National Guidelines for Antiretroviral Therapy, Third Edition, July 2010 - Namibia
(2010; 90 pages)


More than ten years after the introduction of highly active antiretroviral therapy (HAART), new advances in the diagnosis and treatment of HIV/AIDS continue to emerge. The First Edition of the National Guidelines for Antiretroviral Therapy was developed in 2003, a second edition was published in 2007 and this has been revised to keep abreast with the latest evidence based practices.

Research in industrialised and developing countries acknowledged by WHO has shown that only a limited number of regimens ensure optimal viral suppression and long-term adherence to therapy. These regimens are recommended in these guidelines.

To promote early diagnosis of HIV infection and facilitate lifelong adherence to therapy, a favourable environment is essential...The cost of ARVs has continued to decrease over the last years through initiatives of producers of original medications and under pressure of generic substitutes. In addition to public health services, increasing numbers of persons with HIV-related diseases have access to treatment through medical aid schemes or other private sector initiatives.

These guidelines have enabled health care providers to provide standardised national management to HIV/AIDS patients over the last four years and will continue to do so with the revised edition. The guidelines will continue to be regularly updated to reflect new developments as they occur.

HAART is not a cure, but it has converted a potentially fatal disease into a chronic manageable condition. The most important emphasis in curbing the pandemic remains the prevention of primary HIV infection. This Third Edition of the National Guidelines for Antiretroviral Therapy includes several significant changes from the Second Edition. In order for these revised guidelines to be implemented with minimum disruption to patient care, a smooth transition from the second edition to the third edition of the guidelines is essential. This is also important to ensure that the supply of medications through the central medical store all the way to the patient is uninterrupted and wastage of ARVs due to expiry is minimised.

Experience garnered from changes in other treatment guidelines shows that prescribers are eager to change to using newer regimens, even when the necessary medicines may not yet be freely available. This causes disruption to patient care as well as the pharmacy supply system and can easily result in loss of medicines due to wastage of the previously recommended supplies.

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