[pronut-hiv] [sea-aids] Comment: *3by5* disappointment stresses need for more comprehensive AIDS care services

["ProNut-HIV" <pronut-hiv@healthnet.org>]

Comment:  '3by5' disappointment stresses need for more comprehensive
AIDS care services
AIDS Care Watch Campaign
************************

"STAYING ALIVE DURING WAIT FOR ARVS IS NOW EVEN MORE CRITICAL"

Kobe, Japan: Today's [29 June 2005] announcement by the World Health
Organization (WHO) and the Joint United Nations Programme on HIV/AIDS
(UNAIDS) that the much-heralded '3by5' initiative is "unlikely" to be
achieved by the end of 2005, places even greater urgency on the need to
scale up access to other care options that keep people with HIV alive
while they wait for antiretroviral (ARV) drugs.

The two UN agencies, who share responsibility for tackling the global
pandemic, highlight progress during the past 18 months towards greater
ARV access, and report that one million people with HIV/AIDS (PWHA) in
poorer nations are now taking life-saving ARV drugs. They had hoped 3
million people would have access to the medicines by the end of 2005,
but that now looks out of reach.

According to the AIDS-Care-Watch campaign - a civil society-led
initiative with over 240 partner organisations worldwide - what they
fail to adequately address is the plight of the 5 million people who
already require ARV drugs but cannot access them. Eighty-five percent of
the unmet ARV need is concentrated in just 20 countries, where providing
the drugs is particularly challenging. For example in India, where
coverage is less than 10% of need, and where over 700,000 people may die
before they need to because ARVs are still out of reach. Or in Nigeria,
where coverage is at 8% and where close to 600,000 people are waiting
for drugs. Some heavily-affected African countries, such as Tanzania and
Zimbabwe have unmet ARV needs that exceed 95%. Yet in all of these
countries, other available care options that could extend lives are not
being given adequate attention.

"As a bold new initiative for WHO and UNAIDS, the 3by5 campaign has
been good. But we have to ask why is only 1 in 6 of those who need ARVs
now receiving them? What about the 5 million who are not?" asked Dr
Alice Welbourn of the International Community of Women Living with
HIV/AIDS. "What about the food, care, and other drugs and services that
even the 1 million need?"

The 3by5 disappointment indicates that where large unmet ARV needs
persist, a broad package of other readily-available treatment and care
options should be urgently provided to keep people with HIV alive while
they wait for ARVs programmes to deliver on their promise. For example,
care services should also provide prevention and treatment of the
HIV-associated opportunistic infections (OIs), such as tuberculosis
(TB), which people with HIV are especially susceptible to.

"We have given a promise to people that ARVs will be made available,
and we are clearly not keeping up that promise," said Dr NM Samuel, who
runs the Department of Experimental Medicine and AIDS Research in
Chennai, India. "If we are unable to provide ARVs on a regular basis to
people who require them, can we then seriously think about alternatives,
like ensuring prophylaxis and treatment for OIs on a regular basis, or
providing nutritional supplements. Or are we going to wait another three
years for so many more people to die before these measures come into
effect?"

Finally acknowledging the 3by5 delay has also prompted speculation on
the nature of such international initiatives, and about what might now
replace the 3by5 target as a goal to maintain the momentum that the
drive for ARVs has generated.
"WHO launched 3by5 with a loud voice but without having a clear plan at
the national level for urgent treatment scale-up.  Because of this, the
3by5 goal will not be met and the small confidence we have in
multilateral institutions to act is further destroyed. We need a global
plan that builds upon specific national plans," said Marcel van Soest,
Executive Director of the World AIDS Campaign. "For example, how can we
move towards universal drug access in challenging countries like Sudan,
Zimbabwe, and Afghanistan? Unless we draw on the real lessons of the
past 18 months, how can we re-build confidence in WHO, UNAIDS and in
this whole endeavour?"

Earlier this month, G8 finance ministers referred to the need to
mobilise sufficient money to achieve 'universal access' to ARVs by 2010.
This even larger ARV treatment target is now being put forward by some
organisations as the way forward, and they hope that the full G8 meeting
in Scotland next month will fully embrace such a goal.

"The likely failure of 3by5 to reach its target is not just another
missed target. It is an indictment of leaders in rich and poor countries
that failed to back it and save the lives that needed saving," said
Leonard Okello, International HIV Coordinator at ActionAid International
in response to the WHO/UNAIDS report. "The G8 meeting next week has the
chance to correct this. They now need to give their full backing to a
target of universal access for all who need it by 2010 and make sure
this happens," he added.

Before embarking on any new treatment target, van Soest urges that the
lessons of 3by5 be used to map out the road to universal access, and
that the millions of people at risk in the meantime are fully
considered. "What about the people dying now? Why are we talking about
universal access by 2010 when we could not even reach the goal of 3by5?"
he asked. "There are many simple, concrete care and treatment options
available to keep people alive now, we need to provide people with a
comprehensive health programme, focusing only on ARVs is too narrow."

Dr Welbourn added: "This year alone there will be over 10 times the
number of Indian Ocean Tsunami deaths caused by AIDS-related illnesses.
World leaders have shown that they can respond to one horrendous crisis
when pressurised by their citizens to do so. When are they going to
start to respond meaningfully, with real resources and real commitment
to the global crisis of HIV/AIDS?"

"We positive people are their early warning system. We have been
warning the world for over 20 years now what AIDS means to our lives,
our families, our communities. How many more of us will have died before
we hear an answer?"


******************
In 2005 alone, an estimated three million people will lose their lives
as a result of HIV/AIDS - or over 8,000 every day.
There are currently around 40 million people living with the virus.

Sent by:
Abigail Erikson, Global Campaign Coordinator, 
AIDS-Care-Watch
Email: abigail@aidscarewatch.org 
Web: www.aidscarewatch.org