PHA-Exchange> World Health Assembly puts focus on HIV/AIDS treatment

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The July issue of The LAncet Infectious Diseases of
July has many articles on HIV/AIDS before the World
AIDS Conference in BAngkok
     3 of 28

Volume 4, Issue 7 , 1 July 2004, Page 387


WHA puts focus on HIV/AIDS treatment

John Zarocostas

This year's World Health Assembly (WHA; Geneva, May
17–22) agreed as a matter of priority that governments
should beef-up their national health systems to ensure
they deliver concrete HIV/AIDS prevention, treatment,
and care.

Health ministers also welcomed WHO director-general
Lee Jong-Wook's "3 by 5" strategy to assist developing
countries to secure access to antiretroviral treatment
for 3 million people living with HIV/AIDS by the end
of 2005 at a cost of around US$5·5 billion. In 2003,
only about 400000 people in poor nations were
receiving treatment.

In a press conference on the eve of the WHA, Lee said
the world had an "unprecedented opportunity to change
history" and reverse the trend of the HIV/AIDS
pandemic. Similarly, in his keynote WHA address Lee
told delegates "there must be universal access to
treatment by the earliest possible date, and ever more
effective approaches to prevention".

To help scale-up HIV/AIDS treatment and care, the WHA
adopted a resolution that urged governments to pursue
policies to promote, amongst other things, sufficient
and adequately trained personnel, and the availability
of good quality antiretroviral medicines and
technologies.

The text also called for accessibility and affordable
treatment, testing, and counselling, and the
development of health systems designed to promote
access to antiretroviral medicines.

The resolution also requested the WHO chief to
strengthen the key role of the global health agency in
providing technical leadership, direction, and support
to health systems. This included improving access for
developing countries to pharmaceutical and diagnostic
products, and support in improving management of the
supply chain and procurement of quality AIDS
medicines.

But the annual gathering of the world's top 192 health
officials also adopted a resolution—sponsored by many
poor African and Caribbean countries—that calls for
the development of strategies to mitigate the adverse
effects of the "brain-drain" of health personnel on
national health systems, most already stretched to the
limits, and instructed the WHO to find ways to enhance
human-resources capacity.

However, the adopted text was a compromise from a
stronger earlier version, which suggested there was a
need to "establish a mechanism for compensating
developing countries for the loss of health personnel
through migration".

The West African Health Organisation (WAHO) in a joint
statement said the brain-drain has severely affected
health-care delivery and national development goals.
For example, the delegation of Zimbabwe asserted the
brain drain, estimated at 68% "has compromised" the
ability of the health system to rapidly scale-up
efforts to provide comprehensive HIV/AIDS services.

"States now have difficulty to retain their health
workers", WAHO said and underscored the international
community needs to help poor nations in their efforts
to strengthen training and research institutions
locally.

The WHA lauded the move by WHO to place HIV/AIDS at
the top of the global health agenda. "AIDS is the
Black Death of our time. AIDS is close to exploding in
parts of Asia and Europe. Its impact in Africa has
been devastating", said Dagfinn Hoeybraaten, Norway's
Minister of Health. "The global community has the
means to curb epidemics like SARS. The time to give
AIDS the same level of commitment is now."

Tommy Thompson, US Secretary of Health and Human
Services, and current chairman of the Global Fund to
Fight AIDS, Tuberculosis, and Malaria, said on an
optimistic note, "we will stop the AIDS pandemic. We
will stop it because we have the will, the means, and
the passion to do it". Thompson said the Fund has
already approved 224 grant programmes in 121
countries, totalling more than $2 billion.

Moreover, a day earlier, Thompson announced in Geneva
a new procedure that would fast track approval by the
US Food and Drug Administration of fixed–dose
combinations drugs and blister packs from both
innovator and generic companies that would be eligible
for purchase from President Bush's 5 year $15 billion
emergency plan for AIDS relief.

Interventions by ministers from HIV/AIDS-ravaged
countries illustrated in graphic terms the challenges
ahead. P D Parirenyatwa, Minister of Health for
Zimbabwe—one of the worst affected by HIV/AIDS—told
the WHA: "we estimate 1·82 million Zimbabweans are
infected and of these 340000 are in urgent need of
antiretroviral therapy". He pointed out that about
170000 are targeted for 3 by 5 treatment but noted
that so far only 5000 people living with HIV/AIDS are
being treated.

But Parirenyatwa voiced concerns that the
disbursements of approved grants from the Global Fund
have been slow and that distribution of some funds
from the various initiatives "has been politicised to
the detriment of people living with HIV/AIDS".

The minister of health for Uganda Jim K Muhwezi,
reflecting the views of many other ministers, stressed
that while everything possible must be done to combat
HIV/AIDS, "we must not forget other key diseases,
especially malaria, which is the leading killer in
most African countries".

Finally, Pakistan's Minister of health Mohammad Nasir
Khan, and President of the 57th WHA, said we could not
ignore that 8·8 million new cases of tuberculosis are
detected each year.




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