WHO has met its 2004 target for bringing antiretroviral treatment to people in resource-limited countries, WHO Director General Dr Lee Jong-Wook announced today. Approximately 700,000 people are now receiving antiretroviral treatment. The progress towards WHO’s target of 3 million on treatment by the end of 2005 represents a 75% increase in the numbers on treatment since July 2004, he said.
However, an extra US$2 billion is needed from donors during 2005 alone to ensure that the world meets the 3 x 5 target, WHO says.
WHO and UNAIDS estimate that in the region with the heaviest burden - sub-Saharan Africa - the number of people on treatment has doubled over six months from 150 000 to 310 000. In Asia, the figure has doubled since June from 50 000 to 100 000. In Latin America and the Caribbean, the numbers continued to improve and there are now 275 000 people on treatment in this region. Botswana and more than ten countries in Latin America are already treating 50% or more of those in need in their countries. Building on years of AIDS awareness and prevention programmes, Uganda and Thailand are expected to be treating 50% or more people needing ART in the first half of 2005.
WHO and UNAIDS estimate that overall 72% of un-met need for treatment is in Sub-Saharan Africa; 22% is in Asia; India, Nigeria and South Africa alone account for 41% of the overall need for treatment.
“The "3 by 5" target can only be reached if major progress is made in the countries with the greatest unmet need,“ said Dr Lee.
More resources needed urgently
Using the Zambia treatment model with an average drug cost of US$ 304 per person per year as a standard and applying it to 49 high burden and focus countries, it has been estimated that, to achieve “3 by 5”, US$ 3.55 billion to US$ 3.80 billion is needed in 2005. Based on commitments and pledges, about $1.55 billion is available for 2005 from developing and transitional country sources, Global Fund to Fight AIDS, Tuberculosis and Malaria disbursements to countries, the United States President’s Emergency Plan for AIDS Relief, World Bank and other donors. This would leave a shortfall of more than $2 billion.
WHO itself needs US$60 million before the end of 2005 to provide the necessary technical assistance to countries to help them reach their targets.
Obstacles remain
“Enrolling 2.3 million new people on ARV therapy in the next year is clearly the most difficult task the global public health community has ever faced. However, we should be encouraged by the rapid progress we have witnessed in the last six months.”
There remain a number of difficult obstacles that need to be addressed, WHO reports:
- the high cost of first- and particularly second- line treatment and diagnostic tests;
- the lack of affordable and user-friendly AIDS medicines for children;
- the need to ensure equitable access to reach the most vulnerable, including sex workers, prisoners, injecting drug users;
- the need to rapidly accelerate and coordinate prevention and treatment services, and make better use of critical entry points such as TB and maternal health services;
- the need to increase the number of individuals who know their HIV status, in part through the routine offer of testing and counselling at critical health system entry points;
- the continued lack of adequate human resources, trained medical and non-medical health workers in affected communities.
- Increasing access to treatment must go hand in hand with increased prevention efforts.
Further information
To download WHO’s progress report on 3 x 5 and view country by country information on progress, click here.
To view detailed country progress reports on 26 countries that have already received WHO field visits, click here.