PHA-Exchange> WHO AND UNAIDS UNVEIL PLAN TO GET 3 MILLION AIDS PATIENTS ON TREATMENT BY 2005

[Aviva]

WORLD HEALTH ORGANIZATION AND UNAIDS UNVEIL PLAN TO GET 3 MILLION
AIDS PATIENTS ON TREATMENT BY 2005

Geneva - The World Health Organization (WHO) and UNAIDS
today release a detailed and concrete plan to reach the 3 by
5 target of providing antiretroviral treatment to three
million people living with AIDS in developing countries and
those in transition by the end of 2005. This is a vital step
towards the ultimate goal of providing universal access to
AIDS treatment to all those who need it.

The 3 by 5 initiative complements the groundbreaking
commitments made by the United States under President Bush's
HIV/AIDS Initiatives ($15 billion dollars for an enhanced
AIDS response), the pathfinding work of NGOs (like MSF) and
faith-based groups, the efforts of pharmaceutical companies
to reduce the prices of AIDS treatment, the contribution of
international foundations like the Bill and Melinda Gates
Foundation, the initiative and hard work of many national
and international agencies, and, critically, the courageous
contributions of nations increasing their people's access to
AIDS treatment.

"Preventing and treating AIDS may be the toughest health
assignment the world has ever faced, but it is also the most
urgent," said Dr LEE Jong-wook, Director-General of the
World Health Organization. "The lives of millions of people
are at stake. This strategy demands massive and
unconventional efforts to make sure they stay alive."

UNAIDS announced last week that 40 million people around the
world are infected with HIV, and that the global AIDS
epidemic shows no signs of abating. Five million people
became infected with HIV worldwide and 3 million died this
year alone - that's 8,000 people every day. WHO estimates
that six million people worldwide are in immediate need of
AIDS treatment. This strategy outlines the steps needed to
deliver treatment to half of them within two years.

The strategy is a key element in a combined programme of
accelerating HIV/AIDS prevention and treatment. Much has
already been done by countries, by UNAIDS, the World Bank,
foundations, WHO and many other groups. After twenty years
of fighting the epidemic, it is now clear that a
comprehensive approach to HIV/AIDS must include prevention,
treatment and care.

"The 3 by 5 framework is a plan for action by a broad
alliance of nations, institutions, and committed people,
including those living with HIV/AIDS," said Dr. Jack Chow,
Assistant Director-General of WHO for HIV/AIDS, Tuberculosis
and Malaria. "We urge all concerned to work to reach the 3
by 5 target as rapidly as possible."

Evidence and experience shows that rapidly increasing the
availability of antiretroviral treatment in line with 3 by 5
targets can lead to more people knowing their HIV status and
more openness about AIDS. Individuals on effective treatment
are also likely to be less infectious and less able to
spread the virus. Good treatment programmes will make more
people come forward for testing HIV/AIDS status. Treatment
can therefore contribute to the rapid acceleration of
prevention.

Building on work done by UNAIDS, developing and donor
countries, NGOs and other multilateral agencies, WHO and
UNAIDS are taking another big step forward in the global
movement to increase access to prevention and treatment
services.

"The lack of HIV treatment is without a doubt a global
emergency," said Dr Peter Piot, UNAIDS Executive Director.
"We firmly believe that we stand no chance of halting this
epidemic unless we dramatically scale up access to HIV care.
Treatment and prevention are the two pillars of a truly
effective comprehensive AIDS strategy."

3 by 5 Strategy

To reach the 3 by 5 target, WHO and UNAIDS will focus on
five critical areas:

- Simplified, standardised tools to deliver antiretroviral
therapy

- A new service to ensure an effective, reliable supply of
medicines and diagnostics

- Rapid identification, dissemination and application of new
knowledge and successful strategies

- Urgent, sustained support for countries

- Global leadership, strong partnership and advocacy

Simplified Treatment Recommended

The strategy has greatly simplified the recommendations for
AIDS treatment regimens. The number of such WHO-recommended
regimens has been cut to four from 35. All four are equally
effective. The selection of an individual regimen for a
patient will be based on a combination of individual needs,
together with the availability and suitability of a
particular regimen in a country. The strategy also
recommends the use of quality-assured "fixed dose
combinations" or easy-to-use blister packs of medicine
whenever they are available. The aim is to ensure that all
people living with AIDS, even in the poorest settings, have
access to treatment through this simplified approach.

The strategy also includes the global AIDS Medicines and
Diagnostics Service (AMDS), which will ensure that poor
countries have access to quality medicines and diagnostic
tools at the best prices. The service, which will be
operated by WHO, UNICEF and other partners, will help
countries to forecast and manage supply and delivery of
necessary products for the treatment and monitoring of AIDS.
Through the WHO Prequalification Project, AMDS will also
include a medicines and diagnostics evaluation component
which will ensure that manufacturers, products, procurement
agencies and laboratories meet international quality, safety
and efficacy standards.

Another key element is the simplification of monitoring, so
that easy-to-use tests such as body weight and colour-scale
blood tests are used where more complicated and expensive
tests for viral load and white cell (CD4) count are not yet
available. The simpler tests, combined with clinical
evaluations by adequately trained health workers, can be
effective in monitoring the progress of AIDS, the
effectiveness of treatment and its side effects.

Treatment Action in Countries Already Under Way

Antiretroviral therapy programmes can only be expanded if
there is coordinated, scaled-up action in countries,
particularly those hardest-hit by AIDS. Countries are at the
heart of the 3 by 5 strategy and will be the focus of all
efforts to meet the 3 by 5 target. Many countries have
already demonstrated their commitment to this target.
Immediately following the declaration of a global AIDS
treatment emergency, more than 20 countries requested
collaboration and input from WHO, UNAIDS and other partners.

Teams have already travelled to Kenya, Burkina Faso, Malawi
and Zambia. Other teams have done preparatory work in
Ukraine, India and Sudan. In each case, the teams will be
working with governments to identify and help remove
obstacles, so that antiretroviral medicines can be provided
quickly to the people who need them most. Many other
countries, including Russia and Djibouti, have also
requested assistance.

Training of health workers is an urgent need in all
countries involved. Many of the countries with the highest
numbers of people living with HIV/AIDS have very few doctors
or other trained health staff. Many of these health workers
have died as a result of untreated AIDS; others have moved
to seek better pay and job security in wealthier countries.

Thousands of community workers to be trained

One of the most innovative aspects of the 3 by 5 strategy is
a method for urgently training tens of thousands of
community health workers to support the delivery and
monitoring of HIV/AIDS treatment. An intensive training
programme would enable these health workers to evaluate and
monitor patients, and make sure they receive and are taking
their medicines.

The strategy acknowledges that the involvement of
communities and community workers is essential to the
success of this initiative. Significant evidence and
experience shows that without strong community support,
people may have a more difficult time adhering to their
medical regimens. Also, community involvement is a critical
element of any successful HIV prevention strategy.

There is also good evidence that treatment can have an
accelerating effect on prevention efforts. "We know from
experience that the availability of treatment encourages
people to learn their HIV status and receive counselling,"
said Dr Paulo Teixeira, Director of the HIV/AIDS Department
at WHO. "We also know that the availability of treatment
reduces stigma for people living with AIDS. People living
with AIDS have a right to treatment and we must find a way
to deliver."

One of the key elements of the strategy is "learning by
doing". The strategy unveiled today by WHO and UNAIDS
addresses many of the obstacles that have up to now
prevented millions of people in poor countries from
accessing AIDS medicines. The strategy will evolve as
lessons learnt from implementing the strategy are identified
and rapidly applied.

Funding

Reaching the 3 by 5 target will require substantial new
funding for AIDS treatment from all sources - countries,
donor governments and multilateral funding agencies. WHO has
estimated that the extra funding required amounts to
approximately $5.5 billion over the next two years.

"We know what to do but what we urgently need now are the
resources to do it," said Dr Lee. We must waste no time in
building strong alliances immediately to implement this
strategy. Three million people are counting on it."

For further information contact: Melanie Zipperer,
Communications Officer, HIV Department, zippererm at who.int or
Iain Simpson, Communications Officer, WHO Director-General's
Office, simpsoni at who.int
Or please check the WHO HIV web site on www.who.int/hiv or
write to threebyfive at who.int.