Reaching global HIV/AIDS goals: What got us here, won't get us there
Publication Date
November 07, 2017
Wafaa M. El Sadr, Katherine Harripersaud & Miriam Rabkin
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{"title"=>"Reaching global HIV/AIDS goals: What got us here, won't get us there", "type"=>"generic", "authors"=>[{"first_name"=>"Wafaa M.", "last_name"=>"El-Sadr", "scopus_author_id"=>"57196059891"}, {"first_name"=>"Katherine", "last_name"=>"Harripersaud", "scopus_author_id"=>"55611467300"}, {"first_name"=>"Miriam", "last_name"=>"Rabkin", "scopus_author_id"=>"8567747500"}], "year"=>2017, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491676", "scopus"=>"2-s2.0-85033557058", "sgr"=>"85033557058", "pui"=>"619520639", "isbn"=>"1111111111", "pmid"=>"29112691", "doi"=>"10.1371/journal.pmed.1002421"}, "id"=>"d856334f-ec96-309b-88b1-a2eebbf703e7", "abstract"=>"Much accomplished, but much more needed A decade ago, today's progress towards confronting the global HIV epidemic would have been unimaginable. A remarkable global mobilization of resources through the United States Presi-dent's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund for AIDS, Tuberculosis and Malaria, combined with the commitment of affected countries and communities, has enabled 19.5 million persons living with HIV (PLHIV) to access life-saving antiretroviral ther-apy (ART) [1]. This has resulted in decreasing HIV-related morbidity and mortality and con-tributed to a significant decline in the number of new infections [1]. Despite earlier concerns about the feasibility of scaling up HIV services in resource-limited settings, the majority of PLHIV accessing ART are in sub-Saharan Africa, where many coun-tries have austere health systems characterized by scarce healthcare providers and weak labora-tory, infrastructure, drug procurement, monitoring, and governance systems [2]. One of the critical enablers of this achievement was the adoption of the public health approach to HIV service delivery [2]. This strategy used simple evidence-based algorithms for HIV testing, pre-vention, and treatment; employed a single first-line antiretroviral regimen, standardized labo-ratory tests, and testing schedules; and involved streamlined data monitoring systems [3]. The simplicity and consistency of this approach enabled HIV services to be provided by nonphysi-cian clinicians and facilitated the establishment of simplified laboratory and medication pro-curement systems, enabling the successful scale-up of treatment [3]. By facilitating the successful scale-up of HIV services, the public health approach is arguably \" what got us here, \" to a context in which more than half of all PLHIV are accessing treatment [1]. However, in order to reach ambitious global targets and achieve epidemic control, much more must be done—and swiftly. Not only must the number of PLHIV accessing ART increase substantially to reach 30 million people by 2020, but the quality of HIV services must be enhanced and effective primary prevention interventions must be brought to scale [1]. Chal-lenges include reaching diverse patient populations, retaining them in either treatment or pre-vention programs, supporting adherence to ART and prevention methods, and addressing long wait times and health facility crowding, a problem for both recipients of care and health work-ers. In addition, concern over the plateauing of global resources highlights the vital importance of efficiency and cost-effectiveness as a possible way to address this enormous challenge [1].", "link"=>"", "reader_count"=>14, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>2, "Student > Master"=>4, "Other"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>2, "Student > Master"=>4, "Other"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Nursing and Health Professions"=>2, "Agricultural and Biological Sciences"=>1, "Medicine and Dentistry"=>4, "Business, Management and Accounting"=>1, "Social Sciences"=>4}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>4}, "Social Sciences"=>{"Social Sciences"=>4}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>2}}, "group_count"=>2}

Scopus | Further Information

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