WHO to miss 2005 AIDS drug target

A million people in poor countries are receiving life-saving AIDS drugs but the World Health Organization is unlikely to reach its goal of getting three times that number on treatment by the end of 2005.

Dr Jim Yong Kim, director of the WHO’s HIV/AIDS department, admitted the “3 by 5” target was ambitious. The 300,000 additional patients worldwide getting antiretroviral therapy every six months is not enough to meet it.

“It is much slower than we thought. Three by the end of 2005 looks very unlikely,” he told Reuters.

Kim could not say when the 3 million mark would be reached but he was very hopeful it would be quickly.

The WHO and the Joint United Nations Program on HIV/AIDS (UNAIDS) had hoped to provide treatment to 1.6 million of the 6 million people in poor countries who need it by June 2005 but the real acceleration in numbers they had hoped for did not materialize.

Instead they saw breadth -- meaning more countries joining the program and providing access to AIDS drugs.

In sub-Saharan Africa, the region worst affected by HIV/AIDS, about half a million people are receiving treatment --a three-fold increase in the last year. But it is still only after 15 percent of those who need it.

Asia has seen numbers rise from 55,000 to 155,000 since June 2004, while in eastern Europe and central Asia people on treatment have nearly doubled in a year to 20,000, according to an update report on “3 by 5”.

In Latin America and the Caribbean about two out of three people, or 290,000, in need of treatment receive it. But in north Africa and the Middle East coverage is only 5 percent.

Much clearer picture
“We learned some really important things,” said Kim. “First of all targets are extremely important. There were no targets for treatment. In fact, there was no target for prevention. We had no outcome targets globally before ’3 by 5.’”

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The program has shown that AIDS drugs, which must be taken for life, can be successfully administered even in the poorest countries, something which many had doubted.

It has also taught global health officials what is needed to scale up treatment -- training programs for health workers, developing a drug procurement and management system for countries and long-term financing.

“Those are the three things that came up over and over again,” said Kim. “We see a very clear pattern of need. We feel we know what the WHO has to do.”

Innovative countries are seeing the need to train health workers as an employment opportunity. In Mozambique, recent high school graduates who are unemployed are being trained to provide support for people on antiretroviral therapy.

Kim acknowledged that there are problems in health systems which must be fixed to provide long-term care. The WHO has a training package in 30 countries that is geared towards building up health infrastructures.

Despite missing its goal, the WHO is already looking past “3 by 5” to providing universal access to treatment to everyone who needs it by 2010.

“For the vast majority of countries, I think it is doable. Moreover, it is the right way to shape our activities,” said Kim.