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Management of HIV in resource-poor countries, with a focus on sub-Saharan Africa.

HIV/AIDS is the modern world's greatest pandemic, the brunt of which falls on sub-Saharan Africa. HIV/AIDS control efforts have up till now focused mainly on prevention, with little attention paid to care. This approach must change, and prevention has to be linked with an essential package of care if there is to be any hope of reducing HIV incidence rates or curbing the morbidity and mortality associated with AIDS. The package of care includes psycho-social support, screening for sexually transmitted infections and tuberculosis, clinical care for opportunistic infections, palliative care for terminal illness, home based care, care and support for orphans, prevention of mother to child transmission of HIV, preventive therapy and the possibility of antiretroviral (ARV) drugs. Many countries in sub-Saharan Africa are developing plans to scale-up treatment and prevention programmes, including the use of ARV drugs. However, any meaningful challenge to the AIDS epidemic requires a huge scale-up of support from the international community, both for ARV drugs and for basic prevention and care packages.