Abstract:
The South African (SA) National Department of Health (DoH)
released new guidelines for the management of HIV/AIDS in April
2010. We discuss here controversial issues and operational challenges
in the guidelines; the stimulation of debate and contributing to future
guidelines; the timing of initiation of antiretroviral treatment, scope
and timing of laboratory monitoring and testing of concomitant
conditions, operational challenges such as paediatric HIV treatment
and nurse-driven care, and procedures relating to the guidelines such
as the need for transparency of the guideline committee and the
standard of evidence used to develop the guidelines. We welcome
comment and sharing of further insights that will contribute to future
guidelines.
Our motivation stems from the facts that South Africa’s HIV epidemic
is not abating; its Millennium Development Goals are not being met;
and child and maternal mortality are worse than they were in 1990.1
The Department of Virology of the University of Pretoria convened a
meeting of private and public health practitioners in June 2010 to debate
the DoH’s new antiretroviral treatment (ART) guidelines.
