AHF questions UNAIDS' claim of 17 million on AIDS treatment

The US-based AIDS Healthcare Foundation (AHF), the largest global AIDS organization, has requested clarification from UNAIDS Executive Director Michel Sidibé over a recent announcement by his organization declaring that 17 million individuals worldwide were on antiretroviral treatment by the end of 2015.

The UNAIDS announcement—which reflects an additional two million individuals on treatment than in the prior year—came just before the UN’s High Level Meeting on AIDS, which was held in New York the first week of June.

In response to the announcement, AHF sent a letter to Mr. Sidibé expressing concern about the accuracy of the treatment numbers. In a June 21st letter, AHF President Michael Weinstein wrote, “While the numbers are quite impressive, we were concerned with the validity of the report.”

AHF also asked Mr. Sidibé whether the treatment numbers reported are based on actual patient records or on estimates, modeling and extrapolation—numbers which would be far less reliable.

Read AHF’s full letter below:

Dear Mr. Sidibé,

According to your 2016 Fact Sheet, 17 million people are accessing antiretroviral treatment as of December 2015. While the numbers are quite impressive, we were concerned with the validity of the report.

AIDS Healthcare Foundation currently provides and directly supports health care services and antiretroviral treatment to people with HIV in 335 care sites in 36 countries. We were the first non-government HIV organization that started providing ART services in South Africa in 2001.

With that being said, we know how difficult it is for sites and clinics to guarantee that a person who has started treatment not only starts treatment but remains in treatment. We also know how difficult it is for a site to monitor the current status of patients that have dropped off the radar due to death, migration or lack of commitment to remain in treatment.

For this reason and because we have invested in human resources and equipment to monitor our AIDS care sites on a weekly basis, as well as monitoring its growth and discounting those lost to follow-up, the UNAIDS announcement on the 17 million on ART, raises concern.

With the number reported, we'd like to clarify the following...

1) Are the 17 million people on antiretroviral treatment based on patient records or based on estimates and modeling?

2) If the 17 million on ART is based on reports from countries, has UNAIDS verified if these country reports are not cumulative numbers?

3) What mechanism exists at the country level to ensure that there is no double counting of patients on antiretroviral therapy? (i.e. patients who were originally registered on ART on one site and now attend another site)

4) Are country-by-country volumes of people on ART compared with antiretroviral procurements?

In addition to the answers to the above questions, could UNAIDS share with us the information and data of people on ART country-by-country?

We appreciate any information you could supply.

Michael Weinstein

President, AIDS Healthcare Foundation