PHA-Exchange> Open letter to WHO Director General regarding Universal Access from ITPC

Tue Apr 10 12:11:47 PDT 2007

 from Vern Weitzel <vern.weitzel at undp.org> -----
Dr. Margaret Chan
Director General
World Health Organization (WHO)
Avenue Appia 20, CH 1211
Geneva 27, Switzerland

Dear Director-General Chan,

   Thank you for meeting with representatives of the International
Treatment Preparedness Coalition (ITPC) last month. We are heartened by
your words of commitment to Africa , to women, and to primary health
care. We are encouraged that you embrace the legacy of Dr. Lee and his
understanding of the fundamental importance of universal access to AIDS
treatment, care and prevention. So in this letter we write not as
adversaries but as persons sharing a common commitment. We still believe
that by working together all of us can halt and begin to reverse the
spread of HIV/AIDS by 2015.

We are gravely concerned that the world has lost the momentum of the 3
by 5 campaign and that WHO is on the brink of squandering its legacy of
leadership role in the battle to bring universal treatment access to
people living with HIV/AIDS.

In this letter we outline five reasons for concern, make six specific
demands to be met before the end of 2007 and give four commitments that
ITPC will fulfill to do our part in this most critical global effort.

   *_Five reasons for grave concern _*

  1.      Only 26 of over 100 countries have provided targets linked to
costed national plans for key HIV/AIDS interventions. This first
universal access deliverable was due in December 2006. A 75% failure
rate to comply with even the preliminary step makes us seriously doubt
that national leadership alone can sustain the momentum for the scale-up
of antiretroviral therapy or other interventions.

2.      By all accounts, WHO is not sufficiently funded to maintain a
strong focus on AIDS treatment scale-up while attending to multiple
other critical priorities. Without sufficient funding to fulfill your
policy, normative and technical responsibilities on a global, regional
and country level, there is no chance that near universal access to AIDS
treatment will happen by 2010.

3.      The G8 countries have not adequately honored their 2005
Gleneagles commitments to universal access to treatment, prevention and
care.

4.      Some AIDS policy makers and advocates are pitting treatment and
prevention as competitors for resources, rather than understanding that
only a comprehensive response that integrates treatment, prevention and
care will reverse the pandemic.

5.      Parts of the United Nations system and many country governments
are not demonstrating the political will to sustain and build upon the
momentum and foundations of the 3 by 5 initiative.

   *_Six demands for action in the next six months_*

  1.      All countries must submit by June 30, 2007 their fully costed
universal access plans, including yearly targets and budgets.. These
plans should not compromise the goal of achieving quantitative ‘near
universal access’, but should also state clearly where there are
deficiencies in funding, human resources and health systems capacity.
The G8 countries and other donors must then be induced to take specific
actions to fill gaps.

2.      WHO, in partnership with UNAIDS, must review the treatment
scale-up targets and plans, ensure that they are both ambitious and
realistic, and declare a single, unified global target for universal
access to treatment by 2010 either as 9,800,000 (UNAIDS currently
published target) or a number based on WHO-approved cumulative country
targets. The Global Fund and PEPFAR each report their own quantitative
global results but only WHO is charged to be the focal organization with
responsibility and capability to systematically monitor top-level
progress against global, regional, and country treatment access and
uptake targets.

3.      The G8, guided and encouraged by the WHO Director-General, must
deliver a funding plan for their commitment to universal access to AIDS
treatment, prevention and care at their meeting in Germany in June 2007.
This G8 funding plan should include specific resource commitments based
on fair share contributions and ensure additional, predictable and
sustainable AIDS funding to achieve the universal access goal by 2010.

4.      A Universal Access Strategic Planning and Monitoring Group must
be set-up as a standing committee of WHO, UNAIDS, the Global Fund,
PEPFAR, DFID, representatives of the other G8 countries, developing and
middle-income countries, PLWHA networks, treatment activists and
organisations representing key populations. It should hold its first
meeting by September 2007 and continue to convene and report
semi-annually until universal access to treatment, prevention and care
is achieved. WHO should assume active leadership for the treatment
aspects of the integrated plan.

5.      Multilateral, bilateral and private funders must ensure that WHO
has the resources to fulfill its mission and leadership role on HIV/AIDS.

6.      WHO must ensure that its structures, human resources and
performance at global, regional, and country levels are adequate to
fulfill its universal access mission with particular emphasis on
building on the foundations, lessons learned, and momentum of the 3 by 5
initiative. Regional and country WHO offices especially must be
re-organized and strengthened to be fully effective.

Specific outcomes should include: a) a robust plan on second line drugs,
b) a system to learn lessons in scale up and rapidly share them to
improve operations, c) improved technical support to countries to ensure
GF and other programs work, d) ensuring that the WHO human resources
effort “Treat, Train, and Retain” is fully operational and soon shows
concrete outcomes.

   *_Four ITPC commitments to ensure demands are met_*

  1.      Monitoring and watchdogging – we will be active in critiquing,
cajoling and supporting WHO and the other multilateral and bilateral
agencies.

2.      We will partner to get WHO appropriate funding to do what you
need to do.

3.      Through ‘Missing the Target’ reporting and grassroots advocacy
we will continue our work on country and local levels – pointing out
issues, giving solutions and monitoring results. We will meet with you
regularly to share our findings with you and your team.

4.      We will increase our efforts on treatment literacy – helping
people understand that AIDS can be stopped only through integrated
programs of treatment, care, support, and prevention.

Director-General Chan, we believe that by making access to treatment a
core issue of your tenure, you are in a unique position to lead the
HIV/AIDS Millennium goal to control the pandemic and to fulfill your
priorities for Africa , for women, and for primary health care. We will
be at your side in this endeavor. Our lives and the lives of millions
depend on it.

Please contact any of us for further discussion or comment.

Greg Gray, International Coordinator, International Treatment Preparedness

Coalition

Matilda Moyo, Zimbabwe representing ITPC African Region and Pan African

Treatment Access Movement

Obatunde Oladapo , Nigeria representing ITPC African Region and Treatment

Access Movement Nigeria

Rajiv Kafle, Nepal representing ITPC South Asia Region and Nava Kiran Plus

Frika Chia Iskandar, Indonesia representing ITPC Southeast Asia and the Asia

Pacific Network of PLWHAs

Rodrigo Pascal, representing CIAT (ITPC South America)

Solomon Adderley, Bahamas representing ITPC Caribbean Region

Polly Clayden, UK representing ITPC Western European Region and HIV i-Base

Gregg Gonsalves, USA representing ITPC North American Region and AIDS
and Rights Alliance for Southern Africa

Svilen Konov , Bulgaria representing ITPC Eastern European Region

Gregory Vergus, Russia representing ITPC NIS/Baltics Region

Representing the International Treatment Preparedness Coalition, a
network of over 800 people living with HIV / AIDS and their supporters
from 125 countries.

Dgroups is a joint initiative of Bellanet, DFID, Hivos, ICA , IICD,
OneWorld, UNAIDS

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