U.N. Agency Falls Short of AIDS Treatment Goal

The World Health Organization has fallen well short of its goal of getting 3 million AIDS patients in treatment by the end of 2005, with fewer than half that number now receiving life-sustaining antiretroviral therapy, according to a report issued Tuesday.

The program tripled the number of people in low- and moderate-income countries receiving drugs between 2003 and 2005, but overall, only one in every five people requiring treatment now receives it -- a total of 1.3 million out of an estimated 6.5 million with AIDS.

Fewer than 10% of HIV-infected pregnant women are receiving the drugs, and 2,000 infected babies are born every day.

Each year, more than 570,000 children younger than 15 die of AIDS, most of them having acquired it from their mothers at birth, according to the report.

An estimated 3 million people die of acquired immune deficiency syndrome each year, and WHO officials believe that the “3 by 5” program prevented as many as 350,000 deaths in 2005.

“People have died and continue to die of what is a treatable disease,” said Dr. Kevin De Cock, director of the WHO’s HIV/AIDS Department.

The program was launched by the WHO and UNAIDS on World AIDS Day, Dec. 1, 2003, with high hopes that the drug benefits achieved in industrialized countries could be quickly spread to the developing world.

But within a year it was clear that the 2005 goal could not be reached, primarily because of insufficient money, the high cost of drugs and the poor health infrastructure in many of the most affected countries.

Global spending on AIDS totaled $8.3 billion in 2005, up from $4.7 billion in 2003. Nearly half of that sum came from the United States through the President’s Emergency Plan for AIDS Relief.

But the report predicts an $18-billion shortfall in funding for 2005-07. If treatment coverage is to continue expanding, it says, at least $22 billion a year will be required by 2008.

The price of drugs has been declining, by as much as 53% for some regimens. Even so, the funding agencies are still forced to rely on branded drugs for many uses, particularly when first-line drugs fail. Increasing the number of generic drugs would enable the program to get more coverage for its money, according to the report.

Identifying AIDS patients and delivering the drugs are a particular problem in sub-Saharan Africa, home to more than 20 of the world’s 25 poorest countries. The region already has a shortage of more than 1 million professional healthcare workers, the report says, and is losing an additional 20,000 each year through emigration.

Nonetheless, more than 810,000 people in the region are receiving the drugs, about 17% of those in need.

East, South and Southeast Asia also showed significant gains, nearly tripling the number of people receiving drugs over 2003-05. Thailand, which is manufacturing generic forms of some AIDS drugs, “was a major driver of this increase,” according to the report.

Latin America and the Caribbean nations are also doing well, with 68% of those in need, about 315,000 people, receiving the drugs. Thirteen countries in the region provide treatment to more than half their population in need.

The regions with the least access to antiretroviral drug treatment are Eastern Europe and Central Asia, with just 21,000 receiving treatment, and the Middle East and North Africa, with 4,000 getting drugs.

None of those countries has a major AIDS problem yet, the report says.