The Clinton Health Access Initiative (CHAI) published the Advanced HIV Disease (AHD) Impact Report, which provides a detailed look at progress made since 2019 to avert preventable deaths among people with AHD, best practices for AHD program implementation, and CHAI’s perspective of what more will be needed to effectively end deaths from AHD-related opportunistic infections.
Despite progress toward reducing AIDS-related mortality over the past decade, the HIV epidemic remains a persistent global challenge. In 2020, there were still 680,000 AIDS-related deaths—only a six percent decrease from 2019. Of these deaths, 210,000 were from tuberculosis (TB) and 85,000 from cryptococcal meningitis. Advanced HIV disease contributes to these deaths, as clients with AHD who present to or re-enter care are at a higher risk of opportunistic infections and death. AHD or late-stage HIV refers to the point by which the immune system is severely damaged and unable to fight off opportunistic infections.
Sub-Saharan Africa has the highest burden of AHD. Here, an estimated 32 to 71 percent of clients who initiate care have AHD, and up to 60 percent of clients present with AHD after disengagement.
Yet, despite the high prevalence of AHD, screening remains low. People living with HIV continue to die from preventable and treatable opportunistic infections because they do not have access to the necessary diagnostics and medications.
Since 2019, Unitaid has invested more than US$25 million in measures to avert preventable deaths among people with AHD through the Unitaid-CHAI AHD Initiative. The AHD Impact report highlights the achievements made since 2019 and next steps to build effective AHD programs to increase access to lifesaving treatment to the people that need them.
 The Clinton Health Access Initiative, 2021, 2021 HIV Market Report, https://3cdmh310dov3470e6x160esb-wpengine.netdna-ssl.com/wp-content/uploads/2021/10/2021-CHAI-HIV-Market-Report.pdf.
 Gils, Tinne, et al. “Feasibility of Implementing The Advanced Hiv Disease Care Package as Part of Community-Based HIV/TB Activities: A Mixed-Methods Study Protocol.” BMJ Open, vol. 12, no. 2, 2022, https://doi.org/10.1136/bmjopen-2021-057291.