March 27, 2009
An international delegation from AIDS Healthcare Foundation (AHF) met today with officials from the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to call for action and partnership to vastly increase global access to HIV/AIDS treatment, testing and condoms. The delegation, led by new AHF Chief of Global Affairs Jorge Saavedra, M.D. (previously the General Director of CENSIDA, Mexico's National Center for the Prevention and Control of HIV/AIDS) also presented letters signed by hundreds of advocates from around the globe calling for a change in guidelines to raise the antiretroviral therapy (ART) initiation threshold from a CD4+ T cell count of <200 cells/mm3 to <350 and to recommend full-course ART for all expecting and breastfeeding mothers worldwide.
In addition to Dr. Saavedra, the AHF delegation included Terri Ford, AHF's Senior Director of Global Policy; Chinkholal Thangsing, M.D., AHF's Asia Pacific Bureau Chief; Zoya Shabarova, AHF's Bureau Advisor for Eastern Europe and Laurent Fischer, M.D., Chair of AHF's Board of Directors. The AHF team met with Kevin De Cock, M.D., Director of the WHO HIV/AIDS Department, Ying-Ru Lo, M.D., Coordinator, Prevention in the Health Sector, Department of HIV/AIDS and F. Amolo Okero, Technical Officer, Department of HIV/AIDS. Present at the UNAIDS meeting were Barbara de Zalduondo, Chief of Programmatic Priorities Support, Evidence, Monitoring and Policy Department; Michael Bartos, Chief, Prevention, Care and Support and Karusa Kiragu, Senior Prevention Advisor.
"AHF appreciates this opportunity to meet with representatives from WHO and UNAIDS and we are pleased that our concerns regarding the need for updated treatment guidelines and new HIV testing and prevention models are being heard," said Dr. Saavedra. "It was especially gratifying to hear from WHO officials Dr. De Cock and Dr. Lo that the letters signed by AHF and hundreds of supporters advocating early treatment for all and full-course antiretroviral therapy for pregnant women had been read and considered. At today's meeting, we were told that WHO is in agreement with the evidence-based arguments presented in the letters and that new, updated WHO guidelines are expected to be released in the fall."
Dr. Saavedra added: "As AHF moves forward with worldwide efforts to expand access to treatment, rapidly increase HIV testing to identify the millions of people who are estimated to be unaware of their HIV-positive status and launch a massive condom distribution campaign, we look forward to partnering with WHO and UNAIDS who, during these meetings, both expressed support for these endeavors."
A primary purpose of today's meetings was to initiate a paradigm shift in HIV/AIDS treatment, testing and prevention models. In addition to advocating earlier treatment for all and an end to harmful short-course therapy for pregnant women, AHF representatives discussed "lessons learned" from the success of its recent One Million Tests -- World AIDS Day 2008 campaign, which leveraged innovative testing models to mobilize 1,000 nonprofit, government and private-industry partners from 72 countries to provide 1,602,737 free HIV tests. The AHF delegation also stressed the importance of restoring the condom's critical place at the front-line of effective global AIDS prevention strategies. To this end, AHF is launching the LOVE Condoms Campaign, a global effort to scale-up the distribution of condoms. The organization is urging the support of WHO and UNAIDS in this lifesaving endeavor.
"We would like to thank WHO and UNAIDS for this morning's productive dialogue on ways to increase access to HIV/AIDS treatment, testing and prevention," said Ms. Ford. "We were especially pleased with the agencies' positive response to AHF's One Million Tests -- World AIDS Day 2008 campaign and the expression of their willingness to work with on our upcoming 2009 Ten Million Tests campaign, as we prepare to mobilize hundreds of thousands of people to participate across the globe. It was also heartening to receive their support for the LOVE Condoms Campaign. We look forward to partnering with WHO and UNAIDS to advance our common goals, including making condom distribution a priority among high-risk groups, as well as the general population."
The One Million Tests -- World AIDS Day 2008 campaign successfully mobilized over 1,000 NGOs, local and national governments, international relief agencies, faith-based organizations, civil and industry partners from 72 countries to provide 1,602,737 free HIV tests. To achieve these remarkable results, the campaign leveraged the training of partner organizations, innovative testing strategies including a variety of rapid testing modalities, streamlined group pre-test counseling, community-based on-site testing and accessible treatment referrals. Internet technologies were utilized to support uniform data reporting. A campaign website with online access to down-loadable campaign social marketing materials provided valuable support to AHF's partners. More information about the 2008 campaign, as well as the upcoming 2009 Ten Million Tests Campaign can be found at www.onemilliontests.org.
Condom availability and distribution was another key topic of today's meetings which included discussion of AHF's upcoming worldwide LOVE Condoms Campaign, the goal of which is to scale-up global support for renewed condom usage by distributing ten million WHO-approved, high-quality condoms free of charge to any individual, non-governmental or government agency that makes a commitment to support the campaign's aim of achieving 100% access to free condoms worldwide. AHF believes that to achieve global AIDS control an aggressive re-integration of condoms is critical and that it is vital that world health agencies such as WHO and UNAIDS support such efforts. More information about the campaign can be found at www.getfreecondoms.org.
Each of the letters presented to WHO and UNAIDS by AHF were signed by hundreds of supporters including HIV/AIDS medical providers and advocates from around the world. Urging a change in the guidelines for antiretroviral treatment for HIV-infected pregnant and breastfeeding women, the letter addressed to Dr. Margaret Chan, Director General of WHO states: "We the undersigned HIV/AIDS medical care providers and advocates are concerned about the use and recommendation of short-course therapy (such as single-dose Nevirapine and/or Zidovudine) for expecting and breastfeeding mothers considered ineligible for full-course Highly Active Antiretroviral Therapy (HAART) by WHO's current guidelines. Short-course treatment has been proven to be less effective at preventing HIV transmission and less safe for both mother and child than a full HAART regimen. Therefore, we call for World Health Organization (WHO) treatment guidelines to be changed to recommend full-course antiretroviral treatment for all expecting and breastfeeding mothers worldwide." The full text of the letter and a complete list of supporters can be viewed here.
Regarding the revision of guidelines for CD4+ T cell treatment initiation threshold, AHF's sign-on letter, addressed to Dr. Chan and Michel Sidibe UNAIDS' Executive Director, states: "In light of scientific evidence correlating earlier treatment with vastly improved health outcomes and lower death rates, we the undersigned HIV/AIDS medical care providers and advocates call on the World Health Organization (WHO) and UNAIDS to immediately revise its current guidelines to raise the recommended treatment initiation threshold from a CD4+ T cell count of <200 cells/mm3 to <350." The full text and complete list of supporters can be viewed here.