WHO’s 3 by 5 Initiative Has Garnered Momentum for Universal Antiretroviral Access, Provided Lessons for Future Initiatives, Editorial Says
The World Health Organization's 3 by 5 Initiative -- which aimed to treat three million HIV-positive people in developing countries with antiretroviral drugs by December 2005 -- "has generated real momentum behind providing broad access to antiretroviral therapy," but it is important to learn from the "missed" goal of the initiative when making future plans, a Lancet editorial says. The editorial says that the initiative has made "considerable progress" since its launch in 2003 despite WHO's June 2005 progress report, which showed that the initiative was 600,000 people short of its original goal of 1.6 million people receiving antiretroviral treatment by that date. New efforts are being focused toward providing antiretroviral drugs to all HIV-positive people in developing nations because the 3 by 5 initiative has shown how much can be achieved with "sufficient will and resources," according to the editorial. However, barriers to achieving the universal access goals -- including "inadequate leadership at the national level, a global system that does not efficiently address bottlenecks, [and] inadequate and uncertain funding from the major donors" -- must be recognized, the editorial says. The editorial "wholly endorse[s]" several action points from the International Treatment Preparedness Coalition report, including that pledged resources be distributed more efficiently; that a "better collaboration between WHO, UNAIDS, bilateral donors, and funding bodies such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, with a clear assignment of responsibilities" be formed; that detailed plans for nations to help with the "treatment scale-up" and plans to which WHO, UNAIDS and governments will be held accountable be made; and that there be more UNAIDS and WHO visibility in the countries in which these agencies work. Unless these barriers are addressed in "plans for universal access" to antiretrovirals, "there is a danger of jumping from one over ambitious target to another," the editorial says (Lancet, February 2006).
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