Strategic information guidelines for HIV: Global perspective

Sir,

Globally, human immunodeficiency virus (HIV) infection has been acknowledged as one of the major public health concerns, which has accounted for the death of close to 40 million individuals till date. ^[1],[2] In fact, HIV has acquired the status of the leading infectious killer worldwide, including 1.5 million deaths in the year 2013 alone across the globe. ^[1] Though HIV is universal in its distribution, with almost 35 million people including 3.2 million children who are living with HIV, the sub-Saharan African region is the most severely affected both in terms of the incidence and prevalence of HIV infection. ^[1] Further, despite the availability of antiretroviral therapy (ART), which can enable infected people to lead a normal healthy life, more than 64% of HIV cases from middle- and low-income nations still have no access to ART, which in itself is an alarming fact. ^[1],[3]

Worldwide, it has been acknowledged and repeatedly emphasized by stakeholders that the availability of strategic information about HIV epidemic and the response by the health sector are very crucial to assist national policy makers in order to guide them in the process of planning and implementation and to ensure accountability. ^[4],[5] Furthermore, in order to achieve the proposed goals and targets, it is very much necessary to adopt more comprehensive yet simplified tools to collect HIV strategic information. ^[3] In fact, realizing its importance in heterogeneous settings, the World Health Organization (WHO) has released new guidelines to facilitate the generation of comprehensive and strategic information in the field of HIV. ^[3] These guidelines can be used by all professionals working in the national HIV program and even in the private sector (namely, nongovernmental agencies, etc.), which engages in HIV services at the national or international level. ^[6]

The released guidelines advocate the use of 10 simplified indicators, namely, the number of people living with HIV (PLWH), domestic funding, coverage of the prevention services, number of diagnosed people, HIV care coverage, treatment coverage, treatment retention, viral suppression, the number of HIV deaths, and the number of new infections in order to collect information about HIV care/treatment to track epidemics (magnitude of the disease) and measure the health sector’s response to HIV (especially, the reach of HIV services and their impact at the national and international levels). ^[3] In fact, it has been proposed that the collected strategic information on these indicators will enable nations to monitor the progress toward the 90-90-90 targets (90% of PLWH will be diagnosed, 90% of diagnosed HIV infection cases will receive antiretroviral therapy, and 90% of all people on ART will achieve viral suppression) by the year 2020. ^[3],[6]

In addition, the information collected from the 10 indicators will provide the desired comprehensive evidence, which in turn can assist the program managers in modifying the program activities or strategies based on the needs of PLWH. ^[3],[7] Apart from this, it provides an opportunity for nations to disaggregate their data, as a result of which the existing inequities can be highlighted and due attention can be given to address them effectively. ^[3]

To conclude, in the global mission to extend quality assured health-care services to PLWH, it is the need of the hour to assist national policy makers by providing them a tool to assess the impact of investments made in HIV programs. Hence, the recently released guidelines provide a comprehensive mechanism to monitor the national and global responses of the health sector to HIV.

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Conflicts of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.162658