Journal editorial: Lack of cash hampers global HIV treatment effort

The World Health Organization's "3 by 5" goal of providing lifesaving anti-HIV medicines to 3 million people in developing countries by the end of 2005 is being jeopardized by a lack of funding, staff, and commitment from key nations, according to an editorial published in the medical journal The Lancet. "For what was a modest target, it is tragic that many of those with HIV/AIDS who desperately need treatment will not receive it by the end of 2005 and will die as a result," the editorial says. At the time WHO launched the initiative in 2003, just 400,000 HIV-positive people--or 8% of the approximately 6 million people in need of treatment--were getting antiretrovirals, says the journal. By the end of 2004, an estimated 720,000 people (12%) were receiving treatment. The target for the next progress report, due in two months, is 1.6 million. There are enough health outlets to distribute the drugs, but what is urgently needed is more funding, says the editorial. WHO has deployed 112 staff for the program, but this is a fraction of what it needs to be. "Crucially, the number of countries that have established treatment goals is 30, yet the December target was 50," the journal's editorial says. Africa remains the program's largest hurdle. Just 325,000 of the continent's 4 million people who need antiretroviral drugs are receiving them. About half of patients in Uganda and Botswana are now getting treatment, but distribution is lacking in South Africa, Nigeria, Zimbabwe, Tanzania, and Ethiopia. Strategies to pressure ministries of health in sub-Saharan Africa to work toward the goal are needed, according to The Lancet's editorial, titled "Predicting the Failure of 3 by 5." The editorial also calls for more treatment donations from drugmakers and continued leadership from WHO, the Joint United Nations Programme on HIV/AIDS, the World Bank, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. (Reuters)