Here is a comment from a reader on the 'healthy scepticism' posting and recent discussion. The [him] moderator welcomes comment on the resources needed and the constraints to be overcome in doubling the number of people on antiretroviral treatment.

[him] moderator

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"In addition to financial factor, there are several other important factors to double the uptake of ART.

One factor is human resource as mentioned by the moderator. In order to fulfill the human resource requirement, GPs should be trained in a systematic way to be able to prescribe and monitor ARTs, in a way that secondary drug resistance would be prevented or occur at its minimum. Besides GPs, HIV consultants or experts should be within the contact reach of GPs to get expert opinion in cases of complicated treatment scenarios.

The other thing is increasing access and coverage. ART clinics should be established at district level in minimum. Use of trained GPs up to township level will increase the access further. The better and easier the access is, the more likely the patients will present themselves to doctor.

There are also several important constraints that need to be overcome such as well validated monitoring system, lowering degree of discrimination and stigma among public, increasing public awareness of disease condition and treatment, etc."