TuSalud Web Exclusives : WHO Done It? - by James Wortman
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June 4, 2008

WHO Done It?

by James Wortman

WHO, UNAIDS and UNICEF announced that they’ve met their goal of treating 3 million HIV-positive people worldwide. That’s the good news. The bad news? HIV continues to infect people faster than we can find them and get them access to care.

An annual progress report issued on Monday June 2 entitled “Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector,” announced that an additional 1 million people living with HIV in developing countries began antiretroviral meds within the last year, bringing the total number of people being treated for HIV globally to a record high of nearly 3 million. The report, issued by the World Health Organization (WHO) in collaboration with the United Nations Programme on AIDS (UNAIDS) and the United Nations Children’s Fund (UNICEF) highlighted other good news: Nearly 500,000 women (up from 350,000 the previous year) were able to get antiretroviral medications to prevent HIV transmission to their unborn children in 2007, and 200,000 children (up from 127,000 the previous year) received antiretroviral therapy during that same period. And yet, despite the headway that’s been made in the last year, the AIDS pandemic continues to outpace those struggling to keep up with it. In 2007, 2.5 million people were newly infected with HIV.

“Interventions for preventing HIV transmission from mothers to their babies and for treating infected children are established and functioning in nearly every country in the world,” said UNICEF program officer Patricia Doughty in a telephone news conference. “However, there are still enormous challenges to overcome before we reach our final goal, which is universal access for prevention, care, treatment and support.”

Indeed, other stats highlighted in the UN report paint a less-than-uplifting picture of global health care around HIV. More than 400,000 children worldwide became infected with HIV in 2007, and while an increasing percentage of people are being given antiretroviral medications worldwide, and while the number of people on treatment rose by 54 percent in 2007, those in care still represent a minority—only 31 percent of the world’s estimated 9.7 million HIV-positive people who need treatment are receiving it. And, only 12 percent of HIV-positive pregnant women were examined to determine whether they themselves needed antiretroviral therapy.

With the release of this report, WHO and UNAIDS, two UN agencies, say they have officially met the target of their “Three by Five” initiative, which aimed to get 3 million HIV-positive people on antiretroviral medications by the end of 2005. While the goal was met two years later than intended, Dr. Kevin M. De Cock, director of WHO’s HIV/AIDS department, remains optimistic. “In retrospect, maybe [the timeline of the original goal for the ‘Three by Five’ initiative] was excessively aspirational,” said De Cock. “But aspiration is necessary to drive progress. I think that reaching that target [even] two years late is quite a remarkable achievement.”

WHO has also set what many might consider a rather aspirational global goal: universal health care access for people living with HIV by 2010. De Cock says he is advising his colleagues to temper their expectations over the next few years in light of persistent barriers to treatment and prevention, including a shortage of trained health care personnel, weak health systems in developing nations and insufficient long-term sustained funding.

“We need to accept that universal access by 2010 is not going to be achieved everywhere, but there will be countries that will be very close,” De Cock said. “What’s been encouraging over the last year is that not only has the overall total [of positive people on treatment] increased, but the rate of scale-up has increased. Whether or not that can continue, we don’t really know. We need to think sober.”

Read the full report here.

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