Recent scientific evidence has confirmed two paradigm-changing clinical and public health realities with regard to the global HIV/AIDS epidemic. First, that placing HIV-infected individuals on antiretroviral therapy (ART) as early as practically possible increases the probability of healthy life and thus enhances their economic and social contributions to their communities and countries. Second, that placing HIV-infected individuals on antiretroviral therapy greatly reduces the risk that they will transmit the virus.
In May 2011, the U.S. National Institutes of Health released findings from a landmark clinical trial, HPTN 052, showing that early initiation of ART by HIV-infected individuals reduced the chance of death and severe illness by 41% and reduced transmission of HIV to uninfected sexual partners by 96%. The trial was named Breakthrough of the Year for 2011 by Science, because of the potential of mass testing and treatment to greatly reduce HIV-related morbidity and mortality and the number of new infections occurring each year.
These findings suggest a new approach to the fight against HIV/AIDS, increasingly referred to as Treatment as Prevention (TasP). While further trials are getting underway on six continents to fully explore the epidemiological and operational implications of large-scale implementation of TasP, there is an urgent need for thought leaders and policy makers to debate the implications of these findings. How can we move from a world of limited antiretroviral therapy and knowledge of HIV status to a world of widespread HIV testing and treatment? What are the political and operational hurdles to be overcome in this journey? And most importantly, how can the massive scale-up in testing and treatment required over the next few years be financed?
This small and invitation-only meeting in Geneva brought together a select group of leaders from international policy organizations, international financing organizations and the scientific community, as well as programmatic and political leadership from the most affected countries, to share their perspectives and experience and to chart a course for further collaboration and action.
This high level meeting was convened to discuss cutting edge scientific developments in HIV/AIDS treatment and prevention, and the implications for programme delivery and funding.
Treatment as Prevention (TasP), a new approach to HIV/AIDS control, was the key topic of discussion. Early treatment of HIV-infected individuals, with anti-retroviral therapy (ART), saves lives and reduces HIV transmission from infected to non-infected persons. More specifically, a recent clinical trial (HPTN 052) demonstrated that early ART treatment of HIV-infected people reduced death and severe illness by 41%, and also achieved a 96% reduction in virus transmission.
This evidence raises the prospect of a strategic and large scale use of ART, in mass population ‘test and treat’ efforts, for clinical and prevention benefits.