Bill and Melinda Gates Foundation, Seattle, Washington 98104, USA.
Curr Opin HIV AIDS. 2013 Jan;8(1):4-11. doi: 10.1097/COH.0b013e32835ba7ff.
This review provides an update on the WHO/UNAIDS Treatment 2.0 strategy by reviewing the documents and technical updates issued under the initiative. Launched in 2010, this global initiative provides a framework for the continued scale-up of access to HIV care and treatment.
WHO has prioritized once daily fixed-dose combination as the preferred antiretroviral (ARV) regimen to initiate HIV treatment, paving the way for programmatic simplification, with reduced toxicity and improved adherence. WHO also recommends the use of point-of-care diagnostics, with CD4 cell count technologies being implemented in the field and progress towards improving access to simplified viral load testing. The strategy also seeks mechanisms that can contribute to reducing treatment costs, such as pooled commodity procurement and public health-oriented licensing approaches. Improved service delivery, specifically through decentralization, task shifting, integration and community mobilization also has the potential to reduce costs and improve access. Support to countries has been provided through the timely release of a series of programmatic and technical updates on specific treatment-related topics.
The Treatment 2.0 strategy articulates how innovation and greater efficiency can make HIV care and treatment more accessible and affordable, and guide treatment and prevention scale-up.
目的综述：本综述通过审查该倡议下发布的文件和技术更新，介绍了世卫组织/艾滋病规划署 2.0 治疗策略的最新进展。该全球倡议于 2010 年启动，为扩大获得艾滋病毒护理和治疗的机会提供了框架。
最新发现：世卫组织优先选择每日一次的固定剂量联合疗法作为启动艾滋病毒治疗的首选抗逆转录病毒（ARV）方案，为方案简化铺平了道路，减少了毒性，提高了依从性。世卫组织还建议使用即时诊断检测，现场已实施 CD4 细胞计数技术，并在改善简化病毒载量检测方面取得进展。该策略还寻求有助于降低治疗成本的机制，例如集中采购商品和采取以公共卫生为导向的许可方法。改善服务提供，特别是通过权力下放、任务转移、整合和社区动员，也有可能降低成本并增加获得治疗的机会。通过及时发布一系列关于具体治疗相关主题的方案和技术更新，为各国提供了支持。
总结：2.0 治疗策略阐明了创新和提高效率如何使艾滋病毒护理和治疗更易于获得和负担得起，并指导治疗和预防的扩大。
