Antiretroviral in the context of "HIV/AIDS in Zambia"

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⭐ Core Definition: Antiretroviral

The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the replication cycle of HIV. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load.

Treatment has been so successful that in many parts of the world, HIV has become a chronic condition in which progression to AIDS is increasingly rare. Anthony Fauci, former head of the United States National Institute of Allergy and Infectious Diseases, has written, "With collective and resolute action now and a steadfast commitment for years to come, an AIDS-free generation is indeed within reach." In the same paper, he noted that an estimated 700,000 lives were saved in 2010 alone by antiretroviral therapy. As another commentary noted, "Rather than dealing with acute and potentially life-threatening complications, clinicians are now confronted with managing a chronic disease that in the absence of a cure will persist for many decades."

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👉 Antiretroviral in the context of HIV/AIDS in Zambia

HIV/AIDS is considered the deadliest epidemic in the 21st century. It is transmitted through sex, intravenous drug use and mother-to-child transmission. Zambia is experiencing a generalized HIV/AIDS epidemic, with a national HIV prevalence rate of 11.3% among adults ages 15 to 49 as of 2018. Per the 2000 Zambian census, the people affected by HIV/AIDS constituted 15% of the total population, amounting to one million, of which 60% were women. The pandemic results in increased number of orphans, with an estimated 600,000 orphans in the country. It was prevalent more in urban areas compared to rural and among all provinces, Copperbelt Province and Lusaka Province had higher occurrence.

The government of Zambia created an AIDS surveillance committee as early as 1986, and created an emergency plan to control the spread by 1987. By 2005, the government made antiretroviral therapy free for every individual. There are several UN and NGO voluntary organizations that are helping combat the disease.

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Antiretroviral in the context of Essential medicines

Essential medicines, as defined by the World Health Organization (WHO), are medicines that "satisfy the priority health care needs of the population". Essential medicines should be accessible to people at all times, in sufficient amounts, and be generally affordable. Since 1977, the WHO has published a model list of essential medicines, with the 2023 list for adult patients containing over 500 medicines. Since 2007, a separate list of medicines intended for child patients has been published. A new list was published in 2021, for both adults and children.

Several changes have been implemented since the 2021 edition, including that medication cost should not be grounds for exclusion criteria if it meets other selection criteria, and cost-effectiveness differences should be evaluated within therapeutic areas. The following year, antiretroviral agents, usually used in the treatment of HIV/AIDS, were included on the list of essential medicines.

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