WHO early HIV treatment guidelines: AHF applauds, Thailand balks

In Global, Thailand by AHF


The World Health Organization (WHO) formally announced Sunday its recommendation to initiate antiretroviral treatment (ART) at a raised CD4 count of 500 – while AIDS Healthcare Foundation (AHF) and Doctors Without Borders (MSF) laud the organization for this decision that could save millions, the Thai government is hesitant to adopt the guideline due to country health budget concerns


WHO doc shot of four.png

AHF Representatives meet with WHO’s Dr. Gottfried Hirnschall: (from left)
Anna Zacowicz, Advocacy and Partnership Manager for AHF Europe; Dr.
Penninah Iutung-Amor
, AHF Africa Bureau Chief; Dr. Chhim Sarath, AHF
Asia Bureau Chief; and Dr. Damir Bikmukhametov, AHF Europe’s
Medical Director


KUALA LUMPUR, MALAYSIA (July 1, 2013) – At the opening day of the International AIDS Society 2013 Conference in the Malaysian capital of Kuala Lumpur, representative from the World Health Organization (WHO) formally announced new guidelines for starting antiretroviral treatment (ART) for people living with HIV. The new recommendation regards the patient’s CD4 cell count, which indicates the strength of a person’s immune system – where previous WHO guidelines recommended ART be initiated when a patient’s CD4 count falls below 350, statistics indicating the benefits of earlier treatment led the global health group to raise the CD4 count needed for ART to 500.


“These guidelines represent another leap ahead in a trend of ever-higher goal and ever-greater achievements,” WHO Director-general Dr. Margaret Chan said.


“We at AIDS Healthcare Foundation applaud WHO for moving to treatment initiation at 500 CD4 count,” AHF Chief of Global Advocacy and Policy Terri Ford said at Sunday’s conference in Kuala Lumpur. “If fully implemented, this will save millions of lives – but only if fully implemented. We now all know that treatment is prevention and a critical component in the global control of AIDS.”


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Ford went on to stress the importance of rapid and large-scale HIV testing to identify people in need of treatment as early as possible, advocating for rapid testing with same-day results as a global standard. Also at the Kuala Lumpur conference, Dr. Gottfried Hirnschall, Director of the WHO HIV Department, acknowledge and thanked AHF for the massive HIV testing efforts held by the international Foundation, which he said were instrumental in implementing the new guidelines at a country level.


However, despite clinical evidence that earlier treatment reduces both mortality rates and the rate of spreading the virus, the Thai government expressed hesitation to adopt the new WHO guidelines – Public Health Minister Pradit Sintawanarong told the Bangkok Post that earlier ART implementation for Thai people living with HIV would place a heavy new burden on the national health care budget, and he said the Public Health Ministry would have to take time to study the new guidelines in detail before acting on them.


“We are surprised and disappointed that Thailand, a country that
has shown such leadership in the cost-effective use of generic ART medications, would balk at these new life-saving recommendations.
The fact that Thailand is forced into this difficult financial predicament
is also, however, sadly indicative of the lack of funding for AIDS treatment from leading global economies.”

Michael Weinstein, President of AHF


When WHO raised CD4 count for ART to 350 from 200, it took the Thai Ministry of Public Health about four years to implement the new guidelines, according to the Post article. The National Health Security Office’s Director of Fund Management for HIV/AIDS and Tuberculosis, Sorakij Bhakeecheep, told the Post that the country’s current priority is “to extend the lives of those with CD4 100-350” before those with a CD4 count of 500.


“Early HIV treatment makes a major difference,” said Unni Karunakara, President of Doctors Without Borders (MSF), a leading international medical organization that backs the new WHO guidelines. “It keeps people healthier and also helps prevent the virus from spreading, but we need political and financial support to see these recommendations rolled out rapidly.”


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(from left) AHF Global Ambassador Dr. Jorge Saavedra; AHF Chief
of Global Advocacy and Policy Terri Ford; Director of WHO HIV
Department Dr. Gottfried HirnschallAnna Zacowicz, Advocacy
and Partnership Manager for AHF Europe; Dr. Penninah Iutung-Amor,
AHF Africa Bureau Chief; Dr. Chhim Sarath, AHF Asia Bureau Chief; and
Dr. Damir Bikmukhametov, AHF Europe’s Medical Director

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