PARIS, Nov 29, 2006 (AFP) - Hard-won gains in the effort to get anti-HIV drugs to the world's poor face being wiped out by government inaction, experts are warning in the runup to World AIDS Day on Friday.
After a brief spell of encouraging news in the fight against AIDS, the signs today are that the peril is on the move once more and the response to it is uneven and, very often, too late, they say.
"There is new evidence the AIDS epidemic is worsening," said Stephen Lewis, UN Secretary General Kofi Annan's envoy on HIV/AIDS in Africa, declaring it "a moral imperative" that leaders and institutions urgently scale up their campaign.
The agency UNAIDS last week estimated nearly three million people will have died of AIDS this year and 4.3 million new HIV infections will have occurred.
Some 39.5 million people are now living with the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS), nearly two-thirds of them in sub-Saharan Africa.
In developing countries and former Soviet-bloc nations, 6.8 million people urgently need the antiretroviral drugs that keep HIV at bay, and the figure could reach 9.8 million by 2010, UNAIDS says.
At present, only 1.65 million are getting these life-saving treatments.
"At the current rate, the world will miss the 2010 universal access goal [made by the G8 and UN] by five million people," said Chris Collins, a member of the International Treatment Preparedness Coalition, a group of 800 treatment activists from more than 125 countries.
According to a study appearing on Monday in the open-access Public Library of Science (PLoS) Medicine, the annual death toll from AIDS could more than double by 2030, to 6.5 million. The disease, which was first detected in 1981, has already killed 25 million people.
The grim warnings are being made after three years of relative success, in which governments, led by the US, and philanthropists, led by Bill Gates, started to gear up their funds for AIDS.
The price of antiretrovirals also plunged, driven by cuts by Big Pharma and the introduction of low-cost generics.
There was political impetus too, given by the World Health Organisation (WHO), which set the target of getting drugs to three million poor, needy people by the end of 2005.
On this score, the WHO failed badly, but the initiative at least focused minds and helped build infrastructure in countries lacking trained personnel, clinics and equipment.
Laura Ciaffi, a specialist in Geneva with the aid group Medecins Sans Frontieres (MSF, Doctors Without Borders) said there were several reasons why the drug rollout in developing countries was hitting snags.
"In many countries, the drugs are not free and obviously this hampers access to treatment," she told AFP. "Nigeria and Kenya tell us that the drugs are going to be free, but this will not be the case for treatment for opportunistic infections and lab analysis."
Opportunistic infections are diseases such as fungal infections and tuberculosis, which often arise -- and can be life-threatening -- when the immune system is weakened by the AIDS virus.
Laboratory analysis is used to assess the level of virus and count immune cells in the blood, to see whether a patient is responding to treatment.
Ciaffi said she warmly welcomed the decline in antiretroviral costs, but the fall applied mainly to fixed-dose triple therapy drugs, the first line of pharmaceutical attack against HIV.
"Unfortunately, around 20 percent of patients cannot tolerate this drug combination and need a different combination which is also more expensive," she said.
Access to drugs is only one aspect in a complex, fast-moving battlefront.
HIV prevention also needs to be scaled up, especially in China and former Soviet bloc countries, grass-roots problems such as gender inequality, violence against women and stigma remain entrenched in many countries -- and the begging bowl needs to be topped up again.
Global AIDS spending stood at more than eight billion dollars in 2005, a five-fold increase over 2001. But the estimated need in developing countries for 2006 is 15 billion dollars, rising to 22 billion in 2008.
+ World AIDS Day, celebrated every December 1, carries a message of accountability this year, under the slogan "Stop AIDS -- Keep the Promise."
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