HIV Report: Treatment Lags Behind Need
ROBERT SIEGEL, host:
The World Health Organization says it has reached one of its main goals two years late. The WHO had aimed to get life-saving drugs to three million people with HIV/AIDS by 2005. The pace of treatment is picking up, but prevention is not keeping up.
And as NPR's Brenda Wilson reports, that means it will be difficult for Western countries to carry out another commitment to provide universal access to AIDS treatment by 2010.
BRENDA WILSON: As the director of HIV/AIDS for the World Health Organization, Dr. Kevin De Cock has a lot of practice in explaining how one should see the proverbial glass as half full.
Dr. KEVIN DE COCK (Director, Department of HIV/AIDS, World Health Organization): I think it's a remarkable achievement. Obviously, the target of three million has been met two years late, which is terrible for people who missed out on therapy and may have lost their lives. At the same time, this is a remarkable achievement when, just four years ago, it was less than half a million.
WILSON: Most of that treatment is provided by the U.S. under the President's Emergency Plan for AIDS Relief and by the Global Fund to Fight AIDS, TB and Malaria to which other governments make contributions. WHO's monitoring of treatment has been credited by AIDS activists for spurring the push for treatment. In 2004, just 10 percent of pregnant women with HIV - in sub-Saharan Africa, mainly - were getting treatment to prevent passing the virus to their babies. Now, a third of those women who test positive get a dose of the drug during labor. A dose is also given to the baby.
Dr. DE COCK: But it's obviously nowhere near enough. The other thing that we're not doing well enough is identifying those pregnant women who require HIV treatment for their own health. They need treatment to stop them from dying in the near future and leaving orphans behind.
WILSON: The International Treatment Preparedness Coalition has been monitoring efforts to bring HIV treatment to the world's poor. Chris Collins says WHO's report shows what can be achieved when governments, international organizations and donors work together.
Mr. CHRIS COLLINS (International Treatment Preparedness Coalition): We can be encouraged that the pace of scale up of treatment delivery increased in 2007. It had been about 700,000 more people each year, and moved to a million people in 2007. That's certainly the right direction, but not an adequate pace of growth in order to come anywhere near the universal access commitment that the G8 countries and the United Nations has made.
WILSON: WHO's De Cock says that some countries - like Botswana, for example - are already close to providing universal access. But the vast majority of the countries receiving assistance - and two-thirds of them are in sub-Saharan Africa - will have to build health systems at the same time they scale up treatment, prevention and care.
Dr. DE COCK: Continuing to scale up at this pace or this increased pace, how long can you keep on doing that? There will come a time when systems give out, if you will, or you just cannot squeeze more out of inadequate numbers of health care workers and fragile health systems.
WILSON: But he says polarizing debates over whether we should be focusing on health systems instead of fighting specific diseases should be avoided. There are more than nearly 10 million people who need treatment now. Only a third of them are getting it. The rest are waiting in line. Even if all of them could get treatment, there is still the prospect of more than two million new infections each year.
Brenda Wilson, NPR News.
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