HIV is an uncommon type of virus called a retrovirus, and drugs developed to disrupt the action of HIV are known as antiretrovirals or ARVs. These come in a variety of formulations designed to act on different stages of the life-cycle of HIV.
The AIDS virus mutates rapidly, which makes it extremely skilful at developing resistance to drugs. To minimize this risk, people with HIV are generally treated with a combination of ARVs that attack the virus on several fronts at once.
The introduction of ARVs in 1996 transformed the treatment of HIV and AIDS, improving the quality and greatly prolonging the lives of many infected people in places where the drugs are available. Nevertheless, ARVs are not a cure. If treatment is discontinued the virus becomes active again, so a person on ARVs must take them for life.
Although the price of ARVs has fallen significantly in recent years, their cost remains an obstacle to access in the developing world. Moreover, the health infrastructure required to deliver antiretroviral therapy is lacking in many places.
Access to drugs depends not only on financial and human resources. It depends also on people who need them being aware of their HIV status, knowledgeable about treatment, and empowered to seek it.
Thus public information and education are important elements in widening access, alongside efforts to build or strengthen the health services. The campaign for universal access to life saving drugs for HIV and AIDS, started originally by grassroots AIDS activists, is today a major focus of attention of UN agencies and others influential organizations at national and global levels.
The Declaration of Commitment on HIV/AIDS, unanimously endorsed by the UN General Assembly in 2001, embraced equitable access to care and treatment as a fundamental component of a comprehensive and effective global HIV response. Since then many countries, through the support of intergovernmental organizations and donors, have definitively demonstrated the feasibility of delivering HIV treatment in even the most resource-limited settings. Access to treatment has helped mobilize communities in the response to HIV, preserved the health and viability of households vulnerable to HIV, and strengthened HIV prevention efforts in many parts of the world.
In the goal to reach universal access to HIV prevention, treatment, care and support, national leadership is required to establish policies that support the momentum of treatment scale-up through efforts to: increase the number of people who choose to know their HIV status; reduce HIV stigma; build human capacity to sustain treatment through training and better use of current human resources; improve supply management and integrate HIV care with other health services.
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