August 16, 2006

IAC: Challenges of Reaching Countries in Need

August 16, 2006 (AIDSmeds)—According to the World Health Organization (WHO), more than one million people in sub-Saharan Africa are currently receiving HIV treatment. This, WHO HIV/AIDS Director Kevin De Cock, MD, reported this morning at the XVI International AIDS Conference (IAC) in Toronto, is a tenfold increase in treatment access in the region since December 2003.

Dr. De Cock explained that in low- and middle-income countries, approximately 1.6 million HIV-positive people were receiving HIV treatment by the end of June 2006. This, he explained, is a 24% increase over the 1.3 million people who had access to the drugs in December 2005, and four times the 400,000 people receiving treatment in these countries in December 2003.

While Dr. De Cock reported significant increases in treatment access in several regions of the world, he also emphasized that there is considerable work ahead to reach the goal of providing universal access to HIV prevention programs, treatment, care and support by 2010.

Dr. De Cock laid out WHO's vision for continuing to expand HIV treatment access. This included calling for new action to overcome barriers that, if unaddressed, will slow the rate of expansion in access to HIV treatment in the future.

According to WHO, there are 38.6 million persons living with HIV globally. Approximately 6.8 million people living in low- and middle-income countries require antiretroviral therapy now. With 1.6 million HIV-positive people in these countries currently receiving treatment, this means that HIV therapy is only in the hands of 24% of people who need it.

Coverage of HIV treatment varies by region, from 5% in North Africa and the Middle East, 13% in Eastern Europe and Central Asia, to 75% in Latin America and the Caribbean.

Sixty-three percent of HIV-positive on antiretroviral therapy in low- and middle-income countries today are African. Dr. De Cock noted that while sub-Saharan Africa has the greatest number of people on treatment among low- and middle-income countries, it also has the greatest need – the region accounts for 70% of the global unmet treatment need.

Looking forward, Dr De Cock outlined five strategic directions, each of which represents a critical area where the health sector must lead if countries are to make progress towards achieving universal access, and on which WHO will focus its technical assistance. These include expanding HIV testing and counseling; maximizing prevention opportunities in health care settings; increasing access to treatment and care; strengthening health systems; and investing in strategic information.

While stressing that prevention, treatment, and care are inextricably linked, De Cock called for an increased emphasis on prevention efforts where HIV transmission is most intense. He also emphasized the need to be guided by science – and not politics – when determining the effectiveness of prevention intervention.

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