AFRO-NETS> Plan to get 3 million AIDS patients on treatment by 2005

[Claudio Schuftan <aviva@netnam.vn>]

Plan to get 3 million AIDS patients on treatment by 2005
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WORLD HEALTH ORGANIZATION AND UNAIDS UNVEIL PLAN TO GET 3 
MILLION AIDS PATIENTS ON TREATMENT BY 2005
 
Geneva - The World Health Organization (WHO) and UNAIDS today 
release a detailed and concrete plan to reach the 3 by 5 target 
of providing antiretroviral treatment to three million people 
living with AIDS in developing countries and those in transition 
by the end of 2005. This is a vital step towards the ultimate 
goal of providing universal access to AIDS treatment to all 
those who need it.
 
The 3 by 5 initiative complements the groundbreaking commitments 
made by the United States under President Bush's HIV/AIDS Ini-
tiatives ($15 billion dollars for an enhanced AIDS response), 
the pathfinding work of NGOs (like MSF) and faith-based groups, 
the efforts of pharmaceutical companies to reduce the prices of 
AIDS treatment, the contribution of international foundations 
like the Bill and Melinda Gates Foundation, the initiative and 
hard work of many national and international agencies, and, 
critically, the courageous contributions of nations increasing 
their people's access to AIDS treatment.
 
"Preventing and treating AIDS may be the toughest health assign-
ment the world has ever faced, but it is also the most urgent," 
said Dr Lee Jong-Wook, Director-General of the World Health Or-
ganization. "The lives of millions of people are at stake. This 
strategy demands massive and unconventional efforts to make sure 
they stay alive."
 
UNAIDS announced last week that 40 million people around the 
world are infected with HIV, and that the global AIDS epidemic 
shows no signs of abating. Five million people became infected 
with HIV worldwide and 3 million died this year alone - that's 
8,000 people every day. WHO estimates that six million people 
worldwide are in immediate need of AIDS treatment. This strategy 
outlines the steps needed to deliver treatment to half of them 
within two years.
 
The strategy is a key element in a combined programme of accel-
erating HIV/AIDS prevention and treatment. Much has already been 
done by countries, by UNAIDS, the World Bank, foundations, WHO 
and many other groups. After twenty years of fighting the epi-
demic, it is now clear that a comprehensive approach to HIV/AIDS 
must include prevention, treatment and care.
 
"The 3 by 5 framework is a plan for action by a broad alliance 
of nations, institutions, and committed people, including those 
living with HIV/AIDS," said Dr. Jack Chow, Assistant Director-
General of WHO for HIV/AIDS, Tuberculosis and Malaria. "We urge 
all concerned to work to reach the 3 by 5 target as rapidly as 
possible."
 
Evidence and experience shows that rapidly increasing the avail-
ability of antiretroviral treatment in line with 3 by 5 targets 
can lead to more people knowing their HIV status and more open-
ness about AIDS. Individuals on effective treatment are also 
likely to be less infectious and less able to spread the virus. 
Good treatment programmes will make more people come forward for 
testing HIV/AIDS status. Treatment can therefore contribute to 
the rapid acceleration of prevention.
 
Building on work done by UNAIDS, developing and donor countries, 
NGOs and other multilateral agencies, WHO and UNAIDS are taking 
another big step forward in the global movement to increase ac-
cess to prevention and treatment services.
 
"The lack of HIV treatment is without a doubt a global emer-
gency," said Dr Peter Piot, UNAIDS Executive Director. "We 
firmly believe that we stand no chance of halting this epidemic 
unless we dramatically scale up access to HIV care. Treatment 
and prevention are the two pillars of a truly effective compre-
hensive AIDS strategy."
 
3 by 5 Strategy
 
To reach the 3 by 5 target, WHO and UNAIDS will focus on five 
critical areas:
 
* Simplified, standardised tools to deliver antiretroviral ther-
  apy
* A new service to ensure an effective, reliable supply of medi-
  cines and diagnostics
* Rapid identification, dissemination and application of new
  knowledge and successful strategies
* Urgent, sustained support for countries
* Global leadership, strong partnership and advocacy
 
Simplified Treatment Recommended
 
The strategy has greatly simplified the recommendations for AIDS 
treatment regimens. The number of such WHO-recommended regimens 
has been cut to four from 35. All four are equally effective. 
The selection of an individual regimen for a patient will be 
based on a combination of individual needs, together with the 
availability and suitability of a particular regimen in a coun-
try. The strategy also recommends the use of quality-assured 
"fixed dose combinations" or easy-to-use blister packs of medi-
cine whenever they are available. The aim is to ensure that all 
people living with AIDS, even in the poorest settings, have ac-
cess to treatment through this simplified approach.
 
The strategy also includes the global AIDS Medicines and Diag-
nostics Service (AMDS), which will ensure that poor countries 
have access to quality medicines and diagnostic tools at the 
best prices. The service, which will be operated by WHO, UNICEF 
and other partners, will help countries to forecast and manage 
supply and delivery of necessary products for the treatment and 
monitoring of AIDS. Through the WHO Prequalification Project, 
AMDS will also include a medicines and diagnostics evaluation 
component which will ensure that manufacturers, products, pro-
curement agencies and laboratories meet international quality, 
safety and efficacy standards.
 
Another key element is the simplification of monitoring, so that 
easy-to-use tests such as body weight and colour-scale blood 
tests are used where more complicated and expensive tests for 
viral load and white cell (CD4) count are not yet available. The 
simpler tests, combined with clinical evaluations by adequately 
trained health workers, can be effective in monitoring the pro-
gress of AIDS, the effectiveness of treatment and its side ef-
fects.
 
Treatment Action in Countries Already Under Way
 
Antiretroviral therapy programmes can only be expanded if there 
is coordinated, scaled-up action in countries, particularly 
those hardest-hit by AIDS. Countries are at the heart of the 3 
by 5 strategy and will be the focus of all efforts to meet the 3 
by 5 target. Many countries have already demonstrated their com-
mitment to this target. Immediately following the declaration of 
a global AIDS treatment emergency, more than 20 countries re-
quested collaboration and input from WHO, UNAIDS and other part-
ners.
 
Teams have already travelled to Kenya, Burkina Faso, Malawi and 
Zambia. Other teams have done preparatory work in Ukraine, India 
and Sudan. In each case, the teams will be working with govern-
ments to identify and help remove obstacles, so that antiretro-
viral medicines can be provided quickly to the people who need 
them most. Many other countries, including Russia and Djibouti, 
have also requested assistance.
 
Training of health workers is an urgent need in all countries 
involved. Many of the countries with the highest numbers of peo-
ple living with HIV/AIDS have very few doctors or other trained 
health staff. Many of these health workers have died as a result 
of untreated AIDS; others have moved to seek better pay and job 
security in wealthier countries.
 
Thousands of community workers to be trained
 
One of the most innovative aspects of the 3 by 5 strategy is a 
method for urgently training tens of thousands of community 
health workers to support the delivery and monitoring of 
HIV/AIDS treatment. An intensive training programme would enable 
these health workers to evaluate and monitor patients, and make 
sure they receive and are taking their medicines.
 
The strategy acknowledges that the involvement of communities 
and community workers is essential to the success of this ini-
tiative. Significant evidence and experience shows that without 
strong community support, people may have a more difficult time 
adhering to their medical regimens. Also, community involvement 
is a critical element of any successful HIV prevention strategy.
 
There is also good evidence that treatment can have an acceler-
ating effect on prevention efforts. "We know from experience 
that the availability of treatment encourages people to learn 
their HIV status and receive counselling," said Dr Paulo 
Teixeira, Director of the HIV/AIDS Department at WHO. "We also 
know that the availability of treatment reduces stigma for peo-
ple living with AIDS. People living with AIDS have a right to 
treatment and we must find a way to deliver."
 
One of the key elements of the strategy is "learning by doing". 
The strategy unveiled today by WHO and UNAIDS addresses many of 
the obstacles that have up to now prevented millions of people 
in poor countries from accessing AIDS medicines. The strategy 
will evolve as lessons learnt from implementing the strategy are 
identified and rapidly applied.
 
Funding
 
Reaching the 3 by 5 target will require substantial new funding 
for AIDS treatment from all sources - countries, donor govern-
ments and multilateral funding agencies. WHO has estimated that 
the extra funding required amounts to approximately $5.5 billion 
over the next two years.
 
"We know what to do but what we urgently need now are the re-
sources to do it," said Dr Lee. We must waste no time in build-
ing strong alliances immediately to implement this strategy. 
Three million people are counting on it."
 
For further information contact: 
Melanie Zipperer
Communications Officer
HIV Department
mailto:zippererm@who.int 
 
or 
Iain Simpson
Communications Officer
WHO Director-General's Office
mailto:simpsoni@who.int 
 
Or please check the WHO HIV web site on 
http://www.who.int/hiv or mailto:threebyfive@who.int

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