WHO plans to get three million people on ARVs by 2005

The World Health Organisation (WHO) has thrown out a challenge to the international community to support its target of providing anti-retroviral (ARV) treatment for three million people worldwide by the end of 2005.

Speaking at a press briefing at the 13th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), WHO Director of HIV/AIDS, Dr Paulo Teixeira, declared the lack of access to ARV drugs a "global health emergency".

WHO's "3 by 5" plan, as it is known, targets half of the six million people who need treatment now, and a fraction of the 40 million currently living with the virus. Although modest in numbers, the challenge represents a significant hurdle given the current state of global funding for AIDS and technical capacity.

It is estimated that the "3 by 5" plan will cost at least US $5 billion a year, but WHO is still conducting more in-depth studies to produce a more accurate figure. In the meantime, there was no time for "more discussions" as ARV treatment was feasible, Teixeira said.

Although progress had been made on HIV prevention and the support of people living with the virus, it had become clear that developing countries were not moving fast enough on access to ARVs, he noted.

Teixeira admitted that WHO's "3 by 5" plan was "ambitious", but added that studies had shown that with enough resources, it was possible to treat 3 million people by 2005. WHO has set out an action plan outlining how it will achieve this goal and is in the process of drawing up a detailed roadmap to be put in place by 1 December 2003.

To do this, WHO will provide emergency response teams to work with treatment implementers in countries, "where the treatment gap is most evident", to assess any barriers in reaching the target.

Drug procurement remains one of the major obstacles to increasing access to treatment in African countries, and activists have been skeptical about how WHO will address this. "WHO is organising an internal team to help countries and provide technical and legal advice on procurement," Teixeira pointed out.

Expanding treatment in such a short time would also require "new approaches", UNAIDS Executive Director Dr Peter Piot noted.
"This would entail much simpler types of monitoring - especially on the laboratory side," he added.

The WHO plan would also have to address issues of equity. "Who will get treatment? We have to make sure there is a gender balance and women get their fair share," he said.

Nomfundo Dubula, a South African AIDS activist representing the Pan African Treatment Access Movement, welcomed the initiative but urged WHO to involve communities.

"We also want WHO to support treatment literacy programmes that promote adherence and reduce stigma and dicriminations," she said.

She also called for WHO to give countries with a manufacturing capacity a chance to produce generic ARVs locally.

African treatment activists were willing to help governments reach the "3 by 5" target, but would also be "watchdogs" if countries failed to deliver, she warned.