%0 Journal Article
%T When to start antiretroviral therapy in resource-limited settings: a human rights analysis
%A Nathan Ford
%A Alexandra Calmy
%A Samia Hurst
%J BMC International Health and Human Rights
%D 2010
%I BioMed Central
%R 10.1186/1472-698x-10-6
%X According to our analysis, a policy of earlier ART initiation would better serve both public health and human rights objectives. We highlight a number of policy approaches that could be taken to help meet this aim, including increased international financial support, alternative models of care, and policies to secure the most affordable sources of appropriate antiretroviral drugs.Widespread implementation of earlier ART initiation is challenging in resource-limited settings. Nevertheless, rationing of essential medicines is a restriction of human rights, and the principle of least restriction serves to focus attention on alternative measures such as adapting health service models to increase capacity, decreasing costs, and seeking additional international funding. Progressive realisation using well-defined steps will be necessary to allow for a phased implementation as part of a framework of short-term targets towards nationwide policy adoption, and will require international technical and financial support.Highly active antiretroviral therapy (ART) has transformed HIV/AIDS from a death sentence into a manageable, chronic disease. Today, an adult 20 years of age diagnosed with HIV/AIDS in the developed world can expect to live at least 23 years [1,2]. In the developing world, fewer therapeutic options are available for patients; nevertheless current treatment approaches are effective at reducing mortality, with studies demonstrating similar survival outcomes compared to western countries, at least in the short term [3].Among the different strategies for improving long-term survival for people with HIV/AIDS in resource-limited settings, the question of when to start ART is gaining increasing attention. Studies from developed and developing country settings conclude that early initiation results in substantial gains in survival and reduced incidence of opportunistic infections, in particular tuberculosis (TB). However, a number of concerns have been put forward agains
%U http://www.biomedcentral.com/1472-698X/10/6