Meeting reviews country adaptation of guidelines for HIV prevention and mother to child transmission of HIV

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Brazzaville, 15 February 2010 – Twenty five experts from WHO, the US President's Emergency Plan For AIDS Relief (PEPFAR) and the US Centers for Disease Control met in Brazzaville from 4-5 February to discuss how countries in the Africa could be assisted to review and adapt their antiretroviral therapy (ART) guidelines in line with the 2009 WHO recommendations on treatment of HIV infected children, adults and adolescents, as well as prevention of maternal to child transmission of HIV and infant feeding in the context of HIV.

The specific objectives of the planning meeting were to:

  • introduce the guidelines revisions and review their potential impact on the na-tional treatment, PMTCT and infant feeding programmes and health systems in the countries of the African region.
  • review the draft country adaptation guide.
  • evaluate and explore the results of feasibility studies recently conducted in Tanza-nia and Malawi.
  • develop a plan for introducing and supporting countries in the Region to use the new recommendations on treatment of HIV infected children, adults and adolescents; prevention of maternal to child transmission of HIV and infant feeding in the context of HIV.
  • explore and address how to best roll out and ensure linkages of ART, PMTCT, In-fant feeding, Paediatric HIV, TB, guidelines.

The meeting adopted detailed recommendations related to the stage at which stage HIV-infected persons including infected children, adults and adolescents and pregnant women should be placed on ART. Participants also adopted recommendations on infant feeding as they relate to HIV-infected mothers and HIV-exposed infants.

The key changes that are expected to result from adapting the revised 2009 WHO ART Guidelines in countries include: earlier diagnosis and treatment of HIV for a prolonged and healthier life; greater use of more patient-friendly treatment regimens; expanded laboratory testing to improve the quality of HIV treatment and care; placement of a larger group of HIV-positive pregnant women on ART for the benefit of both mother and the prevention HIV transmission to the child during pregnancy, and breastfeeding of HIV-exposed infants for a longer period.

According to a report on the meeting, the implications of the 2009 WHO guidelines are that countries will be treating significantly larger numbers of HIV positive patients. This means that people will live longer and more fulfilling lives. On the other hand, there are significant cost implications of the revision of the WHO ART Guidelines. For example, initiating ART earlier may also present adherence challenges and the increased pre-ART care and need for laboratory testing which are bound to challenge the weak health systems in the Region.

The meeting recommended that the WHO Regional Office for Africa should:

  • Establish an inter-divisional working group (ATM, DRH, DSD) to coordinate, monitor and evaluate the adaptation & implementation process
  • Prepare an integrated policy brief on the four guidelines for dissemination to the leader-ship of Ministries of Health in the Region
  • Develop briefing documents to be used for sensitization and dissemination of the new guidelines
  • Work with WHO-HQ and finalize the new guidelines and adaptation guides
  • Organize inter-country workshops to disseminate and identify best mechanisms for im-plementing the integrated guidelines
  • Support situation analysis in country and assist with tools for feasibility / costs
  • Conduct joint missions to provide guidance and technical assistance to countries
  • Use the pool of consultants, WHO regional collaborative centers, knowledge hubs and technical partners on HIV/AIDS to provide technical assistance for adaptation and implementation at country level

 

For more information, please contact:

Dr Rui Vaz, Tel : + 47- 241-39427
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Samuel T Ajibola, Tel: + 47 241 39378
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