[pronut-hiv] "3x5" AIDS Initiative Imperiled By Low Funding, U.N. Says

[Leela McCullough <leela@healthnet.org>]

 From U.N. Wire
Monday, March 15, 2004 

"3x5" AIDS Initiative Imperiled By Low Funding, U.N. Says 

The U.N. initiative to provide anti-retroviral drugs (ARVs) to 3 million AIDS sufferers in developing countries by 2005 is facing funding shortfalls that could put it out of operation, U.N. and World Health Organization officials have said.

Just $2.3 billion has been secured out of the $5.5 billion needed, with only the United Kingdom, Sweden and Spain having contributed to date.

"If <http://www.who.int/3by5/en/>3 x 5 fails, as it surely will without the dollars, then there are no excuses left, no rationalizations to hide behind.  There will only be the mass graves of the betrayed," said Stephen Lewis, the U.N. secretary general's special envoy for HIV/AIDS in Africa.

The <http://observer.guardian.co.uk/international/story/0,6903,1169196,00.html>London <http://observer.guardian.co.uk/international/story/0,6903,1169196,00.html>Observer reports that some countries, particularly the United States, are reluctant to fund the project in part because of its reliance on fixed-dose combination of ARVs, which infringe on patent law in some wealthier nations.  

The United States has said it questions the safety of the combination drugs, but AIDS activists argue that the U.S. stance has been shaped by resistance from pharmaceutical companies, which disapprove of the drugs because they are made from ingredients discovered by the companies and under patent. 

"The U.S.'s position is to buy drugs only approved by the (Federal Drug Administration)," said Ellen 'T Hoen of <http://www.msf.org/>Medecins sans Frontieres.  "The fixed dose can't be approved by the FDA because of patent problems, not because of their safety and efficacy." 

The United States is sponsoring a two-day conference later this month in Botswana to discuss the principles of regulation of the ARV combination drugs (Alison Langley, London Observer, March 14).

In other news, Zimbabwe is set to launch ARV treatment this month at five pilot centers, with 260,000 HIV sufferers expected to benefit by the end of next year, <http://www.irinnews.org/report.asp?ReportID=39969&SelectRegion=Southern_Africa&SelectCountry=ZIMBABWE>Integrated Regional Information Networks reports.  WHO is providing technical support for the project, which is estimated to cost less than $25 per month because of partnerships with local manufacturers (IRIN, March 10).

Meanwhile, activists in nearby Swaziland, which introduced ARVs last year after significant international pressure, warn that distribution is haphazard and patients are not given enough guidance in their treatment programs, <http://www.irinnews.org/report.asp?ReportID=39885&SelectRegion=Southern_Africa&SelectCountry=SWAZILAND>IRIN reports.

"There are pharmacies in Mbabane that sell ARVs to anyone coming off the street," said Siphiwe Hlope, co-director of the AIDS support group Swazis for Positive Living.  "They do not dispense instructions, because the queue of people wishing to buy (the drugs) is so long."

"We concur with the government's policy to permit ARVs, but a law regulating their distribution is needed - anyone can sell ARVs.  Taxi drivers going to clinics to pick up ARVs for people get an extra supply, and they sell them to passengers," Hlope added.

Activists also worry that patients are starting and then stopping treatment, risking treatment resistance.

"People are not told to expect side effects.  When they become nauseous, dizzy and develop flu-like symptoms, which is to be expected with ARVs, they tell us they stop taking the pills because they think they are poisoning them," said one health worker.

The Health Ministry has said it will prepare a statement to address improper distribution.

According to U.N. figures, 38.6 percent of adults in Swaziland are infected with HIV.  The National Emergency Response Committee on HIV/AIDS says half of all Swazis in their twenties have the virus (IRIN, March 5).


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Leela McCullough, Ed.D.
Director of Information Services

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