An estimated forty million people carry the human immunodeficiency virus (HIV), and five million more become newly infected annually. In recent years, many HIV-infected patients in wealthy nations have enjoyed significantly longer, good-quality lives as a result of antiretroviral therapy (ART). However, most infected individuals live in the poorest regions of the world, where ART is virtually nonexistent. The consequent death toll in these regions--especially sub-Saharan Africa--is begetting economic and social collapse.
To inform the multiple efforts underway to deploy antiretroviral drugs in resource-poor settings, the Institute of Medicine committee was asked to conduct an independent review and assessment of rapid scale-up ART programs. It was also asked to identify the components of effective implementation programs.
At the heart of the committee's report lie five imperatives:
Table of Contents
|2 Opportunities and Challenges||32-61|
|3 Lessons Learned||62-88|
|4 Principles of Scale-Up||89-133|
|5 Managing Scale-Up of Antiretroviral Therapy||134-175|
|6 The Path Forward||176-198|
|Appendix A: Information Gathering Workshop Agenda||199-206|
|Appendix B: Primer on Humanimmunodeficiency Virus, Acquired Immune Deficiency Syndrome and Antiretroviral Therapy||207-219|
|Appendix C: Scaling Up Antiretroviral Therapy in Resource-Limited Settings: Treatment Guidelines for a Public Health Approach||220-278|
|Appendix D: Human Ethical Issues Arising in ARV Scale-Up in Resource Constrained Settings||279-291|
|Appendix E: Human Resource Requirements for Scaling Up Antiretroviral Therapy in Low-Resource Countries||292-308|
|Appendix F: Glossary and Acronyms||309-317|
|Appendix G: Committee and Staff Biographies||318-326|
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