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Choices. 2004; 7.I left the 1998 International AIDS Conference in Geneva frustrated and angry. The slogan of the conference--'Bridging the Gap'--was right on target, but none of the major players in the conference (the international agencies, governments, the big pharmaceutical companies) offered a vision, let alone a strategy, for making life-saving treatments available to the millions of HIV-positive people in poor and developing countries. As has been true since the beginning of the AIDS epidemic, it was left to HIV-positive people themselves and to advocacy groups to formulate demands, mobilize the political support to challenge the status quo and lead in the development of new policies. Dramatic changes have occurred between 1998's 'Bridging the Gap' and 2004's 'Access for All' conferences. In the intervening six years, an alliance of NGOs from around the world with a bloc of progressive poor and developing countries has won significant victories: It is no longer morally acceptable to do nothing about the death and suffering of millions; The broader global AIDS community has accepted that any effective approach to stopping the epidemic must include treatment as well as prevention and mitigation. (excerpt)
Odessa workshop helps build capacity among Ukrainian clinicians who care for people living with HIV / AIDS.
Connections. 2004 Jan;  p..A recent Anti-retroviral Therapy Training Workshop held in Odessa, Ukraine, marked the start of an ongoing collaboration between AIHA and the Los Angeles-based AIDS Healthcare Foundation (AHF). It was the first training hosted under the aegis of the newly established World Health Organization Regional HIV/AIDS Care and Treatment Knowledge Hub for which AIHA is the primary implementing partner. This Knowledge Hub was created in response to the burgeoning HIV/AIDS pandemic in Eastern Europe and Central Asia to serve as a crucial capacity-building mechanism for reaching WHO's "3 by 5" targets for the region. (excerpt)
Africa Renewal. 2005 Apr; 19(1): p..When a reporter first met seven-year-old Bongani in a hardscrabble shantytown near Johannesburg in 2003, it was evident the child was dying. He was too weak for school, stunted and racked by diarrhoea. There was little question that he, like his deceased parents, was infected with the human immunodeficiency virus that causes AIDS. It seemed equally certain that he would soon lie in a tiny grave next to theirs -- joining the 370,000 South Africans who died from the disease that year. But when the journalist, Mr. Martin Plaut of the BBC, returned a year later, he found a healthy, laughing Bongani poring over his lesson book. “The transformation,” Mr. Plaut wrote last December, “was remarkable.” That transformation -- and the difference between life and death for Bongani and a growing number of people living with HIV and AIDS in Africa -- has resulted from access to anti-retroviral drugs (ARVs) that attack the virus and can dramatically reduce AIDS deaths. For years high costs severely limited their use in Africa. The Joint UN Programme on HIV/AIDS (UNAIDS) estimated that only about 50,000 of the 4 million Africans in urgent need of the drugs were able to obtain them in 2002. But with prices dropping in the face of demands for treatment access and competition from generic copies of the patented medications, the politics and economics of AIDS treatment have finally begun to shift. (excerpt)
Implementing GIPA: how USAID missions and their implementing partners in five Asian countries are fostering greater involvement of people living with HIV / AIDS.
Washington, D.C., Futures Group International, POLICY Project, 2004 Jan.  p. (USAID Contract No. HRN-C-00-00-00006-00)On behalf of the Asia/Near East Bureau (ANE) of the U.S. Agency for International Development (USAID), the POLICY Project undertook an assessment of how the Greater Involvement of People Living with HIV/AIDS (GIPA) Principle is being implemented in the ANE region. Five USAID Missions and 12 implementing agencies (IAs) in the region participated in the assessment, which was undertaken in May and June 2003 in Cambodia, India, Nepal, Philippines, and Viet Nam. The purpose of the assessment was to ascertain how Missions, IAs, and NGOs are incorporating GIPA principles into their organizations and into the programmatic work they support and implement. A self-administered questionnaire was completed by 23 respondents from Missions, IAs, and NGOs. The assessment found a high level of awareness of GIPA and a commitment by most organizations to foster and promote GIPA principles, within their organizations and in the work they carry out. Ninety-one percent of respondents from the three types of organizations believe that their organizations’ planning, programs, and policymaking activities are or would be enhanced by GIPA. (excerpt)
BMJ. British Medical Journal. 2004 Jul 17; 329:129.A huge international effort is under way to get lifesaving antiretroviral treatment to three million people with AIDS in poor countries by the end of 2005, said the World Health Organization, but added that its six month campaign had fallen short of interim targets. In all, 400 000 AIDS patients in developing countries were receiving antiretrovirals when WHO launched its "3 by 5 strategy." That figure has edged up to 440 000, said WHO's progress report, presented at the international AIDS conference this week. "Although this was disappointing, the absolute increase of 40,000 people in a few months dose indicate that country and international efforts to scale up HIV- AIDS treatment are resulting in progress report. The progress report is likely to fuel critics of WHO's 3 by 5 campaign, who contend that it is overambitious, poorly managed, and too focused on lowering drug prices. (excerpt)
Johannesburg, South Africa, ActionAid International, 2004 Jun. 11 p. (3 by 5 Discussion Paper)This paper addresses these concerns. Prevention, care and support: in the push to provide antiretrovirals, prevention, care and support programmes must not slip down the priority list of the world’s governments. ActionAid International calls on developing countries to demonstrate clearly in their 3 by 5 plans how ARV treatment delivery will interface with, and be balanced by, other prevention, care and support initiatives, including the promotion of good nutrition. Equity: initially, the limited supply of ARVs under 3 by 5 will be the focus of a struggle between different interest groups trying to ensure access for their client populations. ActionAid International’s past experience would suggest that men, and those that are better off or living in urban areas, will win out over women, children, marginalised groups and those living in rural areas. We call on all involved in developing 3 x 5 plans to ensure equity in access by focusing on the special needs of women, marginalised groups, poor and rural communities. Ideally, such groups should be involved in the design and implementation of care services that will be appropriate to their needs and be located close to where they live. Health systems: ActionAid International welcomes the recent emphasis given by the WHO World Health Assembly to health system strengthening as an essential component in delivery of 3 by 5. In many of the countries most affected by HIV/AIDS health systems are not working, having been undermined by World Bank/IMF structural adjustment programmes as well as attrition caused by HIV/AIDS. The rapid rebuilding of health systems is a basic requirement if 3 by 5 is to succeed. ActionAid International calls on donors to provide increased funding and support and to ensure that large-scale capacity building programmes for health service personnel are instituted without delay. (excerpt)
Geneva, Switzerland, WHO, 2003. 2 p. (WHO/HIV/2003.15)In accordance with the overall 3 by 5 strategic framework, the objective of the 3 by 5 Community Mobilization Plan is to strengthen the capacity of community and faith-based organizations to be fully involved at all levels of the planning and implementation of ART programmes. This involvement is potentially very broad, and could range from participating in the design of national ART scale-up plans and acting as treatment supporters for family members and friends living with HIV/AIDS to conducting programme evaluation, including quality assurance and operational research. The plan was developed in consultation with community-based treatment advocates, practitioners and other experts in the community sector, as well as individuals within and outside the United Nations system. Many partner groups also contributed. (excerpt)