AS PART of its broad-based effort to fight the global pandemic of HIV/AIDS, the U.S. Agency for International Development (USAID) makes large and important contributions to providing antiretroviral (ARV) drugs in developing countries where HIV infection results in far too many deaths.

Individuals living with HIV do not succumb to the virus itself. Rather, the virus (HIV) weakens the body’s immune system to a point where it is unable to defend itself against illnesses that healthy immune systems are usually able to stave off. Ultimately, it is these other illnesses that cause death. As such, antiretroviral drugs have been a lifesaving advance in the treatment of HIV/AIDS because they limit the virus’ power to weaken the immune system.

Evidence shows that programmes providing ARVs in resource-limited settings can be remarkably successful, with treatment adherence and clinical outcomes comparable to those in developed countries. In its work in the developing world, USAID recognizes that, in addition to the necessity of ARVs being available and accessible, it is equally important to help host countries provide critical support to ensure drug therapy occurs – and on terms that will make it effective. For this reason, USAID not only focuses narrowly on the provision of ARVs themselves but also works broadly to establish a full system for the achievement of antiretroviral therapy (ART), a term that denotes a comprehensive program of treatment, care, and support.

Antiretroviral drugs are just one aspect of a comprehensive HIV/AIDS treatment, care, and support program that includes meeting the medical, psychological, socioeconomic, and legal needs of those affected by the disease. In USAID’s ART programs, the treatment component consists of the use of at least three ARV medications. The objective of the drug component is to suppress HIV replication and slow the progression of HIV disease.      

Antiretroviral Therapy: Benefiting Individuals and Communities
When antiretroviral drugs are delivered through a broad ART effort, they provide important benefits for both individuals and communities. For example, they can dramatically decrease the number and severity of illnesses associated with HIV infection. They can prolong the life and reduce the suffering of HIV-positive people.

Enabling patients to live longer maintains the integrity of families, societies, and economies, particularly in severely affected countries. When HIV-positive people receive ART, they are able to maintain not only their health but also their productivity. They are able to find and keep jobs and to continue to earn an income, provide for their children, and pass on their knowledge to future generations. Pregnant and breastfeeding mothers who are receiving treatment can reduce the risk of passing the virus to their babies. Treatment allows for a more effective, productive workforce, as AIDS patients can continue to work.
Properly implemented ART programs also allow for more effective prevention by reducing the stigma associated with HIV and reducing HIV transmission. Reducing transmission and the number of new cases makes providing treatment more affordable. Because ARV treatment is effective, it has been shown to reduce stigma associated with HIV testing. People are less afraid to be tested and find out their HIV status, since they know they have options if they are positive. Treatment can reduce the stigma associated with HIV, since it enables people to return to a better health status, and others in the community realize that HIV-positive people can continue to live and lead fulfilling lives.

The resources USAID provides for treatment can help improve infrastructure for prevention and other health services. The training USAID provides to health providers and the improvements it brings to laboratory services, pharmacy, logistics, commodity management, and health information systems can benefit both treatment and prevention services. Furthermore, in many countries, a large number of health care workers are themselves infected. Treatment enables these health professionals to continue to provide critically needed AIDS prevention and treatment services, as well as other health care services to the community. (Source: USAID)