AN
OPEN LETTER TO THE WORLD HEALTH ORGANIZATION
To: Dr Gottfried
Hirnschall. (
hirnschallg@who.int)
Director of
the HIV/AIDS Department, World Health
Organization
From: Arthur Ammann M.D.
On behalf of
those who supported us through the Treat-All website
www.treatall.org
TREAT ALL HIV INFECTED
NOW
On behalf of the TREATALL.ORG campaign and its
supporters, we urgently petition the World Health
Organization to update their HIV treatment
guidelines.
By taking action now to ensure that ALL of those
affected by HIV are treated — men, women and children,
regardless of their clinical status or CD4 count — WHO
can save lives, prevent countless numbers of new HIV
infections, dramatically reduce long-term healthcare
costs, and take a lead in this stage of the battle
against HIV/AIDS around the world.
THE PROBLEM
Clinical research indicates that starting
antiretroviral treatment (ART) earlier than
recommended by WHO could significantly reduce the
continued long term human and economic cost of the
epidemic.
The current WHO guidelines are in urgent need of
revision. They fail to incorporate the results of
clinical research studies that have caused other
international organizations to revise their guidelines
(such as the US Department of Health and Human Services
and the International AIDS Foundation [ref 1].)
In failing to update their guidelines we believe
that WHO is out of step with the standard-of-care
recommendations of the majority of international HIV
experts who have taken into account the broad benefits
of early ART – benefits such as: reducing mortality,
morbidity, opportunistic infections including
tuberculosis; decreasing HIV transmission
(treatment as prevention); decreasing non
HIV-related diseases; decreasing hospitalization
costs; maintaining CD4 counts; preserving
the life of HIV infected care givers, and potentially
reducing the vast HIV related orphan epidemic.
WHO projects that an update to the guidelines will
not occur until 2013 [ref. 2]. We believe that this
delay will cost the lives of hundreds of thousands of
men, women and children.
The emergence of treatment regimens, including
HAART, costing substantially less than at any time in
the epidemic has dramatically lowered the cost of
effective treatment. Simplifying treatment
recommendations by “treating all” is the best public
health approach to controlling the HIV epidemic. Without
revising the WHO guidelines now, the change to "treat
all patients" will be slow and ineffective, and will
cost many lives and much unnecessary suffering.
THE SOLUTION
WHO should take action now to change their HIV
treatment guidelines for men, women, pregnant women,
infants and children — they should be updated to
recommend the treatment of ALL HIV infected persons,
regardless of their CD4 counts or their clinical
status.
WHO WE ARE
The TREAT ALL campaign is a subsidiary of “Global
Strategies for HIV Prevention” - a 501(c)3 non-profit
organization established since 1998 to save the lives
and alleviate the suffering of women and children,
through HIV prevention, treatment, and care.
We launched the TREATALL.org campaign at the World
AIDS conference in July 2012 — the campaign solicited
petitions from attendees and friends requesting that WHO
change their guidelines to provide treatment for all HIV
infected individuals.
Since its launch, we have received support from
over 40 different countries, these include:
Argentina, Australia,
Azerbaijan, Belgium, Bermuda, Bhutan, Brazil, Cambodia,
Cameroon, Canada, Central African Republic, Colombia,
Congo, Denmark, Egypt, Ghana, Greece, India, Indonesia,
Kenya, Laos, Liberia, Malawi, Mexico, Netherlands,
Nigeria, Pakistan, Philippines, Poland, South Africa,
Spain, Switzerland, Thailand, Turkey, U.K., U.S.A.,
Venezuela, Vietnam, Zaire, Zambia
At the time of its launch TREATALL.ORG was the
first entry in Google searches for this topic.
PLEASE ACT NOW
On behalf of our supporters, and of those presently
affected by HIV around the world, we ask you to
immediately update your guidelines for HIV
treatment.
Sincerely
Arthur Ammann M.D.
Global Strategies for HIV
Prevention
References
[1] “Guidelines
for the Use of Antiretroviral Agents in HIV-1-Infected
Adults and Adolescents” Department of Health and
Human Services, 2012
[2] “The Strategic Use of Antiretrovirals”
World Health Organization,
2012