Antiretroviral (ARV) Therapy in Resource Poor Countries: What do we Need in Real Life?

Francesco Castelli1, *, Virginio Pietra2, Ismael Diallo3, Richard F. Schumacher4, Jacques Simpore5
1 University of Brescia, Italy; CLIA – Network for International Fight against AIDS; President, Medicus Mundi Italy
2 Medicus Mundi Italy Project to Fight AIDS in Burkina Faso
3 Department of Internal Medicine, Hospital Yelgado, Ouagadougou, Burkina Faso; Department of Infectious Diseases, University of Brescia, Italy
4 Childrens’ Hospital, Spedali Civili, Bresica, Italy
5 University of Ouagadougou and Director, Bio-Molecular Research Center “Pietro Annigoni” (CERBA), St Camille Medical Center, Ouagadougou, Burkina Faso

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© Castelli et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Institute for Infectious and Tropical Diseases, University of Brescia, Piazza Spedali Civili, 1, 25123 – Brescia, Italy; Tel: +39.030.3995664; Fax: +39.030.303061; E-mail:


Significant progresses have been made in the last 5 years towards the ultimate goal to provide universal access to care for all HIV/AIDS patients needing antiretroviral treatment in resource-poor countries. However, many barriers are still to be overcome, including (●) cost of care for the individual, (●) stigma, (●) lack of qualified human resources and infrastructure, especially in the rural setting, (●) rescue drugs for failing patients and (●) pediatric formulations. Priority actions to be promoted if the fight against HIV/AIDS is to be successful include: (i) promoting access to care in the rural areas, (ii) strengthening of basic health infrastructures, (iii) waiving of users’ fee to get ARV, (iv) a larger variety of drugs, with particular regard to fixed dose combination third line drugs and pediatric formulations, (v) local quality training and (vi) high quality basic and translational research. While the universal access to HIV care is crucial in developing countries, a strong emphasis on prevention should be maintained along.