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L08 - Universal access to AIDS treatment: targets and challenges - countries where almost half of the population are diseased - antiretroviral drugs: medications for the treatment of infection by retroviruses, primarily HIV (when 3 or 4 are taken in combination: highly active antiretroviral therapyHAART) - first line therapy - develop side effects and the body develops resistance to the drugs, no longer effective second line therapy - much more expensive, less side effects, combination of less drugs (easier to take) but for warmer climates and have longer shelf life - even people who have access to antiretroviral have high prevalence - Sub-Saharan Africa increased recipient of antiretroviral therapy - estimated that access to antiviral treatment is below 10% in every region except the Americas - Sub-S Africa, ~4.3 million ppl need AIDS home-based care but only 12% receive (SE Asia - 2%) - several South American countries have universal coverage for antiretroviral therapy (Argentina, Brazil, Chile, Cuba, Mexico, Uruguay), 23 (Barbados, Colombia, Costa Rica, Paraguay) - to monitor and contain disease - few HIV medicines are produced in paediatric formulations (have short shelf life, difficult to measure correct doses, taste, very expensive) - social and financial challenges in treating children childrens treatment may be a low priority within family & research - rankto determine who receives treatment (often the eldest male) - AIDS challenges health systems (deadly chronic disease in need of life-long regular follow- up) - CD4+ cell count threshold fo
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