In a move to remedy this bleak situation, the World Health Organisation (WHO) has developed a detailed strategy to get three million people on anti-retrovirals by the end of 2005.
Dubbed ‘3 by 5’, the strategy aims to eventually make anti-retrovirals universally accessible to all those who need it, also complementing and accelerating prevention efforts.
Officially launched in Geneva on December 1, World AIDS Day, the strategy includes three specific steps.
First is simplifying treatment guidelines. Already the drug regimens have been cut to four from 35. All four are equally effective. The medicines will also be packaged together in the hope of improving adherence by patients and distribution of the drugs.
Dr Joy Phumaphi, an Assistant Director General of the WHO told a gathering at the University of Cape Town that the recommended anti-retroviral drugs had already been combined into a single pill that would have to be taken twice a day. She said the cost would be about U$140 per patient per year.
Another crucial part of the strategy is improving access to quality medicines and diagnostics needed for ARV treatment. By forming an AIDS Medicines and Diagnostics Service (AMDS) WHO is aiming to address one of the most significant challenges countries face. AMDS will help countries to improve the procurement of quality commodities at sustainable prices and support them in all aspects of management and distribution.
The third part of the strategy is the creation of uniform standards and simplified tools to track the progress and impact of ARV treatment programmes. This would include surveillance of drug resistance.
Over an above the three crucial steps, WHO has undertaken to provide support teams at the request of governments with the support of partners in the United Nations system, non-governmental organisations, donors, community based organisations and people living with HIV/AIDS. These teams will work with treatment implementers and conduct a rapid assessment of barriers and opportunities that exist in achieving the 3 by 5 target.
Another aspect of the plan is to start the emergency expansion of training and capacity development for health professionals and community workers to deliver simplified, standardised ARV treatment.
Together with it’s partners, UNAIDS and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, the WHO will advocate for funding to achieve the target. The WHO warned that achieving the 3 by 5 target would require not only funding for medicines and diagnostics, but a massive investment in training and for strengthening health services in countries.
By strengthening the health system to deliver anti-retrovirals, other health services will benefit. It is believed that this fact was the final impetus which convinced the South African government to start an anti-retroviral treatment programme.
About 50 000 South Africans are likely to receive treatment within a year of the Government plan kicking off next year.