2. What's 90-90-90?
A new HIV treatment narrative that lays the ground works to end the AIDS epidemic
• By 2020, 90% of all people living with HIV will know their HIV status.
• By 2020, 90% of all people with diagnosed HIV infection will receive sustained
antiretroviral therapy
• By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.
The target was initiated by UNAIDS under WHO.
3.
4. Why the 90-90-90 Target
• Target will drive progress. Until December 2013 more than 60% of people
living with HIV lacked HIV treatment underscoring the need for intensified
efforts to bring HIV treatment to all those who need it
• Target guides action taken beyond 2015-Ending AIDS will require new
milestones to guide and accelerate progress in the post 2015 era
• Target promotes accountability-A clearly articulated goal enables diverse
stakeholders to identify respective roles and responsibilities.
• A bold Target undescores that ending AIDS epidemic is achievable-
Boldly grasping this challenge ensures that ending AIDS epidemic in the
world is possible by 2030.
5. How will 90-90-90 succeed
• Focus on the new quality and outcomes of antiretroviral therapy as
treatment services are scaled up.
• The new target captures both the therapeutic and preventive benefits of
HIV treatment.
• It prioritizes equity- Unless all communities affected by HIV have full and
equitable access to life saving treatment and other prevention services the
world will not end the AIDS epidemic.
6. First 90:90% diagnosed
• African countries are either approaching or within the striking distance of
having at least 90% of people living with HIV/AIDS tested at least.
• Until December 2013 only 45% of people living with HIV knew their status
in sub-Saharan Africa.
• The gap underscores a need for more frequent testing.
• Testing in multi disease health campaigns in Kenya and Uganda increased the
testing coverage to 86% and 72%.
7. Second 90:90% on HIV treatment.
• High treatment coverage is also achieved in some settings e.g. in Botswana
and Colombia more than 70% of people diagnosed with HIV are now
receiving antiretroviral therapy.
• Recomending antiretroviral therapy to all people with HIV infection without
requiring prior CD4 count will enhance treatment and reduce loss to follow
up.
• Countries will need to implement issues that slow up implemtation like;
pharmacy stock outs, procurement of medicnes and second and third line
regimens.
8. Last 90:90%Viral Suppressed
• High levels of viral suppression have been achieved in some countries e.g 17
countries in Latin America and Carribean countries have 66% of those
diagnosed are viral suppressed.
• Viral suppression doesn’t count for AIDS related mortality or loss to follow
up highlighting efforts to retain those who are loss to follow among the ones
enrolled in care.
• Viral load testing will lower treatment costs and help clinicians identify early
treatment failure.
9. Last 90 contd…..
• Ensuring universal access to viral load testing in all settings is vital.
• UNAIDS,WHO, ASLM and US CDC jointly convened the role of
laboratory medicine in meeting the 90-90-90 targets in June 2014
• The meeting was aimed at building robust, sustainability laboratory capacity
that will be needed to meet the global treatment goals
10.
11. Challenges along the road!
• Societal Challenges- Stigma, discrimination
• Delivery Challenges-Centralization of treatment centers reduces success of
treatment. Strategies should be tailored by stakeholders to make sure even
those in remote areas can access HIV treatment.
• Costs of achieving the 90-90-90 target-Increased funding will be needed to
end the AIDS epidemic.Costs are incured in drugs,delivery service,laboratory
capacity and community mobilization to ensure testing and retention in care.
