Dr. Avnish Jolly,8 June:Margaret Chan, Director General, WHO, expressed that this represents a remarkable achievement for public health and This proves that, with commitment and determination, all obstacles can be overcome. People living in resource-constrained settings can indeed be brought back to economically and socially productive lives by these drugs.
Around 3 million people in the developing world are now on drugs to prevent their HIV infection becoming AIDS, two years after the original deadline set by the World Health Organisation, it was announced this week. The efforts to get antiretroviral drugs into developing countries have still been only partly successful, however. Only a third (31%) of those who are in immediate need of treatment were getting it in 2007, figures compiled and released by the WHO, UNAIDS and Unicef show. A further 6.7 million will soon die without the drugs and more are infected every day – an estimated 2.5 million last year alone.
According to report despite substantial progress in 2007, most of developing countries are still far from achieving universal access goals. Hinderences include weak healthcare systems, a critical shortage of health care providers and a lack of sustainable, long-term funding. The target to get 3 million people on treatment by 2005 was considered ambitious by some when it was set by the WHO in 2003. Although it was missed, it is widely credited with concentrating efforts on the struggle to make AIDS drugs available at an affordable price in Africa and Asia.
Large numbers of people with HIV still do not know their status, the report says, and therefore do not get advice on preventing transmission to their partners or treatment or care. Although the number of children on antiretroviral drugs has increased from 127,000 in 2006 to 200,000 last year, many go untreated and are very vulnerable to disease because HIV is hard to diagnose in infants. While a growing number of pregnant women – 33% last year – are being given drugs at the onset of labour to prevent transmission of the infection to their infants, only 12% were assessed to decide whether they needed to be on the drugs themselves. That raises the possibility that the infants might survive, but the mother die soon afterwards.
The target now set by the G8 is for universal access to not only AIDS drugs but also prevention and care. The report notes that few of the hoped-for technologies to prevent the spread of infection have been successful. The only method that appears to reduce risk is male circumcision. Countries with high HIV rates are now exploring culturally acceptable ways to increase the take-up of circumcision.