Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
Los Angeles Times - June 3, 2008
Thomas H. Maugh II, thomas.maugh@latimes.com
About 1 million people received the life-saving drugs for the first time during 2007, according to the report from UNAIDS, the World Health Organization and UNICEF.
During the same period, however, an additional 2.5 million people were infected with HIV, the virus that causes AIDS, indicating that health agencies are not gaining ground on the deadly infections.
"We have to do better with prevention," said Dr. Kevin De Cock, director of the WHO's HIV/AIDS department.
The new numbers mark the attainment of the goal set in the widely publicized "3 by 5" program, which sought to have 3 million people receiving treatment by 2005.
That target was "excessively aspirational," De Cock said Monday in a telephone news conference.
"Reaching that target even two years late is quite a remarkable achievement," he said, adding that when the goal was set in 2003, fewer than half a million people were getting treatment.
Despite the improvements, an estimated 6.7 million additional people still need treatment. An additional 23 million are infected with HIV and will eventually need treatment, according to the latest WHO figures.
The agencies combined are now spending between $8 billion and $10 billion a year on AIDS programs, with about 55% of it going toward treatment, according to Elhadj As-Sy, director of the partnerships and external relations department of UNAIDS.
To achieve universal treatment, funding would have to grow to $35 billion in 2010 and $40 billion by 2015, according to the agencies.
One reason the number of people in treatment has increased is a decline in the price of AIDS drugs. Between 2004 and 2007, the cost of first-line treatments in the low- and middle-income countries fell by 30% to 64%, depending on the drug. But experts said similar price drops have not occurred among the second-line drugs that are used when the first treatments begin to fail. The nations referred to in the report are primarily in Africa and Southeast Asia.
The agencies also have made substantial progress in preventing pregnant women from transmitting HIV to their babies, according to Patricia Doughty, a program manager for the United Nations Children's Fund, UNICEF.
During 2007, 37% of the estimated 1.5 million pregnant women in the developing countries received AIDS drugs to prevent transmission of the virus during delivery, up from only 10% in 2004.
"Many of the countries with the highest number of infected pregnant women are making excellent progress," she said.
In Swaziland, for example, the number of pregnant women receiving treatment increased to 57% last year from 5% in 2004, while in Mozambique the number grew to 46% from 3%. Nonetheless, in 2007, nearly 400,000 children were newly infected.
In addition, the women are not faring well. After they give birth, fewer than 10% continue to receive treatment for their infections and many die of AIDS, Doughty said.
One of the chief impediments to further improvements in AIDS care is the lack of healthcare infrastructure in the most affected countries and the shortage of personnel to distribute medications and other interventions.
One of the most promising prevention methods, according to the report, is widespread male circumcision, which has been shown to reduce the number of new infections by as much as 60%, De Cock said. Experts speculate that widespread use of the procedure in Africa could prevent 2 million new infections and 300,000 deaths over the next decade.
But, De Cock said, the healthcare infrastructure is now stretched too thinly to provide circumcisions.
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