Huge challenge remains to treating 3 million AIDS patients by end of 2005 – UN

By the end of 2004, 700,000 AIDS-infected people in developing countries were receiving antiretroviral treatment (ART), an increase of 75 per cent over a year ago but still posing an enormous challenge in order to meet the target of reaching 3 million people by the end of this year, United Nations agencies reported today.

Of the estimated $3.5 billion to $3.8 billion required to achieve the so-called “3 by 5” target – treating 3 million of the estimated 6 million people in need in developing countries by the end of 2005 – at least $2 billion is still needed, a gap that can be cut by reductions in the costs of drugs or service delivery.

“We salute the countries who have now shown us that treatment is possible and can be scaled up quickly even in the poorest settings,” World Health Organization (WHO) Director-General Lee Jong-wook told a joint press conference at the World Economic Forum’s Annual Meeting in Davos, Switzerland.

“AIDS treatment access is expanding every day thanks to the dedicated work of doctors, nurses, health workers and people living with HIV and AIDS, who are often working under difficult circumstances to turn the dream of universal treatment into a reality,” he added.

But participants were keenly aware of the major continued efforts needed in affected countries and internationally to achieve the “3 by 5” target. The 700,000 now being treated represents only just over 12 per cent of the total needing ART.

“While today’s figures are encouraging, the work so far has been laying the groundwork for a much larger expansion in the months and years to come,” Richard Feachem, Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria, a unique public-private partnership created three years ago on Secretary-General Kofi Annan’s initiative to attract additional resources in the battle against the three diseases.

Participants at the news conference, which also included the Joint UN Programme on HIV/AIDS (UNAIDS) and the United States Government, stressed the importance of collaboration across all sectors. Treatment is happening because national governments are taking the lead to coordinate efforts with all partners to scale up treatment in rural and urban areas.

The Global Fund is providing flexible funds to governments and projects. The United States is funding, as well as providing technical assistance and guidance for, programme and capacity development to support national strategies. WHO and UNAIDS are providing guidance and technical assistance to help countries turn finance into programmes, and non-governmental organizations (NGOs), faith-based organizations, networks of people living with HIV/AIDS and the private sector are all contributing.

A regional and country breakdown shows that the number of people on treatment doubled over six months from 150,000 to 310,000 in sub-Saharan Africa, and from 50,000 to 100, 000 in Asia, while in Latin America and the Caribbean, the numbers continued to improve and there are now 275,000 people on treatment there. Botswana and more than 10 Latin American countries are already treating half or more of those in need, while Uganda and Thailand are expected to be treating 50 per cent or more people needing ART in the first half of 2005.

WHO and UNAIDS estimate that overall 72 per cent of the unmet need for treatment is in sub-Saharan Africa; 22 per cent is in Asia. India, Nigeria and South Africa alone account for 41 per cent of the overall need for treatment.

“We know that treatment is more than just access to antiretrovirals,” UNAIDS Executive Director Peter Piot said, embracing a wide approach to the AIDS crisis. “People living with HIV need comprehensive services, from testing and counselling to nutritional support. Just as there is an urgent need to increase access to treatment, we must also renew our commitment to preventing new HIV infections.”

Key obstacles that must be tackled urgently include the high cost of first- and particularly second-line treatment and diagnostic tests; the lack of affordable and user-friendly AIDS medicines for children; the need to ensure equitable access to reach the most vulnerable, including sex workers, prisoners, injecting drug users; and the need to rapidly accelerate and coordinate prevention and treatment services.

Among other problems are the need to increase the number of individuals who know their HIV status, in part through the routine offer of testing and counselling at critical health system entry points; and the continued lack of adequate human resources, trained medical and non-medical health workers in affected communities.

WHO needs $60 million before the end of 2005 to provide the necessary technical assistance to countries to help them reach their targets.