Despite the significant progress that continues to be made in the expansion of ART programs globally, reductions in AIDS-related mortality have slowed in many contexts. Currently an estimated one-third of HIV- positive clients receiving care are living with advanced HIV disease (AHD), defined as a CD4 cell count below 200 cells/μL or WHO stage 3 or 4. These individuals are at increased risk for opportunistic infections and death, often experiencing challenges in continuing to engage in care.
Cryptococcal meningitis (CM), a serious fungal opportunistic infection, is the second leading cause of HIV-related mortality in sub-Saharan Africa, where it accounts for an estimated 15-20% of HIV-related deaths. In order to refocus on AHD mortality the End Cryptococcal Meningitis Death by 2030 Framework was developed by global stakeholders.