Global roll-out of HIV treatment

Access to HIV treatment globally, and especially in countries hardest hit by HIV, has increased dramatically over the last decade. A public-health approach that optimizes treatment and monitoring protocols to reach the widest number of patients with the minimum amount of resources, without compromising quality of care, has been adopted. At the end of 2011 an estimated 8 million people globally were taking antiretroviral treatment, representing great progress. However, just over half (54%) of individuals from low- and middle-income countries who were eligible for treatment received it and antiretroviral coverage varies greatly by country. Knowledge of HIV status remains suboptimal and, once linked into care, the losses of patients from HIV services along the cascade of care are alarming. Improving access to HIV testing, enhancing timely linkage into care of individuals who know they are HIV-infected and increasing the availability of treatment (which is effective, well tolerated and accessible) to patients everywhere are the first priorities. More drug options, better diagnostics and patient-centred delivery of services are much needed. Although treatment continues to be out of reach for many, the achievements to date should provide the necessary motivation for continued efforts for future success.