The International Treatment Preparedness Coalition (ITPC) welcomes encouraging new evidence from an international study, Strategic Timing of AntiRetroviral Treatment, or START for short.
“It is exciting to see that we now have data that provides concrete evidence of the clinical benefits of starting people early on HIV treatment,” explains Christine Stegling, Executive Director of ITPC. “The results were so positive that the study was interrupted early so that all participants could benefit from the new evidence.” The large randomized trial showed that people starting treatment early (more than CD4 500) were 53% more likely to avoid serious illness and death, compared to people who started treatment later (less than CD4 350). ITPC celebrates this significant breakthrough.
There are still outstanding questions, about the implications for long-term adherence, the level of viral suppression and the long-term impact of early treatment initiation on drug resistance. Now, more than ever, we need to find answers to these questions. There is a huge need to understand HIV treatment seeking behaviors, especially the barriers facing people around getting tested, starting treatment, and subsequently staying on treatment. ITPC calls on the scientific community, donors, national health authorities and international normative guidance agencies to embrace the new evidence and plan a way forward that involves finding answers to these questions. It is critical that people living with HIV and communities are at the center of follow-up research, treatment conversations and strategies for implementation.
Many commentators have already raised the issue of the potential high costs of initiating everybody, who needs treatment, earlier. According to UNAIDS fewer than 13 million out of 35 million people living with HIV are accessing treatment.
“We should not perpetuate this narrative of scarce resources for adequate health care. Resources exist to ensure everybody can fulfill their right to health and life,” explains Stegling. “Prices for medicines and diagnostics could be more affordable if the global community and national governments stopped allowing pharmaceutical companies to get away with outrageously unfair and monopolistic practices. It is time to remove patent barriers that make essential medicines unaffordable for the people who need them.”
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ITPC is a global coalition of HIV treatment activists formed in 2003 to respond to the needs of communities worldwide. Structured in nine regions, the global network is driven by individual activists, peer support groups, grassroots networks, community-based organizations, and non-governmental organizations (see list below).
Each of these entities share our values and vision and come together to address issues around access to treatment issues in their countries, regions and at the global level. The Coalition includes organizations and networks run by key populations – lesbian, gay, bisexual, transgender and intersex people (LGBTI), sex workers and people who use drugs – as well as others marginalized within the current HIV response, such as women, girls and migrants. As a Coalition rooted in the Global South, ITPC established its global office in Botswana in early 2015.