The World Health Organisation’s bid to get three million people onto treatment by the end of 2005 is stalled because of lack of financial support for WHO from the world’s richest countries, according to the UN’s Special Envoy on AIDS, Stephen Lewis. He said only three nations – Spain, Sweden and the United Kingdom – have indicated any willingness to give money to WHO that will allow it to carry out its 3 x 5 programme of work.
WHO needs $200 million over 2004 and 2005 to carry out country missions, provide technical assistance, upgrade health care infrastructure, carry out training and coordinate country efforts to scale up treatment. Until this week, aidsmap has learnt, WHO had found only $2 million to fund this year’s work.
WHO is not seeking to raise money that will fund treatment, but does hope to find money to pay for training of health care workers, design of treatment programmes, robust systems for monitoring the use of drug supplies and the progress of patients, design of education programmes and the provision of full-time technical advisers for more than 50 countries that have requested suppport.
“Virtually every African country with medium to high prevalence rates has a treatment plan in place. Many of the countries have some money from the Global Fund, or the World Bank, or the Clinton Foundation, or the Gates Foundation or the United Nations family or bilateral donors. For the first time, they stand a chance to sever the cycle of despair,” said Lewis.
“What they need is exactly what the World Health Organisation can provide: the capacity to give overall co-ordination and direction so that the treatment regimens succeed and countries can move to scale. It's the most exciting prospect of the last twenty years. It would be the first time the world could thumb its nose at the apocalypse,” Lewis said yesterday.
“It simply requires a single-minded exercise of political will, the kind of political will that reverses the moral paralysis of the last twenty years.”
Rumours of WHO’s financial difficulties have been circulating for weeks. In early January, WHO halved its original budget for 3 x 5 activities to $200 million, a move that the technical director of 3 x 5, Prof. Charles Gilks, described as realistic in view of donor attitudes in an interview with HIV & AIDS Treatment in Practice.
Newly appointed staff lured to WHO by the promise of resources to implement an ambitious treatment plan were shocked to learn that they would be expected to work miracles with no cash. Morale at WHO is shaky, with many missions to severely affected countries on hold until more money can be found to scale up WHO technical support. WHO is unable to commission technical support from external agencies due to lack of money and has been told by donors to redeploy staff, many of whom have no expertise in HIV, to carry out country missions.
In a further blow to morale, the overall head of 3 x 5 at WHO, Paolo Teixera, last week quit due to ill health and his place was taken by Dr Jim Yong Kim, a founder of Partners in Health, a project which pioneered the development of antiretroviral treatment programmes using communinity health workers in Haiti.
WHO published details of 3 x 5 progress to date earlier this week, and promised that by July it will have redeployed staff to country offices, begun major training programmes and helped countries that want to implement treatment put together applications to the Global Fund to Fight AIDS, TB and Malaria.