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Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach

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Geneva, WHO, 2016

With this update of the consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, WHO, for the first time, recommends that all people living with HIV be provided with antiretroviral therapy (ART). This will bring us one step closer to achieving universal access to HIV treatment and care and ending AIDS as a public health threat. These guidelines also make service delivery recommendations on how we can expand
coverage of HIV treatment to reach the 37 million people living with HIV. Key recommendations aim to improve the quality of HIV treatment and bring us closer to the universal health coverage ideals of integrated services, community-centred and community-led health care approaches, and shared responsibility for effective programme delivery.

With its “treat-all” recommendation, WHO removes all limitations on eligibility for ART among people living with HIV; all populations and age groups are now eligible for treatment, including pregnant women and children. The same once-per-day combination pill is now recommended for all adults living with HIV, including those with tuberculosis, hepatitis, and other co-infections. The guidelines are ambitious in their expected impact, and yet simplified in their approach, and firmly rooted in evidence. They take advantage of recent findings from clinical trials confirming that the early use of ART keeps people living with HIV alive and healthier and reduces the risk of transmitting the virus to their sexual and drug-sharing partners. Earlier treatment has the further advantage of simplifying the operational demands on programmes.

Additional recommendations in the guidelines aim to help programmes deliver services closer to people’s homes; expedite reporting of test results; integrate HIV treatment more closely with antenatal, tuberculosis, drug dependence and other services; and use a wider range of health workers to administer treatment and follow-up care.

The new guidelines support evidence-based interventions that can improve efficiency and effectiveness – so that more can be achieved with the resources at hand. At the same time, implementation of the guidelines will require increased investment from countries and shared responsibility. Implementing these guidelines fully will have an unprecedented impact on preventing people from becoming newly infected and reducing the number of people dying from HIV-related causes over the coming years.