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![Global Summary of the AIDS Epidemic, 2008 People newly infected with HIV in 2008 AIDS-related deaths in 2008 Total 33.4 million [31.1 - 35.8 million] Adults 31.3 million [29.2 - 33.7 million] Women 15.7 million [14.2 - 17.2 million] Children under 15 years 2.1 million [1.2 - 2.9 million] Total 2.7 million [2.4 – 3.0 million] Adults 2.3 million [2.0 – 2.5 million] Children under 15 years 430,000 [240,000 - 610,000] Total 2.0 million [1.7 – 2.4 million] Adults 1.7 million [1.4 – 2.1 million] Children under 15 years 280,000 [150,000 – 410,000] Number of people living with HIV in 2008](https://image.slidesharecdn.com/panel4cpitterwhoguidelinesglobal-100715140412-phpapp01/75/WHO-Guidelines-2010-and-Beyond-2-2048.jpg)
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WHO Guidelines: 2010 and Beyond
The document summarizes key points from the 2010 WHO guidelines for preventing mother-to-child transmission of HIV, treating pediatric HIV, and HIV treatment for adults and adolescents. Major changes included treating all HIV-positive pregnant women and children under 2, simplifying adult regimens, and emphasizing exclusive breastfeeding. Implementing these guidelines could virtually eliminate pediatric HIV but would require increased resources, integration, monitoring, and research to inform future revisions. The Elizabeth Glaser Pediatric AIDS Foundation aims to support countries in adapting and applying the guidelines through toolkits, advocacy, evaluation, and knowledge-sharing.
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WHO Guidelines: 2010 and Beyond
- 1. Christian Pitter, MD MPH Elizabeth Glaser Pediatric AIDS Foundation WHO Guidelines: 2010 and Beyond
- 2. Global Summary ofthe AIDS Epidemic, 2008 People newly infected with HIV in 2008 AIDS-related deaths in 2008 Total 33.4 million [31.1 - 35.8 million] Adults 31.3 million [29.2 - 33.7 million] Women 15.7 million [14.2 - 17.2 million] Children under 15 years 2.1 million [1.2 - 2.9 million] Total 2.7 million [2.4 – 3.0 million] Adults 2.3 million [2.0 – 2.5 million] Children under 15 years 430,000 [240,000 - 610,000] Total 2.0 million [1.7 – 2.4 million] Adults 1.7 million [1.4 – 2.1 million] Children under 15 years 280,000 [150,000 – 410,000] Number of people living with HIV in 2008
- 3. EGPAF’s Mission TheElizabeth Glaser Pediatric AIDS Foundation seeks to prevent pediatric HIV infection and to eradicate pediatric AIDS through research, advocacy, and prevention and treatment programs.
- 4. Estimate of theannual number of infant infections averted through the provision of ARV prophylaxis to HIV-positive pregnant women, globally, 1996–2008 1996 1998 2000 2002 2004 2006 2008 60 000 50 000 40 000 20 000 0 30 000 10 000 70 000 1997 1999 2001 2003 2005 2007
- 5. Estimated number ofnew pediatric infections with and without PMTCT prophylaxis globally, 1996-2008 UNAIDS, AIDS Epidemic Update 2009 70,000 infections averted in 2008
- 6. PMTCT Study Resultsand Guidelines Revisions (1994-2009)
- 7. Four Linked GuidelinesARVs for Vertical Transmission Pediatric ART Adult & Adolescent ART IYCF
- 8. What the NewGuidelines Represent Progress of knowledge in provision of HIV services The first step in codifying knowledge into standards of care Opportunity to improve approaches, service delivery, and outcomes A relatively rare “leverage point” to focus attention and effort
- 9. New Elements ofthe Guidelines PMTCT: Emphasis on treating eligible pregnant women CD4 threshold 200 -> 350 Start ARV prophylaxis earlier 28 -> 14 weeks Phase out sd-NVP Prophylaxis during the breast-feeding period
- 10. New Elements ofthe Guidelines Pediatrics: Immediately start treatment for all HIV-positive children less than 2 years old Adults: Simplified and more tolerable regimens CD4 threshold 200 -> 350 Infant and Young Child Feeding: Primacy of exclusive breast-feeding System-wide decision of optimal feeding practices
- 11. Overall Major ChangesIf implemented at scale, the virtual elimination of pediatric HIV ↑ logistical and supply-chain needs ↑ need for long-term follow-up and integration between PMTCT and HIV care and treatment ↑ need for treatment Advancement of monitoring and evaluation
- 12. Guidelines as aLeverage Point Elimination of Pediatric HIV WHO Guidelines National Systems and Partners Current Success EGPAF Efforts Implementation Advocacy Research National Systems and Partners EGPAF Efforts Implementation Advocacy Research
- 13. What We Needto Do: Be of Service… To our host countries’ HIV response Assist/Advise in adaptation Assist/Advise in implementation To districts and facilities we serve Implementation planning and support To our Mission See 1 & 2 above Evaluate Document & Share
- 14. Supporting Guideline Adaptation& Implementation Toolkits phases I, II, and III Technical advocacy/support at national level Technical support at implementation level Inter-country support Global sharing and leadership DOCUMENT, EVALUATE, DOCUMENT
- 15. Continuing the CycleRevisions planned for 2012 What direction for the next revisions? What do we need to know to inform the decisions? Who will do the research?
- 16. Final Thoughts ChallengesAccelerate scale-up and improve quality Fundamental changes to health system functioning (Integration! Supply chain! Funding! Human resources!) Monitoring & evaluation Opportunities Collaborate in a new way internally & externally Move closer to our mission: believe, plan, communicate & execute
- 17. Thank You DISCLAIMER:This program was made possible through support provided by the Office of HIV/AIDS, Global Bureau Center for Population, Health and Nutrition, of the United States Agency for International Development (USAID), through the President’s Emergency Plan for AIDS Relief, as part of the Elizabeth Glaser Pediatric AIDS Foundation's International Family AIDS Initiatives (“Call To Action Project”/ Cooperative Agreement No. GPH-A-00-02-00011-00). Private donors also supported costs of activities in many countries. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID.