made when UN Secretary-General Kofi Annan appealed for the world to act on the global emergency AIDS represents have been superseded by other events. It's back to business as usual. Or is it? It must not be. The AIDS crisis is as real now as a few months ago, and it will continue to grow unless the world is constantly reminded of it and plans to stem the epidemic are turned into action. The recent focus on AIDS among the poorest countries of the world--in particular in Africa--may have given an impression that those who live in countries with stable or declining infection rates no longer need to worry. Recent infection figures in the United States showing disturbing increases in some population groups prove this is not so. And the effects of globalization mean that there no longer is such a thing as a localized health problem. The HIV/AIDS epidemic is a global emergency and it calls for global commitment and action. UN Secretary-General Annan recently asserted that "AIDS can no longer do its deadly work in the dark. The world has started to wake up." Frighteningly, it has taken 22 million deaths and 13 million orphaned children to act as a global alarm clock. Today, there are 36 million people living with HIV/AIDS. (author's)
Interim WHO clinical staging of HIV / AIDS and HIV / AIDS case definitions for surveillance. African region.
Geneva, Switzerland, WHO, 2005.  p. (WHO/HIV/2005.02)With a view to facilitating the scale-up of access to antiretroviral therapy (ART) in the African Region the present document outlines recent revisions made by WHO to the clinical staging of HIV/AIDS and to case definitions for HIV/AIDS disease surveillance. These interim guidelines are based on an international drafting meeting held in Saas Fee in June 2004 and on recommendations made by experts from African countries at a meeting held in Nairobi in December of the same year. The revisions to the clinical staging target professionals ranging from senior consultants in teaching and referral hospitals to surveillance officers and first-level health care providers, all of whom have important roles in caring for people living with HIV and AIDS (PLWHA), including children. It is proposed that countries review, adapt and repackage the guidelines as appropriate for specific tasks at different levels of health service delivery. It is hoped that national HIV/ AIDS programmes in African countries will thus be assisted to develop, revise or strengthen their ART guidelines, patient monitoring and surveillance efforts. The interim clinical staging and revised definitions for surveillance are currently being reviewed in the other WHO regions and will be finalized at a global meeting to be held in September 2005. (excerpt)
Geneva, Switzerland, WHO, 2004 Jan. 118 p. (Integrated Management of Adolescent and Adult Illness [IMAI] No. 1; WHO/CDS/IMAI/2004.1)The IMAI guidelines are aimed at first-level facility health workers and lay providers in low-resource settings. These health workers and lay providers may be working in a health centre or as part of a clinical team at the district clinic. The clinical guidelines have been simplified and systematized so that they can be used by nurses, clinical aids, and other multi-purpose health workers, working in good communication with a supervising MD/MO at the district clinic. Acute Care presents a syndromic approach to the most common adult illnesses including most opportunistic infections. Instructions are provided so the health worker knows which patients can be managed at the first-level facility and which require referral to the district hospital or further assessment by a more senior clinician. Preparing first-level facility health workers to treat the common, less severe opportunistic infections will allow them to stabilize many clinical stage 3 and 4 patients prior to ARV therapy without referral to the district. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 2004 Dec.  p.There is an urgent need to define at country level an essential package of interventions that can be delivered through health services to meet the needs of young people. This document summarizes the evidence for effective action, and encourages policy makers and programmers to turn concern and commitment into effective and sustainable action. It is based on an understanding that HIV infects people when they are young, but AIDS affects and kills people at an age when they would be parents and workers who sustain society and domestic and family life. Helping young people to protect themselves against HIV and AIDS protects people now and in the future. It protects the future of family life and the economic prospects of countries in development. (excerpt)
Statement by the chairman of the Technical Working Group on Diagnosis of HIV Infection in Women and Children.
In: International Conference on the Implications of AIDS for Mothers and Children: technical statements and selected presentations jointly organized by the Government of France and the World Health Organization, Paris, 27-30 November 1989. Geneva, Switzerland, WHO, Global Programme on AIDS, 1989. 39-40. (WHO/GPA/DIR/89.12)According to World Health Organization estimates, there are about 2 million women and children throughout the world infected with the human immunodeficiency virus (HIV), most of whom remain asymptomatic and unidentified. At least 30% of infants whose mothers are HIV-positive will become infected before, during, or soon after birth. At present, HIV antibody tests are unable to diagnose perinatally acquired HIV infection in infants under 18 months of age. In such cases, the diagnosis can be made only on the basis of clinical signs and symptoms such as unexplained neurological abnormalities, developmental regression, recurrent severe bacterial infections that fail to respond to conventional therapy, lymphocytic interstitial pneumonitis, or opportunistic infections related to cellular immunodeficiency. Given the importance of timely diagnosis of HIV infection, research focused on both the development of sensitive, specific laboratory tests for the diagnosis of HIV in infants under 18 months of age and refinement of the case definition of pediatric acquired immunodeficiency syndrome (AIDS) should be prioritized. Policy decisions as to whether women of reproductive age should be tested for HIV infection should be based on laboratory testing and counseling resources, the availability of medical and social services for women and children, and the overall prevalence of HIV infection in the locality or country.
USAID HIGHLIGHTS. 1991 Fall; 8(3):1-4.This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.
Report of a technical advisory meeting on research on AIDS and tuberculosis, Geneva, 2-4 August 1988.
[Unpublished] 1989. 21 p. (WHO/GPA/BMR/89.3)A technical advisory meeting on research on AIDS and tuberculosis was held to review and prioritize ongoing and planned research in the field, suggesting essential studies and study design. Studies in need of international collaboration, as well as subjects not covered by ongoing and planned research were considered, with attention given to recommending frameworks for development. The final major objective of the meeting was to determine key areas of TB programs requiring strengthening to facilitate such research, and to suggest developmental steps for improvement. The report provides opening background information of tuberculosis, AIDS, and the relationship between the 2, then launches into a discussion of urgently needed research. Epidemiological, diagnostic, clinical presentation, prevention, and treatment studies are called for under this section heading, each sub-section providing objectives, justification, and specific research questions. Design examples for selected research studies constitute an annex following the main body of text. When planning for action on suggested research, the report acknowledges the need for resources, organizational structures, detailed plans and timetables, and collaborative arrangements. 7 areas in which WHO could provide assistance are offered, followed by discussion of strengthening tuberculosis control capacity in WHO, and at the country and local levels. Selection of research sites is considered at the close of the text.
[Unpublished] 1987. 12 p. (WHO/SPA/GLO/87.2)The usefulness of proposed screening programs for human immunodeficiency virus (HIV) infection must be weighed carefully against potential harmful effects. Because of complex social and ethical issues and the lack of any specific intervention against acquired immunodeficiency syndrome (AIDS), screening programs may be intrusive and divert resources from educational programs. 21 participants from 17 countries attended a special meeting in May 1987 convened by the WHO Special Program on AIDS to discuss criteria for HIV screening programs. There was general consensus among participants that readily accessible counseling and testing for antibody to HIV, provided on a voluntary basis, are more likely to result in behavior changes that reduce the spread of AIDS than are mandatory screening initiatives. There was also agreement that mandatory screening of targeted populations is less likely than a voluntary approach to reach effectively those persons whose behavior can be influenced to reduce the risk of infection. To facilitate awareness of the complexities inherent in mandatory screening of at risk populations such as drug abusers and prostitutes, this report includes a list of criteria that must be considered and resolved in the planning process. These criteria are: what is the rationale of the proposed program, what population is to be screened, what test method is to be used, where is the laboratory testing to be done, what is the intended disposition of data obtained from testing, what plan will be used for communicating results to the person tested, how is counseling to be accomplished, what is the social impact of screening, and what legal and ethical considerations are raised by the proposed screening program?