Access to HIV treatment continues to accelerate, WHO/UNAIDS say

By Henry Neondo

The number of people receiving combination antiretroviral therapy (ART) for HIV/AIDS in developing countries is increasing significantly – more than doubling from 400 000 in December 2003 to approximately one million in June 2005 – according to a new report released today by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

However, access to HIV treatment continues to fall short of the growing need, and overall progress is unlikely to be fast enough to reach the target set by WHO and UNAIDS of treating three million people by the end of 2005.

The WHO/UNAIDS report shows that the number of people receiving ART is increasing in every region of the world, and the rate of scale-up is also accelerating. In sub-Saharan Africa, the region most severely affected by HIV, approximately 500 000 people are currently receiving ART – more than triple the number of people on ART in June 2004, and nearly double the number just six months ago.

Similarly, in Asia -- the second most affected region -- the number of people with access to ART has tripled since June 2004 to approximately 155 000 today. A third of this increase occurred in the first six months of this year.

Today’s WHO/UNAIDS report identifies the factors that have helped some countries to achieve important advances in access to ART, as well as the bottlenecks that have slowed progress in many areas.

The progress made to date has been possible as a result of the concerted efforts of many countries and donors with technical assistance from UNAIDS, WHO and other partners.

The report provides a series of recommendations to increase progress in treatment scale-up, including adopting simplified and standardized treatment approaches that can maximize the number of people receiving quality ART, and help strengthen overall health systems capacity.

“The movement to expand HIV treatment access is making substantial progress,” said WHO Director-General Dr LEE Jong-wook.

“This is the first time that complex therapy for a chronic condition has been introduced at anything approaching this scale in the developing world. The challenges in providing sustainable care in resource-poor settings are enormous, as we expected them to be. But every day demonstrates that this type of care can and must be provided.”

“It is imperative that we continue to speed up access to life-saving HIV treatment, not only as a means of treating the millions in need today, but also as a tool to help prevent millions of additional infections,” said UNAIDS Executive Director Dr Peter Piot.

“One of the key findings of the new report is that the availability of treatment increases the number of people who access key prevention services, such as testing and counseling.”

The “3 by 5” target, endorsed by all 192 WHO Member States, was intended as an interim step toward the goal of universal access to HIV treatment for those who need it.

The target was based on what could be achieved if countries, donors, and international agencies were fully successful in expanding political will, mobilizing funding resources, and building health infrastructure and systems.

Today’s report emphasizes that while political, financial, and technical support for ART scale-up have in some cases met or exceeded expectations, in others the prerequisites of a successful response are still not fully in place.