Gregory Pappas, John-Manuel Andriote, Philip Mwalali
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Directions for national data policy for antiretroviral therapy in resource-poor settings: a focus on durable viral suppression.
The rapid scale-up (that is, full implementation) of programs to provide antiretroviral therapy (ART) for HIV in resource-poor settings has become a major objective for many less-developed nations and the agencies that provide funding to them. The success and sustainability of ART programs will depend upon durable viral suppression, the long-term maintenance of the infected on first-line treatment regimes. This article considers the data policy that will be required to achieve durable viral suppression. The UNAIDS (Joint United Nations Programme on HIV/AIDS) "Three Ones" doctrine calls for one national health information strategy for countries that are scaling-up ART. This article provides a framework for standardizing national data policy. The need for standardization must be balanced with recognition that ART programs are still evolving and that excess standardization (imposing forms and electronic systems) should be avoided while best practices are developed and proven. This independent assessment of data policy for ART may be useful in the further development of routine program monitoring and targeted evaluation of durable viral suppression.