[afro-nets] World Health Assembly puts focus on HIV/AIDS treatment

[Claudio Schuftan <claudio@hcmc.netnam.vn>]

World Health Assembly puts focus on HIV/AIDS treatment
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The July issue of The LAncet Infectious Diseases of July has
many articles on HIV/AIDS before the World AIDS Conference in
Bangkok

Volume 4, Issue 7, 1 July 2004, Page 387

WHA puts focus on HIV/AIDS treatment

John Zarocostas

This year's World Health Assembly (WHA; Geneva, May 17­22)
agreed as a matter of priority that governments should beef-up
their national health systems to ensure they deliver concrete
HIV/AIDS prevention, treatment, and care.

Health ministers also welcomed WHO director-general Lee Jong-
Wook's "3 by 5" strategy to assist developing countries to se-
cure access to antiretroviral treatment for 3 million people
living with HIV/AIDS by the end of 2005 at a cost of around
US$5.5 billion. In 2003, only about 400,000 people in poor na-
tions were receiving treatment.

In a press conference on the eve of the WHA, Lee said the world
had an "unprecedented opportunity to change history" and reverse
the trend of the HIV/AIDS pandemic. Similarly, in his keynote
WHA address Lee told delegates "there must be universal access
to treatment by the earliest possible date, and ever more effec-
tive approaches to prevention".

To help scale-up HIV/AIDS treatment and care, the WHA adopted a
resolution that urged governments to pursue policies to promote,
amongst other things, sufficient and adequately trained person-
nel, and the availability of good quality antiretroviral medi-
cines and technologies.

The text also called for accessibility and affordable treatment,
testing, and counselling, and the development of health systems
designed to promote access to antiretroviral medicines.

The resolution also requested the WHO chief to strengthen the
key role of the global health agency in providing technical
leadership, direction, and support to health systems. This in-
cluded improving access for developing countries to pharmaceuti-
cal and diagnostic products, and support in improving management
of the supply chain and procurement of quality AIDS medicines.

But the annual gathering of the world's top 192 health officials
also adopted a resolution­sponsored by many poor African and
Caribbean countries ­ that calls for the development of strategies
to mitigate the adverse effects of the "brain-drain" of health
personnel on national health systems, most already stretched to
the limits, and instructed the WHO to find ways to enhance hu-
man-resources capacity.

However, the adopted text was a compromise from a stronger ear-
lier version, which suggested there was a need to "establish a
mechanism for compensating developing countries for the loss of
health personnel through migration".

The West African Health Organisation (WAHO) in a joint statement
said the brain-drain has severely affected health-care delivery
and national development goals. For example, the delegation of
Zimbabwe asserted the brain drain, estimated at 68% "has compro-
mised" the ability of the health system to rapidly scale-up ef-
forts to provide comprehensive HIV/AIDS services.

"States now have difficulty to retain their health workers",
WAHO said and underscored the international community needs to
help poor nations in their efforts to strengthen training and
research institutions locally.

The WHA lauded the move by WHO to place HIV/AIDS at the top of
the global health agenda. "AIDS is the Black Death of our time.
AIDS is close to exploding in parts of Asia and Europe. Its im-
pact in Africa has been devastating", said Dagfinn Hoeybraaten,
Norway's Minister of Health. "The global community has the means
to curb epidemics like SARS. The time to give AIDS the same
level of commitment is now."

Tommy Thompson, US Secretary of Health and Human Services, and
current chairman of the Global Fund to Fight AIDS, Tuberculosis,
and Malaria, said on an optimistic note, "we will stop the AIDS
pandemic. We will stop it because we have the will, the means,
and the passion to do it". Thompson said the Fund has already
approved 224 grant programmes in 121 countries, totalling more
than $2 billion.

Moreover, a day earlier, Thompson announced in Geneva a new pro-
cedure that would fast track approval by the US Food and Drug
Administration of fixed­dose combinations drugs and blister
packs from both innovator and generic companies that would be
eligible for purchase from President Bush's 5 year $15 billion
emergency plan for AIDS relief.

Interventions by ministers from HIV/AIDS-ravaged countries il-
lustrated in graphic terms the challenges ahead. P D Pariren-
yatwa, Minister of Health for Zimbabwe­one of the worst affected
by HIV/AIDS­told the WHA: "we estimate 1.82 million Zimbabweans
are infected and of these 340000 are in urgent need of antiret-
roviral therapy". He pointed out that about 170000 are targeted
for 3 by 5 treatment but noted that so far only 5000 people liv-
ing with HIV/AIDS are being treated.

But Parirenyatwa voiced concerns that the disbursements of ap-
proved grants from the Global Fund have been slow and that dis-
tribution of some funds from the various initiatives "has been
politicised to the detriment of people living with HIV/AIDS".

The minister of health for Uganda Jim K Muhwezi, reflecting the
views of many other ministers, stressed that while everything
possible must be done to combat HIV/AIDS, "we must not forget
other key diseases, especially malaria, which is the leading
killer in most African countries".

Finally, Pakistan's Minister of health Mohammad Nasir Khan, and
President of the 57th WHA, said we could not ignore that 8.8
million new cases of tuberculosis are detected each year.