PRESS RELEASE: '3by5' delay points to urgent need for comprehensive care options
'3by5' disappointment stresses need for more comprehensive AIDS care services.
Staying alive during wait for ARVs is now even more critical.
PRESS RELEASE, 30 June 2005
Kobe, Japan: Today's 29 June 2005 announcement by the World Health
Organization (WHO) and the Joint United Nations Programme on HIV/AIDS
(UNAIDS) that the much-heralded '3by5' initiative is "unlikely" to be
achieved by the end of 2005, places even greater urgency on the need to
scale up access to other care options that keep people with HIV alive while
they wait for antiretroviral (ARV) drugs.
The two UN agencies, who share responsibility for tackling the global
pandemic, highlight progress during the past 18 months towards greater ARV
access, and report that one million people with HIV/AIDS (PWHA) in poorer
nations are now taking life-saving ARV drugs. They had hoped 3 million
people would have access to the medicines by the end of 2005, but that now
looks out of reach.
According to the AIDS-Care-Watch campaign - a civil society-led initiative
with over 240 partner organisations worldwide - what they fail to adequately
address is the plight of the 5 million people who already require ARV drugs
but cannot access them. Eighty-five percent of the unmet ARV need is
concentrated in just 20 countries, where providing the drugs is particularly
challenging. For example in India, where coverage is less than 10% of need,
and where over 700,000 people may die before they need to because ARVs are
still out of reach. Or in Nigeria, where coverage is at 8% and where close
to 600,000 people are waiting for drugs. Some heavily-affected African
countries, such as Tanzania and Zimbabwe have unmet ARV needs that exceed
95%. Yet in all of these countries, other available care options that could
extend lives are not being given adequate attention.
"As a bold new initiative for WHO and UNAIDS, the 3by5 campaign has been
good. But we have to ask why is only 1 in 6 of those who need ARVs now
receiving them? What about the 5 million who are not?" asked Dr Alice
Welbourn of the International Community of Women Living with HIV/AIDS. "What
about the food, care, and other drugs and services that even the 1 million
need?"
The 3by5 disappointment indicates that where large unmet ARV needs persist,
a broad package of other readily-available treatment and care options should
be urgently provided to keep people with HIV alive while they wait for ARVs
programmes to deliver on their promise. For example, care services should
also provide prevention and treatment of the HIV-associated opportunistic
infections (OIs), such as tuberculosis (TB), which people with HIV are
especially susceptible to.
"We have given a promise to people that ARVs will be made available, and we
are clearly not keeping up that promise," said Dr NM Samuel, who runs the
Department of Experimental Medicine and AIDS Research in Chennai, India. "If
we are unable to provide ARVs on a regular basis to people who require them,
can we then seriously think about alternatives, like ensuring prophylaxis
and treatment for OIs on a regular basis, or providing nutritional
supplements. Or are we going to wait another three years for so many more
people to die before these measures come into effect?"
Finally acknowledging the 3by5 delay has also prompted speculation on the
nature of such international initiatives, and about what might now replace
the 3by5 target as a goal to maintain the momentum that the drive for ARVs
has generated.
"WHO launched 3by5 with a loud voice but without having a clear plan at the
national level for urgent treatment scale-up. Because of this, the 3by5
goal will not be met and the small confidence we have in multilateral
institutions to act is further destroyed. We need a global plan that builds
upon specific national plans," said Marcel van Soest, Executive Director of
the World AIDS Campaign. "For example, how can we move towards universal
drug access in challenging countries like Sudan, Zimbabwe, and Afghanistan?
Unless we draw on the real lessons of the past 18 months, how can we
re-build confidence in WHO, UNAIDS and in this whole endeavour?"
Earlier this month, G8 finance ministers referred to the need to mobilise
sufficient money to achieve 'universal access' to ARVs by 2010. This even
larger ARV treatment target is now being put forward by some organisations
as the way forward, and they hope that the full G8 meeting in Scotland next
month will fully embrace such a goal.
"The likely failure of 3by5 to reach its target is not just another missed
target. It is an indictment of the leaders of rich and poor countries that
failed to back it and save the lives that needed saving," said Leonard
Okello, International HIV Coordinator at ActionAid? International in response
to the WHO/UNAIDS report. "The G8 meeting next week has the chance to
correct this. They now need to give their full backing to the target of
universal access to treatment for all who need it by 2010 and make sure this
happens," he added.
Before embarking on any new treatment target, van Soest urges that the
lessons of 3by5 be used to map out the road to universal access, and that
the millions of people at risk in the meantime are fully considered. "What
about the people dying now? Why are we talking about universal access by
2010 when we could not even reach the goal of 3by5?" he asked. "There are
many simple, concrete care and treatment options available to keep people
alive now, we need to provide people with a comprehensive health programme,
focusing only on ARVs is too narrow."
Dr Welbourn added: "This year alone there will be over 10 times the number
of Indian Ocean Tsunami deaths caused by AIDS-related illnesses. World
leaders have shown that they can respond to one horrendous crisis when
pressurised by their citizens to do so. When are they going to start to
respond meaningfully, with real resources and real commitment to the global
crisis of HIV/AIDS?"
"We positive people are their early warning system. We have been warning the
world for over 20 years now what AIDS means to our lives, our families, our
communities. How many more of us will have died before we hear an answer?"
Staying alive during wait for ARVs is now even more critical.
PRESS RELEASE, 30 June 2005
Kobe, Japan: Today's 29 June 2005 announcement by the World Health
Organization (WHO) and the Joint United Nations Programme on HIV/AIDS
(UNAIDS) that the much-heralded '3by5' initiative is "unlikely" to be
achieved by the end of 2005, places even greater urgency on the need to
scale up access to other care options that keep people with HIV alive while
they wait for antiretroviral (ARV) drugs.
The two UN agencies, who share responsibility for tackling the global
pandemic, highlight progress during the past 18 months towards greater ARV
access, and report that one million people with HIV/AIDS (PWHA) in poorer
nations are now taking life-saving ARV drugs. They had hoped 3 million
people would have access to the medicines by the end of 2005, but that now
looks out of reach.
According to the AIDS-Care-Watch campaign - a civil society-led initiative
with over 240 partner organisations worldwide - what they fail to adequately
address is the plight of the 5 million people who already require ARV drugs
but cannot access them. Eighty-five percent of the unmet ARV need is
concentrated in just 20 countries, where providing the drugs is particularly
challenging. For example in India, where coverage is less than 10% of need,
and where over 700,000 people may die before they need to because ARVs are
still out of reach. Or in Nigeria, where coverage is at 8% and where close
to 600,000 people are waiting for drugs. Some heavily-affected African
countries, such as Tanzania and Zimbabwe have unmet ARV needs that exceed
95%. Yet in all of these countries, other available care options that could
extend lives are not being given adequate attention.
"As a bold new initiative for WHO and UNAIDS, the 3by5 campaign has been
good. But we have to ask why is only 1 in 6 of those who need ARVs now
receiving them? What about the 5 million who are not?" asked Dr Alice
Welbourn of the International Community of Women Living with HIV/AIDS. "What
about the food, care, and other drugs and services that even the 1 million
need?"
The 3by5 disappointment indicates that where large unmet ARV needs persist,
a broad package of other readily-available treatment and care options should
be urgently provided to keep people with HIV alive while they wait for ARVs
programmes to deliver on their promise. For example, care services should
also provide prevention and treatment of the HIV-associated opportunistic
infections (OIs), such as tuberculosis (TB), which people with HIV are
especially susceptible to.
"We have given a promise to people that ARVs will be made available, and we
are clearly not keeping up that promise," said Dr NM Samuel, who runs the
Department of Experimental Medicine and AIDS Research in Chennai, India. "If
we are unable to provide ARVs on a regular basis to people who require them,
can we then seriously think about alternatives, like ensuring prophylaxis
and treatment for OIs on a regular basis, or providing nutritional
supplements. Or are we going to wait another three years for so many more
people to die before these measures come into effect?"
Finally acknowledging the 3by5 delay has also prompted speculation on the
nature of such international initiatives, and about what might now replace
the 3by5 target as a goal to maintain the momentum that the drive for ARVs
has generated.
"WHO launched 3by5 with a loud voice but without having a clear plan at the
national level for urgent treatment scale-up. Because of this, the 3by5
goal will not be met and the small confidence we have in multilateral
institutions to act is further destroyed. We need a global plan that builds
upon specific national plans," said Marcel van Soest, Executive Director of
the World AIDS Campaign. "For example, how can we move towards universal
drug access in challenging countries like Sudan, Zimbabwe, and Afghanistan?
Unless we draw on the real lessons of the past 18 months, how can we
re-build confidence in WHO, UNAIDS and in this whole endeavour?"
Earlier this month, G8 finance ministers referred to the need to mobilise
sufficient money to achieve 'universal access' to ARVs by 2010. This even
larger ARV treatment target is now being put forward by some organisations
as the way forward, and they hope that the full G8 meeting in Scotland next
month will fully embrace such a goal.
"The likely failure of 3by5 to reach its target is not just another missed
target. It is an indictment of the leaders of rich and poor countries that
failed to back it and save the lives that needed saving," said Leonard
Okello, International HIV Coordinator at ActionAid? International in response
to the WHO/UNAIDS report. "The G8 meeting next week has the chance to
correct this. They now need to give their full backing to the target of
universal access to treatment for all who need it by 2010 and make sure this
happens," he added.
Before embarking on any new treatment target, van Soest urges that the
lessons of 3by5 be used to map out the road to universal access, and that
the millions of people at risk in the meantime are fully considered. "What
about the people dying now? Why are we talking about universal access by
2010 when we could not even reach the goal of 3by5?" he asked. "There are
many simple, concrete care and treatment options available to keep people
alive now, we need to provide people with a comprehensive health programme,
focusing only on ARVs is too narrow."
Dr Welbourn added: "This year alone there will be over 10 times the number
of Indian Ocean Tsunami deaths caused by AIDS-related illnesses. World
leaders have shown that they can respond to one horrendous crisis when
pressurised by their citizens to do so. When are they going to start to
respond meaningfully, with real resources and real commitment to the global
crisis of HIV/AIDS?"
"We positive people are their early warning system. We have been warning the
world for over 20 years now what AIDS means to our lives, our families, our
communities. How many more of us will have died before we hear an answer?"