Early testing and access to drugs could slash number of new HIV cases – UN experts

26 November 2008

Universal and voluntary testing for HIV and early access to antiretroviral treatment could reduce new cases by 95 per cent within ten years, according to a new study carried out by a group of United Nations experts and published in the medical journal, The Lancet, today.

The study involved a mathematical model developed by a group of specialists in the UN World Health Organization (WHO) to stimulate debate and further research on the issue.

The authors also report that universal voluntary testing followed by immediate antiretroviral treatment could have additional public health benefits including reducing the incidence of tuberculosis and the transmission of HIV from mother to child.

In addition, the model suggests that there could be a significant reduction of HIV-related morbidity and mortality in resource limited countries with generalized HIV epidemics.

The experts stress the theoretical nature of the exercise based on data and raise a number of concerns regarding feasibility, including the protection of individual rights, drug resistance, toxicity and financing challenges.

In a press release issued in Geneva, WHO notes that the paper does not signal a change in its guidance. “WHO-recommended preventive interventions need to be maintained and expanded,” states the agency. This includes male circumcision, partner reduction, correct and consistent use of condoms, and interventions targeting most-at-risk populations, also known as “combination prevention.”

The current WHO policy on treatment involves voluntary testing and clinical and/or immunological evaluation to determine eligibility for treatment with antiretrovirals.

WHO will convene a meeting early next year bringing together ethicists, donors, human rights advocates, clinicians, prevention experts and AIDS programme managers to discuss this and other issues related to the wider use of antiretroviral therapy for HIV prevention.

The publication of the study comes just days ahead of the global commemoration of World AIDS Day, which is observed annually on 1 December.


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