Nearly all countries in sub-Saharan Africa (SSA) have adopted national polices for universal HIV treatment, regardless of CD4 cell count or clinical stage. Evidence to date from SSA suggests that, once linked to care, timely ART initiation with retention and viral suppression is the norm. However, ART initiation in SSA usually occurs late in the course of infection, driving up mortality and new infection rates. With 10.3 million people untreated and a projected 1.2M new infections per year in SSA, the universal treatment era presents strategic opportunities for health systems to substantially reduce AIDS-related mortality and HIV incidence. This special issue of the Journal of Virus Eradication, with contributing authors from the African regions of the IeDEA consortium and the World Health Organization (WHO), contains an editorial and eight articles focused on issues critical to ensuring the success and impact of universal treatment implementation in SSA.
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