Future of HIV/AIDS care in low- and middle- income countries

Subsequent chapters in this book describe the great successes in bringing HIV care to hundreds of thousands in Africa, Asia, Eastern Europe, and Latin America. Antiretroviral therapy (ART) rollout has brought new hope and transformed lives in all of these regions. These accomplishments have required overcoming considerable challenges and skepticism, both of which persist. Thus continued success of ART rollout and its long-term contribution to improving health and longevity is not assured, but depends on our ability to address significant ongoing and new challenges, which include maintaining and strengthening political will, expanding international financing, improving integration of HIV care services into national health care programs, training and retaining health care workers, improving prevention efforts and diagnostic programs, and refining ART monitoring and regimen selection. Some of these issues are addressed in other chapters. In this chapter we focus on clinical challenges in expanding HIV care in low and middle-income countries.