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Lancet. 2006 Feb 4; 367(9508):396.Zimbabwe is a small country in southern Africa that is in the midst of an economic, political, social, and HIV/AIDS crisis. Over the past few years at least a quarter of the population, including most of its doctors and nurses, has emigrated, leaving behind them a crumbling health-care system, which was once the envy of most of Africa, and one of the highest HIV/AIDS rates in the world. Zimbabwe does not see any of the US government's PEPFAR funds, and has been excluded from many bilateral programmes designed to improve access to HIV care and treatment. (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)
Report of the expert meeting: “3 by 5”, What Are the Implications? Organized by the Royal Tropical Institute, Aids Fonds and Share-Net, 16 September 2004, Amsterdam.
Amsterdam, Netherlands, KIT, 2004. 27 p.In 2003, the WHO started an initiative to expand access to HIV treatment. “3 by 5” is the name of the global target of providing anti-retroviral therapy (ART) to three million people living with HIV/AIDS in resource-limited countries by the end of 2005. It is a step towards the goal of providing universal access to treatment for all who need it. The WHO’s framework for emergency scaling up of anti-retroviral therapy contains 14 key strategic elements. These elements fall into five categories – the pillars of the “3 by 5” campaign: i) global leadership, strong partnership and advocacy; ii) urgent, sustained country support; iii) simplified, standardized tools for delivering antiretroviral therapy; iv) effective, reliable supply of medicines and diagnostics; and v) rapid identification and application of new knowledge and successes. The strategy also aims to develop guidelines for ensuring the quality of anti-retroviral drugs and to build country-level capacity for delivery and utilization of simple diagnostics for monitoring patient adherence to treatment as well as drug resistance. In the first six months of this strategy, progress was made towards the goal of increasing access to treatment. But much remains to be done, and urgently, if the world is to meet its target of providing treatment to three million people by the end of 2005. (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)