Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Bangkok Post - December 2, 2003
Anjira Assavanonda
The number, referred to as the "3 by 5" target, is half of the total number of people in immediate need of treatment.
The 3 by 5 framework, which is a key element in HIV/Aids prevention and treatment, requires a broad alliance of the nations, institutions and committed people, including HIV-infected persons. Training of health workers and strong community support are urgently needed for the delivery and monitoring of anti-retroviral treatment.
To realise this the two agencies will focus their attention on five critical areas: simplified, standardised tools to deliver anti-retroviral therapy; new services to ensure an effective, reliable supply of medicine and diagnostics; rapid identification, dissemination and application of new knowledge and successful strategies; urgent, sustained support for countries; and global leadership, strong partnership and advocacy.
UNAIDs announced last week that 40 million people around the world are infected with HIV. This year alone, five million people became infected worldwide and three million died. WHO, meanwhile, estimates that six million people are in immediate need of HIV treatment.
Dr Bjorn Melgaard, WHO representative in Thailand, said countries in Southeast Asia are embarking on providing care and treatment for HIV-infected people. Thailand and Indonesia, for example, have started scaling up anti-retroviral treatment while India and Burma are preparing to start.
Evidence shows that increasing the anti-retroviral treatment can lead to more people knowing their HIV status and more openness about Aids. Good treatments will also make more people come forward for testing HIV status, while those on effective treatments are likely to be less infectious and less able to spread the virus.
Thailand, meanwhile, has shown strong support for the strategy. Dr Petchsri Sirinirund, senior expert in preventive medicine from the Disease Control Department, said the government has also decided to fully invest in comprehensive treatment and care for HIV-infected people. One important programme is to provide anti-retroviral drugs to all needy patients, with the target of 50,000 people in fiscal 2004.
The programme will cost 1.62 billion baht, with 904 million baht contributed by the Thai government and the rest by the Global Fund to Fight Against Aids, TB and malaria.
Dr Petchsri said the number of HIV cases recruited into the programme has gradually increased from 2,500 in November last year to more than 15,000 in November 2003.
Doctors, nurses and health professionals in public hospitals had been trained in the system so they could deliver the service appropriately.
Family members were welcome to participate in the programme, at the hospital and in the community.
She said the anti-retroviral treatment requires that both the patients and the service providers participate and learn together.
"Using anti-retroviral drugs is a bit complicated in regard to the appropriate dose for each patient and side effects of the drugs, so patients and health workers need to work closely together," she said.
But despite the effectiveness of anti-retroviral treatment, the best way to control HIV/Aids was still through prevention and education.
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