Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Reuters NewMedia - Wednesday July 30, 2003
Richard Waddington

Paulo Teixeira, who led Brazil's widely-lauded drive against the killer disease, told Reuters much more money must come from wealthy states but poor countries bearing the brunt of the epidemic would also have to play their part.

Without naming names, he said some developing states were still not taking seriously enough a disease which killed over three million last year, mostly in poor countries.

"We are facing a catastrophe and we need all actors to make additional effort. The money -- which is not enough yet -- must come from rich states, but we also need to ensure all countries are doing the best that they can," he said in an interview.

WHO chief Lee Jong-Wook on taking office earlier this month set as a top priority the challenge of getting three million AIDS sufferers in Third World countries on life-prolonging anti-retroviral drugs by the end of 2005. Around 300,000 currently have access to the drugs.

The size of the task is such that even if the campaign got into full swing next month, and it will not, it needs to get 100,000 new patients on treatment each month to hit the target.

The amount of financing currently pledged to organizations such as the Global Fund, the U.N.-approved cash-raising venture, and the World Bank, was only enough to put an additional 900,000 people on life-prolonging drugs.

"My belief is that it is absolutely feasible, despite the magnitude of the task," Teixeira said.

"To do nothing is not acceptable. People are dying, including health workers, and each year we lose will make the task more difficult in the future."

WHO's role would be a "catalyst" giving technical help to affected countries to develop programs and using its influence to mobilize international political support.

BRAZILIAN EXPERIENCE

Brazil's experience could prove important because it showed what could be done with relatively limited resources.

When the South American giant launched its program in 1983 it was among the world's worst affected countries, but two decades on, the infection rate stands at around one percent of adults compared with some 20 percent in South Africa.

Brazil's success showed that some controversies that had long dogged the battle against AIDS -- such as whether prevention or cure should be given priority -- were merely false dilemmas, Teixeira said.

The same went for the assertion that poor countries lacking efficient health systems would be incapable of handling an effective drugs program.

Brazil now has a strong network of hospitals and laboratories to support its AIDS program but it did not when it started.

"We need to act. Waiting for better times or better conditions is not an answer," Teixeira said, adding that one of the best ways to build up health systems was through implementing AIDS treatment programs.

RESISTANCE

The threat that resistance to AIDS drugs might quickly wipe out much of the benefit from an expanded treatment program should also not be used as an argument for doing nothing.

Resistance, due to the mutation of the AIDS-causing HIV virus, was a problem for all, not just the Third World, he said.

With a course of AIDS treatment still costing $250-300 a year, even for out-of-patent, cheaper, generic drugs, big multinational pharmaceutical companies needed to do more to get prices down, he said.

"They have to be open to reduce profits. We are talking about lives and this must change the paradigm of the discussion," he said.

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