Lilongwe — Malawi's government has set itself a major challenge this year, announcing plans to more than double the number of people receiving antiretroviral (ARV)drugs to half a million by the end of 2010.

The country recently adopted new World Health Organization (WHO) guidelines that raise the threshold for starting antiretroviral (ARV) therapy from a CD4 count (a measure of immune system strength) of less than 200, to a CD4 count of 350, regardless of whether the patient is displaying symptoms.

Although implementing the changes will be expensive, some experts argue that starting patients on ARVs earlier could actually save the government money in the long term by reducing the need to treat them for opportunistic infections such as tuberculosis.

Unads Country Coordinator Patrick Brenny said the targets were reachable, provided the country could mobilise the resources, including money, drugs and manpower. An estimated 200,000 HIV-positive people are on treatment in Malawi, where HIV prevalence is at 12 percent.

"Malawi is an extremely resource-constrained country ... more than 90 percent of Malawi's HIV response is externally funded," Brenny told IRIN/PlusNews.

He noted that the Global Fund to Fight AIDS, Tuberculosis and Malaria - which is visiting Malawi - had expressed willingness to fund implementation of new WHO treatment guidelines.

Malawi successfully utilized its Round 1 Global Fund grant and was awarded a rolling continuation channel grant, which extends the Round 1 funding for six years. The country and the Fund are now looking at how to make best use of the money in relation to the new guidelines.

Brenny said Malawi was very aware of the risk that accompanied its high dependence on foreign aid and was looking at ways to reduce this, including the possibility of building a local ARV manufacturing plant in partnership with Indian drug companies.