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Reinvigorating the AIDS response to catalyse sustainable development and United Nations reform. Report of the Secretary-General.
[New York, New York], United Nations, General Assembly, 2017 Apr 7. 25 p. (A/71/864)Bold global commitments, shared financial responsibility and a people-centred approach based on the principles of equity have yielded shared success in the AIDS response. The 90-90-90 initiative has guided a dramatic expansion of antiretroviral treatment and greatly reduced AIDS-related deaths, while also contributing to a reduction in new HIV infections. A global plan to eliminate mother-to-child transmission of HIV has more than halved the number of new HIV infections among children. The AIDS response has made an important contribution to the demographic dividend of Africa, its recent economic growth and the emerging vision of Africa as a continent of hope, promise and vast potential. Global optimism has fuelled the highest ambition within the 2030 Agenda for Sustainable Development: ending the AIDS epidemic by 2030. A fast-track response to reach this target has been agreed by the United Nations General Assembly within the 2016 Political Declaration on HIV and AIDS: On the Fast Track to Accelerating the Fight against HIV and to Ending the AIDS Epidemic by 2030. Achieving our aims on AIDS is interlinked with and embedded within the broader 2030 Agenda: both are grounded in equity, human rights and a promise to leave no one behind. Hard-fought gains must not be lost. An international architecture that has stimulated leadership, provided direction, mobilized unprecedented levels of financial resources and saved millions of lives must not be taken for granted. Closing the investment gap of $7 billion per year and ensuring that financial resources are wisely used will avert tens of millions of new HIV infections and AIDS-related deaths, a return on investment that is nothing short of priceless. (Excerpts)
Progress with Scale-Up of HIV Viral Load Monitoring - Seven Sub-Saharan African Countries, January 2015-June 2016.
MMWR. Morbidity and Mortality Weekly Report. 2016 Dec 02; 65(47):1332-1335.The World Health Organization (WHO) recommends viral load testing as the preferred method for monitoring the clinical response of patients with human immunodeficiency virus (HIV) infection to antiretroviral therapy (ART) (1). Viral load monitoring of patients on ART helps ensure early diagnosis and confirmation of ART failure and enables clinicians to take an appropriate course of action for patient management. When viral suppression is achieved and maintained, HIV transmission is substantially decreased, as is HIV-associated morbidity and mortality (2). CDC and other U.S. government agencies and international partners are supporting multiple countries in sub-Saharan Africa to provide viral load testing of persons with HIV who are on ART. This report examines current capacity for viral load testing based on equipment provided by manufacturers and progress with viral load monitoring of patients on ART in seven sub-Saharan countries (Cote d'Ivoire, Kenya, Malawi, Namibia, South Africa, Tanzania, and Uganda) during January 2015-June 2016. By June 2016, based on the target numbers for viral load testing set by each country, adequate equipment capacity existed in all but one country. During 2015, two countries tested >85% of patients on ART (Namibia [91%] and South Africa [87%]); four countries tested <25% of patients on ART. In 2015, viral suppression was >80% among those patients who received a viral load test in all countries except Cote d'Ivoire. Sustained country commitment and a coordinated global effort is needed to reach the goal for viral load monitoring of all persons with HIV on ART.
[New York, New York], United Nations General Assembly, 2016 Apr 1.  p. (A/70/811)This new report warns that the AIDS epidemic could be prolonged indefinitely if urgent action is not implemented within the next five years. The report reveals that the extraordinary acceleration of progress made over the past 15 years could be lost and urges all partners to concentrate their efforts to increase and front-load investments to ensure that the global AIDS epidemic is ended as a public health threat by 2030. The review of progress looks at the gains made, particularly since the 2011 United Nations Political Declaration on HIV and AIDS, which accelerated action by uniting the world around a set of ambitious targets for 2015. The report outlines that the rapid treatment scale-up has been a major contributing factor to the 42% decline in AIDS-related deaths since the peak in 2004 and notes that this has caused life expectancy in the countries most affected by HIV to rise sharply in recent years. The report underlines the critical role civil society has played in securing many of the gains made and the leadership provided by people living with HIV. Community efforts have been key to removing many of the obstacles faced in scaling up the AIDS response, including reaching people at risk of HIV infection with HIV services, helping people to adhere to treatment and reinforcing other essential health services.
Geneva, Switzerland, UNAIDS, 2010 Dec.  p. (UNAIDS/10.12E/JC2034E)This Strategy has been developed through wide consultation, informed by the best evidence and driven by a moral imperative to achieve universal access to HIV prevention, treatment, care and support and the Millennium Development Goals.
Teddington, United Kingdom, Tearfund, 2008 Jul. 44 p.This report provides an overview of PMTCT and is an attempt to explore what is working, and why, in scaling up access. The report captures innovative examples of successful programming and partnerships, while identifying challenges and bottlenecks that must be overcome if these countries are to meet their nationally set universal access targets by 2010. The research methodology used for this report was based on a desk review, interviews with key global informants (see Acknowledgements) and country case studies in Malawi, Nigeria and Zambia in early 2008. The in-country study included semi-structured interviews with representatives of government and nongovernmental organisations as well as focus group discussions with community representatives, participatory and observational methodologies. The main objectives of the research were to: 1) identify and conduct interviews with the key international and national stakeholders and explore the structure, components, implementation, co-ordination, financing, policies, and guidelines and monitoring system of the PMTCT programmes; 2) determine what was working well and why; and 3) identify specific bottlenecks, challenges and recommendations for progress. This report provides an overview of the perceptions of key experts and communities on PMTCT interventions and approaches, current global action and country progress.
Geneva, Switzerland, WHO, 2005. 64 p.In an effort to keep abreast of rapid changes in the landscape of the HIV pandemic, WHO and UNAIDS report semiannually on progress toward "3 by 5". The first update was presented at the XV International AIDS Conference in Bangkok, Thailand, in July 2004. This second report measures progress made by countries and describes how international partners are supporting their efforts. In addition, it summarizes how the building blocks of antiretroviral (ARV) therapy programmes are being put into place and how issues beyond treatment are being addressed. It provides examples of country progress and a global estimate of the number of people receiving ARV therapy, and it assesses how well the therapy is working. It also identifies some of the challenges faced in resource-constrained settings and how these are being met by improving health care systems, links between prevention and treatment and providing equal access to quality care. This report is based on reports and updates provided by dozens of international, national and community organizations involved in scaling up ARV therapy. We thank everyone who has contributed to this progress report. WHO departments at the headquarters, regional and country levels worked with national governments and nongovernmental organizations to gather the latest information on the scaling up of ARV therapy. The UNAIDS Secretariat and the UNAIDS Cosponsors gathered information on how United Nations agencies and international nongovernmental organizations are translating the rapidly expanding commitment to "3 by 5" into action. (excerpt)
AIDS Bulletin. 2005 Jun; 14(2):6-7.It is 2005 and we don’t have three million people in developing and transitional countries on antiretroviral therapy but the ‘3 by 5’ initiative is none the less making good progress and still has its eye on the target. According to a progress report released at the end of 2004: “In the second half of 2004, the number of people on antiretroviral (ARV) therapy in developing and transitional countries increased dramatically from 440 000 to an estimated 720 000. This figure represents about 12% of the approximately 5.8 million people currently needing treatment in developing and transitional countries.” The ‘3 by 5’ initiative grew out of consultations with UNAIDS, WHO and other international organizational which started in 2001 and was officially launched in 2003. It was always regarded as a highly ambitious goal but one that could galvanise commitment and action from national governments, international funding agencies and community groups. The upward trend in ARV provision was particularly marked in sub-Saharan countries where the number of people receiving ARV therapy doubled to 325 000 in just six months. As of December 2004, an estimated 325 000 people were receiving ARV therapy in sub-Saharan Africa but there are also still an estimated 4 million needing it. ARV therapy coverage in the region is thus estimated at 8%. South Africa, India and Nigeria together account for 41% of the unmet need. (excerpt)
Geneva, Switzerland, UNAIDS, 2004 Jul 6.  p.The global community is at a crossroads in expanding access to HIV treatment and care. Never before have the opportunities been so great: unprecedented political will in countries; unprecedented financial resources to fund treatment, care and support; and unprecedented affordability of medicines and diagnostics. Despite these extraordinarily positive conditions, access to antiretroviral treatment and other HIV-related disease care remains abysmally low. As part of addressing this emergency, UNAIDS, WHO and their partners are fully committed to getting 3 million people on antiretrovirals by the end of 2005. (excerpt)
Global AIDSLink. 2001 Apr-May; (67):9.For many years, I have worked for access to treatment for people living with AIDS in the developing world. In a well-circulated 1997 article I wrote, “While thousands die of AIDS in the developing world, their brothers and sisters in Europe and North America are taking medication and getting back to the business of focusing on life instead of death.... I think in fifty more years, people will be asking the same questions about the AIDS epidemic as they did about the Holocaust. How was it possible that so many people with resources and intelligence, who knew so much about AIDS, sat passively by and watched their brothers and sisters die for lack of the same medications that everyone knows can prevent the deaths of people with AIDS?” Nearly four years later, I continue to work in Central America promoting treatment access for people with AIDS. The panorama has changed somewhat since 1997. But the realities of every day life for people with AIDS have changed very little in my part of the world, and, I would venture to say, in most of the developing world. (excerpt)
Geneva, Switzerland, WHO, 2003.  p. (WHO/HIV/2003.11)The main strategy foreseen in order to implement a global M&E is to simplify and standardize tools for tracking the performance of antiretroviral therapy programmes, including surveillance of drug resistance, with the following steps: develop simple, standard, easy-to-use monitoring and evaluation indicators for ART programmes, promote the universal adoption and use of the core indicators for ART programmes, develop guidelines and networks for surveillance of antiretroviral drug resistance, develop guidelines and networks for monitoring risk behaviour, establishment of a Strategic Information Centre to collect data analyse and present the information on progresses made towards 3 by 5 for all to use. (excerpt)
Geneva, Switzerland, WHO, 2003.  p. (WHO/HIV/2003.17)Country support is central to global efforts to reach the 3 by 5 target of providing antiretroviral therapy (ART) to 3 million people in resource-limited countries by the end of 2005. Achieving the 3 by 5 target will require the concerted efforts of all concerned parties in countries and at the global level. However, countries must take the lead. International partners will need to assist in meeting the resource gap and also in helping to build the necessary capacity to deliver ART. The World Health Organization (WHO), as the UNAIDS Cosponsor responsible for care and treatment, together with UNAIDS and the other Cosponsors and partners, is taking the lead in catalyzing action to reach 3 by 5 by building on existing national and global efforts. (excerpt)
Sexual Health Exchange. 2003; (3):1-3.At the XIV International AIDS Conference in Barcelona in 2002 the World Health Organization (WHO) announced its goal of scaling up access to antiretroviral treatment for HIV-positive people in developing countries to three million people by 2005. At the moment only a mere 350,000 people in developing countries are having access to treatment; this is only 50,000 more than when the so-called "3 by 5" goal was set. This means that reaching the WHO goal will require a massive effort. Not only by international agencies, governments, NGOs, doctors, nurses and health workers, but also by private foundations, national and international companies, unions, faith-based organisations, women's organisations, the pharmaceutical industry, community-based organisations and associations of people living with HIV/AIDS (PLWHA). So far, only a few developing countries have managed to guarantee access to antiretroviral treatment for those who need it. Brazil is the most cited example, with 130,000 people on treatment, due to the government-owned production of generic HIV inhibitors which makes treatment much cheaper. Other countries are rapidly increasing the number of people on antiretroviral treatment (ART): Thailand more than 20,000, Nigeria over 10,000, Botswana 6,300. Recently Mozambique, Rwanda, Tanzania and even South Africa decided to start programmes aiming to treat everyone in need. Clear guidelines from WHO are available to facilitate this process and more and more organisations are training doctors, nurses and other health- care workers to facilitate quality care and treatment. (excerpt)