Scaling up antiretroviral therapy in resource-limited settings: treatment guidelines for a public health approach. Rev. ed.
Currently, fewer than 5% of people in developing countries who need ART can access the medicines in question. WHO believes that at least 3 million people needing care should be able to get the medicines by 2005. This represents almost a tenfold increase. These treatment guidelines are intended to support and facilitate the proper management and scale-up of ART in the years to come by proposing a public health approach to achieve the goals. The key tenets of this approach are as follows. 1) Scaling-up of antiretroviral treatment programmes with a view to universal access, i.e. all persons requiring treatment as indicated by medical criteria should have access to it. 2) Standardization and simplification of ARV regimens so as to support the efficient implementation of treatment programmes in resource-limited settings. 3) Ensuring that ARV treatment programmes are based on scientific evidence in order to avoid the use of substandard protocols that compromise the outcomes of individual patients and create a potential for the emergence of drug-resistant virus. However, it is also important to consider the realities with respect to the availability of human resources, health system infrastructures and socioeconomic contexts so that clear and realistic recommendations can be made. (excerpt)