ABUJA, Dec 7 (AFP) - Half a million Africans living with AIDS have access to antiretroviral treatment, a tiny number given the scale of the pandemic on the world's poorest continent, but experts say while treatment been slow to start, the future looks promising.
In 2003 the World Health Organization (WHO) and UNAIDS, the body that coordinates UN agencies in the fight against AIDS, launched "3 by 5", a program with a catchy name and an ambitious goal: ensuring three million people in developing countries were on antiretrovirals (ARVs) by the end of 2005.
By the end of June this year the program was far behind target with around one million people in the developing world on ARVs.
In Africa, home to two-thirds of people worldwide living with HIV/AIDS, the gap is even wider, with UNAIDS estimating that "at best one person out of 10" awaiting antiretroviral treatment had access to it by mid-2005.
"We've said for a long time that we're not going to meet 3 by 5. But on the other hand we're extremely excited about what happened after 3 by 5," Jim Kim, the WHO's head of HIV/AIDS, told AFP on the sidelines of the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA).
Thanks to 3 by 5 "we have learned a basic lesson that businesses have known for a long time -- the importance of setting a concrete target in a time frame", he added.
Non-governmental organizations (NGOs) also feel the program had its positive aspects, even if the situation they have to confront on the ground gives them a different perspective.
"I think it gave the momentum. We needed a quantitative objective. It was the best and only way to get people to work on these issues," said Eric Goemaere, MSF South Africa Head of Mission before adding that the tiny number of people currently receiving antiretrovirals in Africa "remains a scandal from a moral point of view".
"I have never seen a sophisticated program like the ARV program kick-start so rapidly. I don't think there is any precedent in history," Goemaere said.
Several experts emphasized that starting up distribution programs in many African countries was bound to be slow, given the need to first train medical personnel, but were confident such programs would pick up speed from now on.
"It's normal it should get off to a slow start, a lot of obstacles have to be overcome. You see the same phenomenon across the board in all countries: ARV distribution follows an exponential curve", explained Donald de Korte, an executive for the US pharmaceutical group Merck.
"I think it's reasonable to suppose that the next 500,000 will be reached by the end of 2006," he said.
For WHO, 3 by 5 had the merit of knocking on the head preconceived ideas about access to treatment, particularly in Africa.
"Experts had been saying 'if they can't do clean water how can they do ARVs?' We basically smashed that paradigm. People can no longer say let's wait until everything in the health care system is perfect and then we'll start treating people", WHO's Kim said.
In 2005, 3.2 million Africans contracted HIV/AIDS and 2.4 million died in the pandemic.
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