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Taking stock of ARV access

Written by Health-e News

Less than half of adults and children needing antiretroviral treatment (ART) in sub-Saharan Africa – where two-thirds of all global HIV infections occur – are receiving it. This is despite the region showing the greatest gains worldwide in terms of access to the lifesaving drugs.

According to a report released  today,  (Wed)  45% of HIV positive pregnant women received the drugs needed to prevent them from passing the virus on to their baby, up from 35% the year before.

The World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) yesterday released Towards universal access – the third in a series of annual progress reports to monitor the health sector response to the HIV/AIDS epidemic.

Around 2,9-million people in sub-Saharan Africa received ART in 2008 compared to about 2,1-million in 2007. ART coverage in the region was 44% in 2008, compared to 33% in 2007.

Between 2007 and 2008 the estimated number of children in sub-Saharan Africa receiving ART rose from 158 000 to 225 000. Total coverage among children in the region is about 35%.

The report shows that in South Africa 458 951 people were estimated to be receiving ART in December 2007. This figure rose to 700 500 a year later which means that just over half (53%) of those needing ART were accessing it ‘€“ in both the public and private sector.

Alternative sources indicated that the last reliable estimate of the number of people on ARVs in the public health system was about 450 000 as of July 2008.

South Africa’€™s Budget and Expenditure Monitoring Forum (BEMF) warned last week that six provinces may run out of antiretroviral drugs as a result of a financial shortfall of one billion rand. Some hospitals in the Free State have been without drugs for up to three weeks.

The WHO put a positive spin on the report stating that more than 4 million people in low- and middle-income countries were receiving ART at the close of 2008, representing a 36% increase in one year and a ten-fold increase over five years

WHO Director-General Margaret Chan said the report showed tremendous progress in the global HIV/AIDS response, but that more had to be done.

‘€œAt least 5 million people living with HIV still do not have access to life-prolonging treatment and care. Prevention services fail to reach many in need. Governments and international partners must accelerate their efforts to achieve universal access to treatment,” she said.

The report showed that prices of the most commonly used antiretroviral drugs had declined significantly in recent years, contributing to wider availability of treatment. The cost of most first-line regimens decreased by between 10 and 40% between 2006 and 2008. However, second-line regimens continue to be expensive.

Despite recent progress, the report acknowledged that access to treatment services is falling far short of need and the global economic crisis had raised concerns about their sustainability. Many patients are being diagnosed at a late stage of disease progression resulting in delayed initiation of ART and high rates of mortality in the first year of treatment.

Ninety-three percent of all countries that reported data across all regions provided free HIV testing through public sector health facilities in 2008. Nevertheless, the majority of those living with HIV remain unaware of their HIV status.

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Health-e News

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