Meeting 3 By 5 Initiative’s End-of-Year Goal Will Be ‘Extremely Difficult,’ WHO HIV/AIDS Director Says
Meeting the World Health Organization's 3 by 5 Initiative target to treat three million people with antiretroviral drugs by the end of the year will be "extremely difficult," WHO's HIV/AIDS Program Director Jim Yong Kim said on Tuesday at the 12th Conference on Retroviruses and Opportunistic Infections in Boston, the Boston Globe reports. Although some countries -- including Botswana and Uganda -- have either met their treatment targets or expect to meet them soon, Kim "singled out" South Africa, India and Nigeria as the three countries that "must urgently expedite" efforts to provide access to antiretrovirals, according to the Globe. Although South Africa has increased the number of people receiving antiretrovirals from 20,000 to 50,000 over the past few months, 90% of the HIV-positive people in the country are without treatment, according to Kim (Smith, Boston Globe, 2/23). Noting that Swaziland, Lesotho and Zambia have made significant steps toward meeting their treatment targets, Kim said, "If those three countries can meet their goals at the end of 2005, it might be quite embarrassing to South Africa to say they have reached only 10%" (Russell, San Francisco Chronicle, 2/23).
Drug Prices, Access
UNAIDS Senior Adviser Julian Fleet at the conference said that although "significant progress" has been made in lowering drug prices and establishing delivery systems in developing countries, major barriers still remain, according to the Globe. An annual supply of combination antiretroviral therapy using brand-name drugs can cost about $460 per person in some developing countries -- compared with approximately $10,000 or more annually per person in the United States -- but even such "dramatically reduced" prices can be "overwhelming" in countries where average annual incomes are only several hundred dollars, the Globe reports. In addition, although some treatment initiatives operated by foundations, health agencies and governments aim to cover a significant portion of the cost of medication, there is still "no assurance" that the medications "will get where they are needed," Fleet said, according to the Globe. "Many people just assume that it's enough to air-drop antiretrovirals into the capital city or leave them off at the port," Fleet said, adding that systems must be established to store, transport and track drugs (Boston Globe, 2/23).
Progress, Political Will
Kim also "doled out praise" to the World Bank, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief for contributing to the treatment progress over the last six months, the Chronicle reports (San Francisco Chronicle, 2/23). According to the December 2004 "3 by 5 Progress Report," the initiative experienced dramatic progress in the second half of 2004 -- 700,000 people in developing countries were on antiretroviral drugs at the end of 2004, compared with 440,000 as of June 2004. However, only about 12% of an estimated 5.8 million HIV-positive adults in developing countries who need antiretrovirals are receiving them (Kaiser Daily HIV/AIDS Report, 1/27). Kim said that the failure of some countries to meet their treatment targets might be due in part to a "lack of commitment" from political leaders, according to the Globe. "There are two kinds of political will. There's the political will where presidents stand up and say, 'Yes, we think that HIV is a problem, and we think that we should pay more attention.' Then there's the kind of political will where leaders actually get their hands dirty and really push for treatment scale-up," he said (Boston Globe, 2/23). Kim added, "Please stop speculating whether we will make it or not, and do all you can to make it happen" (San Francisco Chronicle, 2/23).