HIV/AIDS Treatment Goal Unlikely to be Met
UN Goal of Treating 3 Million HIV/AIDS Victims by 2005 Unlikely to be Met
New York, Jun 29 2005 4:00PM
The number of people receiving antiretroviral therapy (ART) for HIV/AIDS in developing countries has more than doubled to about 1 million in the past 18 months but still falls short of growing needs, and the United Nation Health agency is unlikely to reach its goal of treating 3 million people by the end of 2005, a new report said today.
The so called "3 by 5" target, endorsed by all 192 Member States of the UN World Health Organization (WHO), was intended as an interim step toward universal access to treatment and has been a major catalyst for mobilizing international action.
Although the report by WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) said overall progress is unlikely to be fast enough to reach the goal, senior officials today stressed the enormous progress that has already been made.
"The 3 by 5 initiative seems to me to be entirely vindicated. Secretary-General Kofi Annan's Special Envoy for HIV/AIDS in Africa, Stephen Lewis, told a meeting of civil society organizations in Nairobi, Kenya.
"Mind you, I can even now hear the curmudgeonly bleats of the detractors, whining that we will fall short of the target of three million in treatment by the end of this year. Tell that to the million people who are now on treatment and who would otherwise be dead," he added. "The truth is that the 3 by 5 initiative – which, I predict, will be seen one day as one of the UN's finest hours – has unleashed an irreversible momentum for treatment."
The 3 by 5 target was based on what could be achieved if countries, donors, and international agencies were fully successful in expanding political will, mobilizing funding resources, and building health infrastructure and systems and the report noted that current pledges of $27 billion in international aid for the 2005-2007 period left a projected shortfall of $18 billion.
It emphasized that while political, financial, and technical support for ART scale-up has in some cases met or exceeded expectations, in others the prerequisites of a successful response are still not fully in place while bottlenecks abound.
"The movement to expand HIV treatment access is making substantial progress," WHO Director-General Lee Jong-wook said. "This is the first time that complex therapy for a chronic condition has been introduced at anything approaching this scale in the developing world. The challenges in providing sustainable care in resource-poor settings are enormous, as we expected them to be. But every day demonstrates that this type of care can and must be provided."
UNAIDS Executive Director Peter Piot stressed the need to continue to speed up access to treatment, not only as a means of treating the millions in need today, but also as a tool to help prevent millions of additional infections. "One of the key findings of the new report is that the availability of treatment increases the number of people who access key prevention services, such as testing and counselling," he said.
The number of people receiving ART is increasing in every region, the report showed. In sub-Saharan Africa, the area most severely affected, some 500,000 people are receiving ART – more than triple those last June and nearly double the number just six months ago. Similarly, in Asia, the second most affected region, the number with access to ART has tripled since June 2004 to 155,000.
The report provides a series of recommendations including simplified and standardized treatment that can maximize the number receiving quality ART and help strengthen overall health systems capacity. The countries making the most significant progress are those that have adopted such drug regimens and clinical monitoring.
These countries are also addressing bottlenecks in procurement and supply chain management and in human resources capacity – by training non-physician health workers to safely and effectively administer ART. More countries should follow these leads.
Sustainable financing is also essential, the study noted. Donors have committed $27 billion over the next three years but not all these commitments have been delivered, and the total amount pledged leaves a projected shortfall of at least $18 billion for the period 2005-2007.