2.2 Setting the Scene - Treatment

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Transcript 2.2 Setting the Scene - Treatment

Dr Susan Zimba –Tembo
Professional Officer – WHO
1st March 2013, Crest Golf Hotel
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HIV Prevalence 14.3%
PLHIV 1.1 million
Goal to expand the national response to
mitigate the effects of HIV/AIDS and
opportunistic infections, by improving access
to quality care, treatment and support
services
Programme based on WHO/UNAIDS treatment
2.0 principles
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Five pillars
o I – Optimize drug regimens
o II – Promote diagnostics using point of care and
other simplified technologies
o III – Reduce costs
o IV – Adapt delivery systems
o V – Mobilize communities, protect human rights
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ART introduced in public sector in 2002
Abolished user fees in 2004
Rapid scale up 143 in 2003 to 344,000
Coupled with increase in ART sites from 3 to
500
Decentralised service delivery with task shifting
Making progress towards universal access
76.5% (2011)
Millions
15.
15
15
million
0
12.
12.5
5
10
10.
0
7.5
7.5
8
million
5
5.0
2.5
2.5
0.0
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
900,000
780,251
800,000
683,822
700,000
576,138
600,000
500,000
431,364
400,000
455,522
Actual
Estimates
344,407
283,863
300,000
219,576
200,000
100,000
164,435
51,764
78,683
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
90
80
76.5
74
70
80
68.4
60
50
40
30
23.5
20
10
4
0
1996
2002
2005
2008
2010
Proportion Of Population with advanced HIV infection with access to ARVs
2011
2015
Target
Millions
9
8
7
6
5
People on ART
New HIV infections
AIDS-related deaths
4
3
2
1
0
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
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Deaths due to AIDS were averted
approximately 50, 000 lives saved in 2011
Total death rate in adults declined from 1.02
percent in 2000 to 1.31 percent in 2011
Total death rate among infants declined from
19 percent in 1997 to 5.3 percent in 2011
For children aged 1-4 years the decline was
from 17.1 percent in 1999 to 8.8 percent.
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Geographical and age disparities in ART coverage
Early infant diagnosis
Growing need especially with policy change- test
and treat
Adherence and retention in care including
emerging drug resistance
Point of care diagnostic services
Human resource
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Universal access can be reached
Further scale-up must address disparities and
inequities
With new evidence and new policies, the number
of persons eligible for ART will increase
Forward-looking policies, more effective and
innovative approaches, together with further
investments
ARVs for treatment and prevention are a
powerful tool towards ending the HIV epidemic