O131 Where are we with National and International guidelines?

Since the beginning of the HIV/AIDS epidemic, many guidelines have been generated to address various aspects HIV interventions. Some have addressed HIV prevention, for example, prevention of mother to child transmission (PMTCT) and HIV management, for example, Antiretroviral treatment (ART) guidelines. Many of these guidelines were initially generated internationally addressing common ground issues. However, with time it became apparent that at national level there were enough differences that made it necessary to modify the international guidelines to become national. One of the major objectives of any guidelines is to maintain quality within given resources of any interventions that are being addressed. In HIV treatment, the accelerated access programs to ART have considerably bridged the gaps within resource-limited countries and also those of developed ones. This has been possible with the various funding sources like PEOFAR and the Global Fund for the treatment of HIV, Malaria and Tuberculosis. As a result of this, some clinicians are wondering whether we should now have universal guidelines to ensure similar quality of care anywhere in the world. Some believe that such guidelines will reduce costs of commodities by facilitating bulk purchases. However, others are of the view that universal guidelines may negatively affect those countries that are not supported by PEOFAR and the like.