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HIV/AIDS: Despite Criticism WHO Says ‘3 by 5’ Achievable

Cher Jimenez

BANGKOK, Jul 10 2004 (IPS) - Though the World Health Organisation (WHO) conceded that its strategy of delivering antiretroviral drugs (ARVs) to the millions of needy people living with HIV/AIDS is making slow progress, it, however, is optimistic that its 2005 treatment target can be met.

”We are moving in the right direction but too slowly,” Dr Jim Yong Kim, WHO director for HIV/AIDs, told reporters Saturday on the eve of the 15th International AIDS Conference (IAC) here.

”We now have 18 months for governments, non-governmental organisations, and other partners to rapidly increase the availability of prevention, treatment and care in developing countries,” said Kim at a press conference.

In 2001, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other organisations along with scientists at WHO calculated that, under optimal conditions three million people living with HIV/AIDS (PHAs) could be provided with ARVs and access to medical services by the end of 2005.

In September 2003 WHO joined hands with UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria to declare the lack of access to ARVs to be a global health emergency and launched the ‘Treat Three Million by 2005’ (Three by Five) initiative.

ARVs are substances used to kill or inhibit the multiplication of retroviruses such as HIV.

”I hear a lot of (statements) that this (‘Three by Five’) is not possible. I couldn’t care less about prognosticates,” said Kim.

On Jul 9, Prof. Joep Lange, the co-chair of the IAC and president of the International AIDS Society created a stir when he told IPS in an interview that the targets of the ‘Three by Five’ would not be met.

”I think it’s impossible. It’s an inflated target that is totally unrealistic,” he said.

But Dr Peter Piot, executive director of UNAIDS defended the WHO targets and criticism levelled at the ‘Three by Five’ initiative.

“We have to admit there’s a long way to go. But this (project) is not about parachuting. ‘Three by Five’ is about a coalition of international organisations, governments, NGOs, community, who are all committed to achieving this ambitious goal,” he told the press conference.

He said despite slow progress, the WHO target remains to be “realistic” after many countries had pledged additional funding for the project.

Piot also said many state leaders had also given their political commitment to see the project through and promised medical infrastructure to realise the ‘Three by Five’ goals.

Aside from the World Bank which continues to fund this initiative, the United States, Canada, and Sweden have also contributed to the ‘Three by Five’ initiative, according to the WHO.

”I’m convinced that when we meet in Toronto two years from now, where we will have moved from thousands to the millions,” said Dr. Piot.

Toronto is the scheduled venue for the next International AIDS Conference in 2006.

As of Jun. 30 this year, the WHO estimates that there are 440,000 people receiving ARVs but admits that this is 60,000 less than its target for the initial six months since the start of the program.

But WHO representatives could not say how many of these 440,000 people were covered by its ‘Three by Five’ initiative.

Thirty-eight million people around the world are now living with HIV, UNAIDS reported last week.

Five million new cases were diagnosed last year alone – the largest number in any one year since the epidemic began.

Around 5.5 billion U.S. dollars has been allotted for this project but the global health organisation said it needs a further 62 million dollars to provide technical assistance and other services to countries that requested help.

Aside from the slow progress of the project, the WHO also raised difficulties in terms of training health workers to assist in making access to treatment available. Of the 100,000 nurses and physicians needed to achieve the three million target, there are presently only 15,000 who have committed to help.

But as political commitment and increased funding continue to come in, the WHO expressed confidence that it may even surpass its target and called on detractors to tone down their criticism.

According to Dr. Jack Chow, WHO assistant director-general for HIV/AIDS, Malaria and Tuberculosis, 56 countries have asked the agency for assistance in building their public health infrastructure.

“We’ve seen increased political (and) financial commitments,” he told IPS.

Rolake Nwagwu, an NGO worker in Nigeria and a PHA herself, said the ‘Three by Five’ strategy was an ”answer to our prayer,” after having to deal with high prices for ARVs.

” ‘Three by Five’ s not a slogan. It’s our very lives. It must work,” she told IPS, adding that medicines used to cost 500 dollars but has now gone down to 30 dollars for a month’s use.

The price for first line treatment with fixed dose has decreased by 50 percent from 300 dollars in less than 12 months according to the WHO.