Comprehensive Approach to HIV/AIDS Treatment and Prevention - New AIDS Medicine and Diagnostics Service - Simple Treatment Regimens Published - Training Tens of Thousands of People to Support AIDS Treatment and Prevention
The World Health Organization (WHO) and UNAIDS today release a detailed and concrete plan to reach the 3 by 5 target of providing antiretroviral treatment to three million people living with AIDS in developing countries and those in transition by the end of 2005. This is a vital step towards the ultimate goal of providing universal access to AIDS treatment to all those who need it.
The 3 by 5 initiative complements the groundbreaking commitments made by the United States under President Bushs HIV/AIDS Initiatives ($15 billion dollars for an enhanced AIDS response), the pathfinding work of NGOs (like MSF) and faith-based groups, the efforts of pharmaceutical companies to reduce the prices of AIDS treatment, the contribution of international foundations like the Bill and Melinda Gates Foundation, the initiative and hard work of many national and international agencies, and, critically, the courageous contributions of nations increasing their people’s access to AIDS treatment.
Simplified Treatment Recommended
The strategy has greatly simplified the recommendations for AIDS treatment regimens. The number of such WHO-recommended regimens has been cut to four from 35. All four are equally effective. The selection of an individual regimen for a patient will be based on a combination of individual needs, together with the availability and suitability of a particular regimen in a country. The strategy also recommends the use of quality-assured "fixed dose combinations" or easy-to-use blister packs of medicine whenever they are available. The aim is to ensure that all people living with AIDS, even in the poorest settings, have access to treatment through this simplified approach.
The strategy also includes the global AIDS Medicines and Diagnostics Service (AMDS), which will ensure that poor countries have access to quality medicines and diagnostic tools at the best prices. The service, which will be operated by WHO, UNICEF and other partners, will help countries to forecast and manage supply and delivery of necessary products for the treatment and monitoring of AIDS. Through the WHO Prequalification Project, AMDS will also include a medicines and diagnostics evaluation component which will ensure that manufacturers, products, procurement agencies and laboratories meet international quality, safety and efficacy standards.
Another key element is the simplification of monitoring, so that easy-to-use tests such as body weight and colour-scale blood tests are used where more complicated and expensive tests for viral load and white cell (CD4) count are not yet available. The simpler tests, combined with clinical evaluations by adequately trained health workers, can be effective in monitoring the progress of AIDS, the effectiveness of treatment and its side effects.
Treatment Action in Countries Already Under Way
Antiretroviral therapy programmes can only be expanded if there is coordinated, scaled-up action in countries, particularly those hardest-hit by AIDS. Countries are at the heart of the 3 by 5 strategy and will be the focus of all efforts to meet the 3 by 5 target. Many countries have already demonstrated their commitment to this target. Immediately following the declaration of a global AIDS treatment emergency, more than 20 countries requested collaboration and input from WHO, UNAIDS and other partners.
Teams have already travelled to Kenya, Burkina Faso, Malawi and Zambia. Other teams have done preparatory work in Ukraine and India. In each case, the teams will be working with governments to identify and help remove obstacles, so that antiretroviral medicines can be provided quickly to the people who need them most. Many other countries, including Russia and Djibouti, have also requested assistance.
Training of health workers is an urgent need in all countries involved. Many of the countries with the highest numbers of people living with HIV/AIDS have very few doctors or other trained health staff. Many of these health workers have died as a result of untreated AIDS; others have moved to seek better pay and job security in wealthier countries.
Thousands of community workers to be trained One of the most innovative aspects of the 3 by 5 strategy is a method for urgently training tens of thousands of community health workers to support the delivery and monitoring of HIV/AIDS treatment. An intensive training programme would enable these health workers to evaluate and monitor patients, and make sure they receive and are taking their medicines.
The strategy acknowledges that the involvement of communities and community workers is essential to the success of this initiative. Significant evidence and experience shows that without strong community support, people may have a more difficult time adhering to their medical regimens. Also, community involvement is a critical element of any successful HIV prevention strategy.
There is also good evidence that treatment can have an accelerating effect on prevention efforts. "We know from experience that the availability of treatment encourages people to learn their HIV status and receive counselling," said Dr Paulo Teixeira, Director of the HIV/AIDS Department at WHO. "We also know that the availability of treatment reduces stigma for people living with AIDS. People living with AIDS have a right to treatment and we must find a way to deliver."
One of the key elements of the strategy is "learning by doing". The strategy unveiled today by WHO and UNAIDS addresses many of the obstacles that have up to now prevented millions of people in poor countries from accessing AIDS medicines. The strategy will evolve as lessons learnt from implementing the strategy are identified and rapidly applied.
Reaching the 3 by 5 target will require substantial new funding for AIDS treatment from all sources - countries, donor governments and multilateral funding agencies. WHO has estimated that the funding required amounts to approximately $5.5 billion over the next two years.
"We know what to do but what we urgently need now are the resources to do it," said Dr Lee. We must waste no time in building strong alliances immediately to implement this strategy. Three million people are counting on it.”
For more information contact:
Mr Iain Simpson
Telephone: +41 22 791 3215
Mobile phone: +41 79 475 5534
Ms Melanie Zipperer
Telephone: +41 (22) 791 1344
Mobile phone: +41 (79) 477 1722
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