Umbilical vein injection of oxytocin for retained placenta

98 www.thelancet.com Vol 375 January 9, 2010 count below 350 cells per μL, moving away from stavudine in fi rst-line regimens, and, where available, measuring viral load every 6 months. Clearly, another WHO priority is to continue to expand antiretroviral therapy to all those in need (currently defi ned as those with CD4-cell count under 200 cells per μL). Countries will need help from the research community to decide on how to prioritise these developments and maximise the number of healthy lives prolonged, because few will be able to implement everything immediately, particularly against an increasingly challenging economic background. For example, it is recommended to measure viral load every 6 months where available but how high a priority should programmes currently put on making viral load tests available, in view of the current lack of cheap and robust assays? The DART trial clearly shows that expansion of antiretroviral therapy to all those in need must be the very highest priority. Such expansion is logistically diffi cult, but we must not allow other concerns about antiretroviral delivery to detract from meeting that need.