[e-drug] WHO/UNAIDS/UNICEF report: 3 million now receiving life-saving HIV drugs

[e-drug@healthnet.org]

E-DRUG: WHO/UNAIDS/UNICEF report: 3 million now receiving life-saving HIV drugs
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full report at:
http://www.who.int/hiv/mediacentre/2008progressreport/en/index.html

3 million now receiving life-saving HIV drugs
But access to prevention and treatment still lacking for millions

2 JUNE 2008 | GENEVA/PARIS -- The close of 2007 marks an important step in
the history of the HIV/AIDS epidemic. Nearly 3 million people are now
receiving anti-retroviral therapy (ART) in low- and middle-income
countries, according to a new report jointly launched today by WHO, UNAIDS
and UNICEF.

The report, Towards universal access: scaling up priority HIV/AIDS
interventions in the health sector, also points to other gains. These
include improved access to interventions aimed at preventing
mother-to-child transmission of HIV (PMTCT), expanded testing and
counseling, and greater country commitment to male circumcision in heavily
affected regions of sub-Saharan Africa.

This represents a remarkable achievement for public health, said WHO
Director-General Dr Margaret Chan. This proves 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.

Millions now accessing treatment

According to the authors of the report, the close of 2007 saw nearly 1
million more people (950000) receiving antiretroviral therapybringing the
total number of recipients to almost 3 million. The latter figure was the
target of the 3 by 5 initiative that sought to have 3 million
HIV-positive individuals living in low-and middle-income countries on
treatment by 2005. Although that target was not achieved until two years
later, it is widely credited with jump-starting the push towards ART
scale-up.

According to the report, the rapid scale-up of ART can be attributed to a
number of factors, including the:
      Increased availability of drugs, in large part because of price
      reductions;
      Improved ART delivery systems that are now better adapted to country
      contexts. The WHO public health approach to scale-up emphasizes
      simplified and standardized drug regimens, decentralized services and
      judicious use of personnel and laboratory infrastructure; and
      Increased demand for ART as the number of people who are tested and
      diagnosed with HIV climbs.

Greater access: greater need

The authors state that overall, some 31% of the estimated 9.7 million
people in need of ART received it by the end of 2007. That means that an
estimated 6.7 million in need are still unable to access life-saving
medicines.

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, said Dr Peter Piot, Executive
Director of UNAIDS. Building on this, countries and the international
community must now also work together to strengthen both prevention and
treatment efforts.

Preventing HIV in children

At the end of 2007, nearly 500 000 women were able to access
antiretrovirals to prevent transmission to their unborn children  up from
350 000 in 2006. During the same period, 200 000 children were receiving
ART, compared to 127 000 at the end of 2006. The difficulty of diagnosing
HIV in infants, however, remains a major impediment to progress.

We are seeing encouraging progress in the prevention of HIV transmission
from mother to newborn, said UNICEF Executive Director Ann M. Veneman.
The report should motivate us to focus and redouble our efforts on behalf
of children and families affected by HIV/AIDS.

Tuberculosis, weak healthcare systems, hamper progress

Other obstacles to scaling up treatment include poor patient retention
rates in many treatment programmes and the considerable numbers of
individuals who remain unaware of their HIV status, or are diagnosed too
late and die in the first six months of treatment.

Tuberculosis is a leading cause of death among HIV-infected people
worldwide, and the number one cause of death among those living in Africa.
To date, HIV and TB service deliveries are insufficiently integrated and
too many people are losing their lives because they are unable to either
prevent TB or access life-saving medications for both diseases.

The authors warn that future expansion of access to ART is likely to be
slow owing to weak health systems in the worst-affected countries, in
particular, the difficulty of training and retaining health-care workers.
Health-care systems in regions hardest hit continue to erode because of
brain drainthe migration of skilled health-care personnel to other
occupations and to other countriesand to high mortality rates from HIV
itself.

They also emphasize the ongoing need to improve the collection, analysis
and publication of critical public health information. Countries,
international partners and other sources supply the numbers featured in
this report. Despite certain limitations, the data constitute the best and
most up-to-date estimates of the different elements of the health sector
response to HIV/AIDS.