In the 2013 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection (2013 Guidelines), the World Health Organization (WHO) takes a welcomed step in recommending that people living with HIV everywhere be offered a standard of antiretroviral treatment and care that is closer to what is available in resource-rich countries.
The 2013 Guidelines say much more than just ‘start’ earlier (i.e. at CD4 cell counts of or below 500 cells/mm3). They emphasize that the guidelines
should be implemented based on core human rights, health equity and ethical principles. Priority should be given to ensuring antiretroviral therapy (ART) for the people who are most ill and those already receiving treatment, while also working towards implementing expanded eligibility criteria and offering a higher standard of care than most people living in resource-limited settings are currently receiving.
However, the 2013 Guidelines success depends upon the community and civil society as advocates involved in critical policy decisions, as these recommendations are adapted to the local setting, to make sure that they are implemented from a human rights perspective, making certain that the highest quality treatment is made available, with services tailored appropriately to different communities with different needs. They also depend on communities and civil society to serve as mobilizers, educators, service providers and researchers of their needs and perceptions.
But first, we must understand what the guidelines do – and do not – say, why the recommendations are being made, and how we, as people and communities affected, and as civil society, can engage to make sure the results we want get delivered. Thus, the Global Network of People Living with HIV (GNP+), the International HIV/AIDS Alliance and STOP AIDS NOW! have formed a partnership to develop the Community Guide on ART for Treatment and Prevention that offers some answers, guidance, checklists and raises questions not addressed by the 2013 Guidelines. An Advisory Group has been formed consisting of a wide range of community and civil society partners to support the process.
This attached briefing paper (Community ART briefing paper-V7 (FINAL)) is part of this process. It summarizes some of the new 2013 Guidelines’ recommendations and highlights related key issues from a community and civil society perspective.
[This briefing paper is based on something I wrote at the start of the IAS meeting and introduces what I’ve been working on the last six weeks — which I hope to complete this evening! Hold thumbs.]