The report card is a five country snapshot on the progress of scaling up of treatment. Authored by the International Treatment Preparedness Coalition (ITPC), made up of 800 activists, it says that despite pockets of progress, treatment efforts as a whole is stagnating.

They have urged the World Health Organisation to set a similar target as the ‘€œ3 by 5’€ campaign where the global effort was geared towards reaching 3 million people by 2005.

Although acknowledging the worldwide progress in providing treatment to 1.6 million people at the end of June 2006, the report said this success is dwarfed by the 5 million people who may face death if ARV-roll out is not substantially increased.    

‘€œA lot of work needs to be done if we are to have universal access. At the moment we don’€™t have the fastest roll-out and targets needs to be set in order to keep governments accountable,’€ said Fatima Hassan from the AIDS Law Project and South African representative on ITPC.

The report looks at South Africa, India, Russia, Dominican Republic and Kenya and makes recommendation at country and global levels. ‘€ The Global Fund, PEPFAR and other agencies should put clear systems, lines of accountability and guidelines in place to avoid country-level failures to meet goals associated with their programs.’€

Activists said, the report highlights the need for national targets to be informed by global targets. The South African National Strategic Plan on HIV/AIDS came under scrutiny in the report that was criticised for its low targets.

‘€œEven though targets are missed; it creates the incentive for everyone to set up systems and monitor progress.   We can hold government accountable when these targets are not reached,’€ said Hassan. She said the health department cannot use the excuse that high targets will mean lack of quality as the quality of care does not need to drop.

The South African case study found that in October 2006, three years after the South African government agreed to provide ART directly, a combined total of about 265,000 people were on treatment in the public and private sectors. About 165,000 to 175,000 people were accessing ART in the public sector, with some 100,000 to 110,000 receiving it in the private and not-for-profit sectors. But currently 31,000 people are on waiting lists.

‘€œThe bottom line is that although we have made progress, a lot of work needs to be done,’€ said Hassan.