The World Health Organization has revised its HIV guidelines to recommend that anyone who tests positive for the virus should be treated immediately.
The WHO had previously said doctors should wait to treat some people with HIV until their immune systems suggested they were getting sick. The WHO said the new recommendations are based on recent trials that have found early treatment “keeps people with HIV alive, healthier and reduces the risk of transmitting the virus.”
The Associated Press reported that the new guidance means that all 37 million people with HIV globally should be offered immediate treatment, “a prospect that may be unrealistic in poor countries, where many patients are still unable to get medicines.” Last year, only about 15 million people with HIV were being treated.
Experts welcomed the new guidelines but warned that fulfilling them would require a substantial cash injection and an overhaul of current strategies. One expert said that HIV treatment would have to move out of clinics and into the communities where people live.
The WHO and UNAIDS estimated that implementing the new guidelines could avert 21 million AIDS deaths and prevent 28 million new infections by 2030.
Global Fund executive director Mark Dybul told the BBC that “the recommendations are critically important to moving us towards the fast-track treatment and prevention goals. We must embrace the ambition if we are going to end HIV as a public health threat.”
Médecins Sans Frontières told Reuters that the WHO's “treat-all” plan will prevent many HIV-positive people in poorer countries from falling through the treatment net. MSF said its experience showed that a third of people who were diagnosed with HIV, but not eligible to start treatment, never returned to the clinic. MSF warned, however, making the new recommendation a reality would require dramatically increased financial support from donors and governments.
See also the GFO article on the Vancouver Consensus statement.