Life saving antiretroviral therapy for HIV is now reaching nearly 3 million people in low and middle income countries, according to a new report issued today by the World Health Organization (WHO), UNAIDS and UNICEF. A key finding of the report is that more women are able to get antiretrovirals to stop the virus being passed onto their children during pregnancy.
Launced today, 2nd June, the report, titled “Toward Universal Access: Scaling up priority HIV/AIDS interventions in the health sector”, also says that testing and counselling has improved and there is more commitment to male circumcision in the more heavily affected parts of sub-Saharan Africa.
Dr Margaret Chan, Director General of WHO, said:
“This represents a remarkable achievement for public health.”
She said it proved that with “commitment and determination, all obstacles can be overcome”.
“People living in resource-constrained settings can indeed be brought back to economically and socially productive lives by these drugs,” she added.
The report said that at the end of 2007, nearly 1 million more people were on antiretroviral therapy, bringing the overall total to nearly 3 million, which was the target of the so-called “3 BY 5” campaign to have 3 million HIV-positive people in low and middle income countries having treatment by 2005.
Although the target has been missed, even two years later, many are saying that it is the reason behind the big push in getting so many people on antiretrovirals. The report says there are three main reasons for the rapid scale-up in antiretroviral use:
- More drugs are available, mostly because prices have fallen.
- Improved delivery of antiretrovirals that “fit” better with the countries that need them; for instance simpler, more standardized regimens, decentralized services, and more effective staffing and lab resourcing.
- Increase demand for antiretrovirals because the number of people tested and diagnosed with HIV is going up all the time.
The report authors estimated there are 9.7 million people, as at the end of 2007, that need antiretrovirals, which means there are still some 6.7 million without access to life-saving drugs.
Dr Peter Piot, Executive Director of UNAIDS, said:
“This report highlights what can be achieved despite the many constraints that countries face and is a real step forward towards universal access to HIV prevention, treatment care and support.”
“Building on this, countries and the international community must now also work together to strengthen both prevention and treatment efforts,” he added.
For children, the picture is also much improved, with the number on antiretrovirals going up from 127,000 at the end 2006 to 200,000 a year later. A considerable barrier to progress here is the difficulty of diagnosing HIV in infants.
Also at the end of 2007, nearly half a million women were able to get antiretrovirals to prevent giving HIV to their unborn children, compared to only 350,000 a year earlier.
Ann M. Veneman, Executive Director of UNICEF, said:
“We are seeing encouraging progress in the prevention of HIV transmission from mother to newborn.”
“The report should motivate us to focus and redouble our efforts on behalf of children and families affected by HIV/AIDS,” she added.
Barriers to progress still remain hard to shift though, said the authors. These include:
- Poor patient retention.
- Many people don’t know their HIV status.
- Diagnosis is too late for many, and they die in the first six months of treatment.
- Poor integration of treatments for HIV and TB (TB is the leading cause of death among HIV-infected people worldwide, and the number 1 killer for those in Africa).
- Slow progress in countries and regions where health systems are weak, particularly in respect of training and retaining health workers, either because they move to other countries in search of better prospects (the “brain drain”), or sadly, they also die of HIV/AIDS.
- Poor collection, analysis and publication of critical public health information.
Source: WHO.
Written by: Catharine Paddock, PhD