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dc.contributor.authorFord, Nathan
dc.contributor.authorCalmy, Alexandra
dc.contributor.authorHurst, Samia
dc.date.accessioned2010-08-20T19:46:04Z
dc.date.available2010-08-20T19:46:04Z
dc.date.issued2010-06
dc.identifier.citationWhen to start antiretroviral therapy in resource-limited settings: a human rights analysis. 2010, 10:6 BMC Int Health Hum Rightsen
dc.identifier.issn1472-698X
dc.identifier.pmid20356356
dc.identifier.doi10.1186/1472-698X-10-6
dc.identifier.urihttp://hdl.handle.net/10144/110033
dc.description.abstractABSTRACT: BACKGROUND: Recent evidence from developed and developing countries shows clear clinical and public health benefit to starting antiretroviral therapy (ART) earlier. While discussions about when to start ART have often focused on the clinical risks and benefits, the main issue is one of fair limit-setting. We applied a human rights framework to assess a policy of early treatment initiation according to the following criteria: public-health purpose; likely effectiveness; specificity; human rights burdens and benefits; potential for less restrictive approaches; and fair administration. DISCUSSION: According to our analysis, a policy of earlier ART initiation would better serve both public health and human rights objectives. We highlight a number of policy approaches that could be taken to help meet this aim, including increased international financial support, alternative models of care, and policies to secure the most affordable sources of appropriate antiretroviral drugs. SUMMARY: Widespread implementation of earlier ART initiation is challenging in resource-limited settings. Nevertheless, rationing of essential medicines is a restriction of human rights, and the principle of least restriction serves to focus attention on alternative measures such as adapting health service models to increase capacity, decreasing costs, and seeking additional international funding. Progressive realisation using well-defined steps will be necessary to allow for a phased implementation as part of a framework of short-term targets towards nationwide policy adoption, and will require international technical and financial support.
dc.language.isoenen
dc.rightsArchived with thanks to BMC International Health and Human Rights via Open Accessen
dc.titleWhen to start antiretroviral therapy in resource-limited settings: a human rights analysis.en
dc.contributor.departmentMédecins Sans Frontières, Cape Town, South Africa. nathan.ford@joburg.msf.org.en
dc.identifier.journalBMC International Health and Human Rightsen
refterms.dateFOA2019-03-04T08:20:49Z
html.description.abstractABSTRACT: BACKGROUND: Recent evidence from developed and developing countries shows clear clinical and public health benefit to starting antiretroviral therapy (ART) earlier. While discussions about when to start ART have often focused on the clinical risks and benefits, the main issue is one of fair limit-setting. We applied a human rights framework to assess a policy of early treatment initiation according to the following criteria: public-health purpose; likely effectiveness; specificity; human rights burdens and benefits; potential for less restrictive approaches; and fair administration. DISCUSSION: According to our analysis, a policy of earlier ART initiation would better serve both public health and human rights objectives. We highlight a number of policy approaches that could be taken to help meet this aim, including increased international financial support, alternative models of care, and policies to secure the most affordable sources of appropriate antiretroviral drugs. SUMMARY: Widespread implementation of earlier ART initiation is challenging in resource-limited settings. Nevertheless, rationing of essential medicines is a restriction of human rights, and the principle of least restriction serves to focus attention on alternative measures such as adapting health service models to increase capacity, decreasing costs, and seeking additional international funding. Progressive realisation using well-defined steps will be necessary to allow for a phased implementation as part of a framework of short-term targets towards nationwide policy adoption, and will require international technical and financial support.


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