Treatment as Prevention: Vancouver Consensus Calls for Immediate and Universal ART

By Antonia Chan

Leading AIDS scientists and officials have released the Vancouver Consensus at the opening of the International AIDS Society Conference, calling for a worldwide shift to providing immediate antiretroviral treatment (ARV) after diagnosis with HIV/AIDS, rather than waiting for symptoms to manifest. The Consensus states that such treatment “more than doubles an individual’s prospects of staying healthy and surviving.” The call for immediate and universal ARV treatment builds on the long-awaited results of the START trial, which found that those who started antiretroviral therapy (ART) immediately after diagnosis had a 57% reduction in serious AIDS- and non-AIDS- related illnesses and deaths, compared to those who deferred therapy until their CD4 cell count fell to low levels.

In HHR’s June 2015 issue, Kavanagh et al. reviewed the evidence encouraging early treatment of HIV/AIDS and concluded that universal access to immediate ART is now a core State obligation. The START trial results and Vancouver Consensus are in lockstep with the idea that early ART must be made both accessible and known to individuals as a matter of health and human rights. “We now have the opportunity of ending the pandemic,” Julio Montaner, AIDS Society conference co-chair and researcher, said at the meeting. Along with other signatories of the Consensus, as well as organizations such as the World Health Organization, Montaner has called for governments to make more people eligible for immediate ART, as viral suppression drugs no longer simply prevent death, but enable a “normal” life relatively free from crippling side effects.

Since the last global AIDS meeting in Vancouver, in 1996, mounting evidence has shown that the “highest attainable standard of health” must advance with science. Increasingly, rights-based approaches have been applied to understanding and treating the HIV/AIDS epidemic. The global health community has recognized that addressing legal and social inequalities/discrimination is as vital to ending AIDS as developing more effective medications. Given the START trial results, governments can now reasonably be expected to mobilize sufficient resources to provide all people living with HIV immediate, universal access to antiretroviral treatment. As the Vancouver Consensus concludes, “Science has delivered solutions. The question for the world is: When will be put it into practice?”


Read more HHR papers on HIV/AIDS and the Right to Health:

Evolving Human Rights and the Science of Antiretroviral Medicine

HIV/AIDS in Cuba: A rights-based analysis

HIV Stigma in Health Care Settings: A Need for Greater Partnership of Doctors and Lawyers in Ending AIDS

Human Rights and the Global Fund to Fight AIDS, Tuberculosis, and Malaria

Read the Vancouver Consensus here