Via The Lancet: The Vancouver Consensus: antiretroviral medicines, medical evidence, and political will. The authors include Dr. Julio Montaner, the head of the BC Centre for Excellence in HIV/AIDS. Excerpt:
There is growing evidence that rapid expansion of coverage in access to antiretrovirals is not only desirable, but also possible. A series of ongoing implementation studies are already showing promising evidence that public health efforts can reach the UNAIDS 90/90/90 goals with high levels of testing, treatment, and adherence.
About 19 million people who live with HIV today do not yet know their status, so this evidence is especially important in pressing for a robust testing and counselling agenda if access to antiretrovirals for all is to be realised. Many people living with HIV are not reached by current models of care due to geography or social marginalisation, and so high-quality, community-based strategies for treatment and retention have to move from pilot to scale-up.
And ensuring human rights protections will be essential moving forward so that the decision to use antiretrovirals is an individual choice and that all people, irrespective of social or legal status, race, gender, or geography can access effective treatment and prevention. As the Vancouver Consensus also notes, “Knowing medicine cannot work in isolation and ARVs alone cannot end AIDS, a comprehensive response attentive to underserved groups is urgent.”
Medical evidence is unambiguous. At this point, further delays threaten not only millions of lives but also threaten a resurgence of this pandemic. But if we act rapidly, we can drive down HIV incidence, death, and long-term costs. Political will is needed to complete the work of what can be one of the most effective public health interventions in history.