WHO has recently issued new guidance on critically unwell people with advanced HIV disease (AHD) as a key missing element in the fight to end HIV-related deaths.
Tuberculosis and HIV-related CNS infections are leading causes of HIV-related deaths in low-income and middle-income countries (LMICs). However, practicable methods to implement recommendations in resource-poor public hospital settings in LMICs are scarce. In our experience, public hospitals in LMICs face systemic barriers in delivering high-quality care, and they require financial investment and strengthening. Effective life-saving interventions exist, and it is simply not acceptable to wait for the potential arrival of better tools (sometimes called techno-optimism) or strategies in the face of continued human suffering and preventable deaths.
In the results of the humanitarian Driving Reduced AIDS-associated Meningo-encephalitis Mortality (DREAMM) implementation science project published in The Lancet HIV, we showed what can be achieved within public hospital facilities when essential tests and medicines are available to African health leaders who are empowered to strengthen their health system and train their workforce. The new, context-driven methodology reduced short term mortality from meningitis linked to HIV by approximately 50%, and appears to be generalisable to resource-limited public hospital settings in Malawi, Tanzania, and Cameroon.
Read the Full Article: How to DREAMM and end HIV-related deaths