New 'Lite' approach could save more lives with less money

 

A radical approach to delivering antiretroviral drugs to people with HIV to halt the transmission of the virus is being implemented in three countries in Africa, opening the way to treatment for least one million extra patients at no additional cost.

The move, being led by British scientists and funded by the UK Department for International Development, comes at a time when the global economic crisis is threatening progress against the pandemic.

The project, known as "Lab-Lite", is being run in Uganda, Malawi and Zimbabwe and involves monitoring the roll-out of antiretroviral drugs to rural areas, where two-thirds of the population live, without the array of laboratory testing conventionally regarded as necessary. The millions of pounds saved can be ploughed back into purchasing more drugs and treating more patients.

Professor Diana Gibb, of the UK Medical Research Council's clinical trials unit, said: "The Global Fund has cancelled its 11th funding round and less than half the adults who need treatment for HIV are receiving it. This project will help use existing funds to treat at least an extra million patients."

Routine laboratory testing every three or four months had been thought essential to monitor toxicity and side effects in people on antiretroviral drugs. But a study (the Dart trial) by the same researchers, published in 2009, showed routine lab testing made little difference to survival after five years – 90 per cent of those tested regularly were alive compared with 87 per cent of those who were not.

Professor Gibb said: "These are very safe drugs. You don't need regular monitoring for side effects or medically qualified people to deliver the pills. That is what the Dart trial showed and the Lab-Lite project is looking at how to translate those findings into a rural setting."

One of the main barriers to people receiving treatment is that they live too far from the nearest hospital for testing. They often have to trek long distances to get drugs, so many drop out.

"You can train healthcare workers to deliver pills to where people live. But local health centres are struggling to roll out treatment with the staff they have got when they have to run immunisation and mother-and-baby clinics as well," said Professor Gibb. The Dart trial findings had had a hostile reception from some experts, she said. "So we thought, let's go further and show it actually works in the field."

Today's progress report from the World Health Organisation, the Global HIV/Aids Response, says treatment to date has focused on the "most accessible segments of the population" who are better off, better educated and live closest to hospitals. "Greater efforts and novel strategies are required to extend service provision to harder-to-reach populations," it says. WHO guidelines say antiretroviral drug treatment should ideally be monitored with regular tests. But they say that where this is not possible, giving treatment should be the priority.

World Aids Day: Victory within reach – but cuts could spoil it all
New 'Lite' approach could save more lives with less money
Hillary Clinton: We must not waste this historic opportunity
Elton John on the streets with Ukraine's lost generation
Carla Bruni-Sarkozy: Mothers, babies and HIV
Jeffrey Sachs: Politicians just don't care enough to tackle this scourge
Jeremy Laurance: States need to back up fine words with hard cash if great leap forward is not to be wasted
Leading article: Belt-tightening can't apply to Aids
Aids under the lens
World Aids Day: Thirty-four million reasons to act

 

Suggested Topics
Sport
tennisLive: Follow all the updates from Melbourne as Murray faces Czech Tomas Berdych in the semi-final
Arts and Entertainment
'The Archers' has an audience of about five million
radioA growing number of listeners are voicing their discontent; so loudly that even the BBC's director-general seems worried
Arts and Entertainment
Henry VIII played by Damien Lewis
tvReview: Scheming queens-in-waiting, tangled lines of succession and men of lowly birth rising to power – sound familiar?
News
Joel Grey, now 82, won several awards for his role in Cabaret
people
PROMOTED VIDEO
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
Sport
Harry Kane celebrates scoring the opening goal for Spurs
footballLive: All the latest transfer news as deadline day looms
Arts and Entertainment
Master of ceremony: Jeremy Paxman
tvReview: Victory for Jeremy Paxman in this absorbing, revealing tale
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Tradewind Recruitment: Maths Teacher

    Negotiable: Tradewind Recruitment: Our exclusive client in St Albans Hertfords...

    Tradewind Recruitment: KS2 Primary Teachers

    Negotiable: Tradewind Recruitment: Key Stage 2 Teachers needed in Hertfordshir...

    Ashdown Group: Finance Manager - ACCA/CIMA - St Albans, Hertfordshire

    £55000 - £58000 per annum: Ashdown Group: A truly exciting opportunity has ari...

    Ashdown Group: Credit Controller - London, Old Street

    £25000 - £28000 per annum + benefits: Ashdown Group: Credit Controller - Londo...

    Day In a Page

    Isis hostage crisis: Militant group stands strong as its numerous enemies fail to find a common plan to defeat it

    Isis stands strong as its numerous enemies fail to find a common plan to defeat it

    The jihadis are being squeezed militarily and economically, but there is no sign of an implosion, says Patrick Cockburn
    Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action

    Virtual reality: Seeing is believing

    Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action
    Homeless Veterans appeal: MP says Coalition ‘not doing enough’

    Homeless Veterans appeal

    MP says Coalition ‘not doing enough’ to help
    Larry David, Steve Coogan and other comedians share stories of depression in new documentary

    Comedians share stories of depression

    The director of the new documentary, Kevin Pollak, tells Jessica Barrett how he got them to talk
    Has The Archers lost the plot with it's spicy storylines?

    Has The Archers lost the plot?

    A growing number of listeners are voicing their discontent over the rural soap's spicy storylines; so loudly that even the BBC's director-general seems worried, says Simon Kelner
    English Heritage adds 14 post-war office buildings to its protected lists

    14 office buildings added to protected lists

    Christopher Beanland explores the underrated appeal of these palaces of pen-pushing
    Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

    Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

    Scientists unearthed the cranial fragments from Manot Cave in West Galilee
    World War Z author Max Brooks honours WW1's Harlem Hellfighters in new graphic novel

    Max Brooks honours Harlem Hellfighters

    The author talks about race, legacy and his Will Smith film option to Tim Walker
    Why the league system no longer measures up

    League system no longer measures up

    Jon Coles, former head of standards at the Department of Education, used to be in charge of school performance rankings. He explains how he would reform the system
    Valentine's Day cards: 5 best online card shops

    Don't leave it to the petrol station: The best online card shops for Valentine's Day

    Can't find a card you like on the high street? Try one of these sites for individual, personalised options, whatever your taste
    Diego Costa: Devil in blue who upsets defences is a reminder of what Liverpool have lost

    Devil in blue Costa is a reminder of what Liverpool have lost

    The Reds are desperately missing Luis Suarez, says Ian Herbert
    Ashley Giles: 'I'll watch England – but not as a fan'

    Ashley Giles: 'I'll watch England – but not as a fan'

    Former one-day coach says he will ‘observe’ their World Cup games – but ‘won’t be jumping up and down’
    Greece elections: In times like these, the EU has far more dangerous adversaries than Syriza

    Greece elections

    In times like these, the EU has far more dangerous adversaries than Syriza, says Patrick Cockburn
    Holocaust Memorial Day: Nazi victims remembered as spectre of prejudice reappears

    Holocaust Memorial Day

    Nazi victims remembered as spectre of prejudice reappears over Europe
    Fortitude and the Arctic attraction: Our fascination with the last great wilderness

    Magnetic north

    The Arctic has always exerted a pull, from Greek myth to new thriller Fortitude. Gerard Gilbert considers what's behind our fascination with the last great wilderness