Journal Article

From policy to action: how to operationalize the treatment for all agenda

Lee, Stephen, Montaner, Julio, Cohn, Jennifer, Connor, Catherine, Celletti, Francesca, Giphart, Anja

2016

Overview

Treatment for all The TfA approach is not new. Since 2003, the Government of British Columbia has progressively expanded access to ART. [...]many women still presented late, with HIV Stage III or IV disease. Differentiated care packages to reach Treatment for All TfA will require a comprehensive package of differentiated testing, care and treatment fit to different contexts and needs of different patient populations, including children and adolescents. [...]we must support decentralization and simplification at the individual and programmatic level for stable, suppressed individuals and for well‐functioning programmes. Communities, including populations living with HIV, service providers and national and global policymakers, will need to Accept that excellent care can be algorithmic and performed by healthcare workers with limited training Allow stable, undetectable patients in treatment to manage their own care by accessing community‐based care and reducing clinic visits Assess and pilot innovative tools and models of care Exchange CD4 monitoring for viral load monitoring Normalize and integrate ART through service provider education on the benefits of TfA and multi‐disease programming that includes ART initiation and support alongside other primary health interventions such as hypertension screening or blood glucose testing Support operational research on various packages of differentiated care to better define the impact, feasibility and cost‐effectiveness of various models and expand the evidence supporting this promising model of care Provide appropriate investment in such models of care to reach TfA To virtually end AIDS by 2030, a collective investment has to take place now, using our most effective tools, policies, strategies and resources to operationalize TfA.

• Publisher: International AIDS Society,John Wiley & Sons, Inc,Wiley
• Subject: Acquired immune deficiency syndrome / AIDS / Analysis / Antiretroviral drugs / Antiviral agents / Care and treatment / Cellular telephones / Clinical trials / Cohort analysis / Community support / Cost reduction / Counseling / Dosage and administration / Drug resistance / Drug therapy / Evidence-based medicine / Health aspects / Health policy / Health promotion / Highly active antiretroviral therapy / HIV / HIV infection / Human immunodeficiency virus / Hypertension / Infections / Management / Medical policy / Medical tests / Meta-analysis / Methods / Mortality / Pathogenesis / Pediatrics / Prevention / Retention / Risk factors / Systematic review / Viewpoint / Womens health