WHO Releases Guidelines For Developing World Treatment of HIV/AIDS

UN Wire
2002-04-29

According to the WHO, ARVs should now be considered essential drugs in the developing world. Read on for more information about this important development.

The following appears with permission from UN Wire, Copyright, National Journal Group, April 23, 2002:

The World Health Organization yesterday announced its first treatment guidelines for HIV/AIDS in poor nations and endorsed the inclusion of AIDS treatments in its essential medicines list.

The guidelines focus on a "more rational use" of anti-retrovirals (ARVs) and other medicines, to result in fewer side effects, less resistance and better tolerance to the treatments, the WHO said. They also seek to ensure that AIDS patients obtain appropriate combinations of medicines in order to offer those afflicted with disease longer and more productive lives.

"The new treatment guidelines and the designation of ARVs as essential are vital steps in the battle against the AIDS pandemic," said WHO Director General Gro Harlem Brundtland. "They should encourage both industrialized and developing country governments to make HIV treatment more widely available."

The additions to the essential medicines list include 10 ARVs: abacavir, didanosine, efavirenz, indinavir, lamivudine, lopinavir, nelfinavir, ritonavir (low-dose), saquinavir and stavudine. In addition to identifying ARVs as essential, their placement on the list "will also help to train health professionals, to inform patients, to monitor treatment outcomes and to assist reimbursement of such medicines by health insurance schemes," according to Juan-Ramon Laporte, chairman of the WHO Expert Committee on the Use of Essential Medicines (WHO release, April 22).

The WHO guidelines will not ensure that those infected with HIV in poor countries receive these therapies. The guidelines and essential medicines list are advisory only. But according to the Washington Post, they may effectively end the debate about whether ARVs are safe to use.

Of the 38 million people infected with HIV in developing countries, only approximately 250,000 people are on ARVs, 100,000 of them in Brazil, which has guaranteed access to the treatment. The WHO hopes that by 2005, 3 million people in the developing world will be on combination ARV therapy, usually with three drugs.

"If you look at where we were two years ago and where we are today, it's really coming together," said Jonathan Quick, director of the WHO's essential medicines program. "I think we really are at the early phase of takeoff" (David Brown, Washington Post, April 23).

Carmen Perez, pharmaceutical director for the Doctors Without Borders campaign to make drugs more affordable, called the WHO guidelines "a very good victory," which "show[s] that treatment can be done."

"There are 40 million infected people out there," she said. "There are no excuses. We're already late" (Donald McNeil, New York Times, April 23).