E-drug: WHO Press Release on ARVs and the Essential Drugs List
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WHO takes major steps to make HIV treatment accessible:
Treatment Guidelines and AIDS Medicines List Announced by WHO
http://www.who.int/inf/en/pr-2002-28.html
In a decisive move to strengthen action against AIDS in developing
countries, the World Health Organization (WHO) has today
announced the first treatment guidelines for HIV/AIDS in poor
settings. Parallel to that, WHO has endorsed the inclusion of AIDS
medicines in its Essential Medicines List. The action is a
breakthrough in a comprehensive "prevention through care"
package that could contribute to dramatically wider access to
treatment over the coming years.
WHO estimates that nearly six million people living with HIV/AIDS
need access to care and support including antiretrovirals (ARVs).
Currently, fewer than five per cent of those who require treatment
in developing countries can access these medicines. WHO believes
that at least three million people needing care should be able to get
medicines by 2005 - a more than ten-fold increase.
WHO sees wider access to safe and practical treatment as an
important element of an overall strategy to fight HIV/AIDS. It
combines prevention, improved diagnostics and effective care so
that these elements mutually reinforce each other.
"The new treatment guidelines and the designation of ARVs as
essential are vital steps in the battle against the AIDS pandemic.
They should encourage both industrialized and developing country
governments to make HIV treatment more widely available," says
Gro Harlem Brundtland, Director-General of WHO.
The new guidelines propose a practical, standardized and simplified
combination of ARV therapy. They provide guidance on more
rational use of ARV treatments resulting in fewer side effects, less
resistance and better tolerance of the medicines. They ensure that
AIDS patients obtain appropriate combinations of medicines that
will make their lives longer and more productive. The guidelines will
also make it easier to train health workers and make ARVs simpler
to use.
A vital component of the WHO strategy to scale up access to care
and treatment in poor countries is the inclusion of ARVs on the
WHO Essential Medicines List. They include nevirapine and
zidovudine - previously listed for prevention of mother-to-child
transmission but now also recommended for treatment of HIV in
adults and children. The new medicines in the List are abacavir,
didanosine, efavirenz, indinavir, lamivudine, lopinavir, nelfinavir,
ritonavir (low-dose), saquinavir, and stavudine. When used
effectively in the recommended combinations, antiretrovirals
improve life expectancy and quality of life for people living with
HIV.
The decision to add these ARVs follows a strong recommendation
by the Expert Committee on the Use of Essential Medicines, a panel
of independent experts convened by WHO. It is based on a careful
analysis of current evidence of ARV efficacy in developing
countries, which shows that these medicines can be used
effectively and safely in poor settings. The Committee�s selections
allow for several multi-drug combinations, many of which are
becoming increasingly affordable in developing countries.
"The identification of ARVs as essential medicines and the
treatment protocol should help national governments and health
care institutions to select appropriate treatment for people with
AIDS." explains Professor Juan-Ramon Laporte, Chair of the Expert
Committee. "It will also help to train health professionals, to inform
patients, to monitor treatment outcomes, and to assist
reimbursement of such medicines by health insurance schemes."
The first Model List of Essential Medicines was released by WHO in
1977 and has since been updated every two years. It aims to
provide an example for countries to develop their own essential
medicines lists, according to their priority health needs. By the end
of 1999, 156 WHO Member States had official medicines lists, of
which 127 had been updated in the previous five years.
"The antiretroviral treatment guidelines developed by WHO will
greatly assist governments and national AIDS programmes in
providing people living with HIV/AIDS with greater access to these
life-saving medicines," said Dr Peter Piot, UNAIDS Executive
Director. "The long-sought inclusion of antiretrovirals in WHO�s
Essential Medicines List will encourage governments in hard-hit
countries to further expand the distribution of these vital drugs to
those who need them."
Since AIDS was reported over twenty years ago, over 20 million
people have died as a result of HIV infection. Current estimates
suggest that 40 million people worldwide are infected with HIV and
more than 90% of infected persons live in the developing world. In
2001, 5 million people worldwide became infected with HIV, and 3
million others died from HIV/AIDS-related causes.
Left untreated, HIV infection results in a period of 3 to 10 years or
more during which the infected person remains relatively healthy.
Once symptomatic disease or AIDS develops, without access to
antiretroviral treatment, death results within an average of two
years.
In high-income countries, an estimated 1.5 million people live with
HIV, many of them productively, due to pervasive antiretroviral
therapy. In the USA, the introduction of triple combination
antiretroviral therapy in 1996 led to a decline of 70% in deaths
attributable to HIV/AIDS.
TheGuidelines for Scaling Up Antiretroviral Therapy and the 2002
WHO Model List of Essential Drugs are available on WHO web site:
http://www.who.int/
For further information, journalists can contact:
Daniela Bagozzi
Communications, Heath Technology and Pharmaceuticals
WHO, Geneva.
tel. (+41 22) 791 4544, mobile (+41) 79 475 5490
e-mail bagozzid@who.int
or
Chris Powell
Family and Community Health
WHO, Geneva
tel (+41 22) 791 2888, mobile (+41) 79 217 3425
e-mail powellc@who.int
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