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The World Health Organization has revised its guidelines to say that every person infected with HIV should now be given powerful anti-AIDS drugs. But many countries in Africa have struggled to meet previous less-ambitious WHO treatment targets.

Transcript

ROBERT SIEGEL, HOST:

New guidelines from the World Health Organization call for a change in treating HIV, but the recommendations may be difficult to meet. The WHO wants anyone who’s infected with HIV to be given powerful anti-AIDS drugs as soon after diagnosis as possible. And that’s the change – getting the drugs to people earlier. NPR’s Jason Beaubien reports that means millions more people living with HIV should be placed on treatment.

JASON BEAUBIEN, BYLINE: South Africa has more than 6 million people infected with HIV. It also has one of the best programs on the continent to get people onto lifesaving anti-retroviral drug treatment. Most South Africans with later stages of HIV-AIDS are now getting treatment – roughly 3 million of them.

FRANCOIS VENTER: If we do move to this WHO’s recommendations, we’re going to have to double the people that we put onto anti-retrovirals, so that’s a big ask.

BEAUBIEN: Dr. Francois Venter has been treating AIDS patients in Johannesburg since the early days of the epidemic. He also runs the Wits Institute for Sexual and Reproductive Health. Venter calls himself a grudging supporter of these new WHO treatment targets mainly because he’s seen that getting large numbers of HIV-positive people onto treatment in South Africa has helped slow the spread of the disease.

VENTER: What’s interesting, I think, is that we have some preliminary data from the rural areas of South Africa showing quite a dramatic impact into its prevention.

BEAUBIEN: That data links even a modest increase in HIV drug treatment rates with a significant decline in new infections. But the big question remains. How realistic is this goal of universal HIV treatment?

KATHERINE WHETTEN: (Laughter). So I think it’s going to take a long time.

BEAUBIEN: That’s Katherine Whetten at the Duke Global Health Institute. She says getting millions of additional people on treatment in some of the poorest countries in the world is going to be a massive challenge.

WHETTEN: It’s the funding and infrastructure. South Africa or Tanzania, where I do a lot of work, or Kenya – they’re working so hard to get people on treatment already and to keep them on treatment. I’m not sure that the recommendations will help them a lot in the next couple years.

BEAUBIEN: Venter in Johannesburg describes the problem as trying to shove expensive pills down a very weak health care delivery pipeline. Currently, it’s unclear even where the funding will come from to pay for anti-AIDS drugs for another 9 million people around the world. There are also concerns about side effects and drug resistance when you start putting lots of asymptomatic people on powerful medications for the rest of their lives. Jason Beaubien, NPR News.

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