The UN's attempt to get antiviral drugs to people with the AIDS virus fell far short of its goal of 3 million people by the end of last year, but it saved hundreds of thousands of lives nonetheless, the UN health agency said yesterday.
The total of treated people in low and middle-income countries has jumped to 1.3 million from the 400,000 people already on the drugs when the drive was declared two years earlier, an 84-page progress report issued by the World Health Organization (WHO) said.
Kevin De Cock, new AIDS director at the WHO, said the so-called "3 by 5 program" -- 3 million people on antiretroviral drugs by the end of last year -- helped lay the groundwork for the more ambitious goal of coming as close as possible to universal access to the medicine by 2010.
Much was learned from the difficulty of distributing the drugs in resource-poor countries and will help in the new goal -- set by the G8 last year, De Cock said.
"It is the aspiration that anybody with HIV should have access to treatment and care and prevention services should be delivered everywhere they're needed," he said. "It's a logical continuation of 3 by 5. There's no break."
De Cock, interviewed during his first day on the job on Monday, said he saw how difficult the challenge could be during his previous six years heading Kenya operations of the US Centers for Disease Control and Prevention.
In one area of Kenya the life expectancy is only 38 years, he said.
"What's been achieved is very impressive," De Cock said. "Obviously it is regrettable that the target of 3 million wasn't reached, and that does mean people have died and continue to die of what is a treatable disease."
Some 3 million people die of AIDS each year, he said. The WHO believes that the program averted between 250,000 and 350,000 deaths last year.
De Cock's predecessor Jim Yong Kim said last year that the development of systems and training of health workers would help the numbers of people treated to start increasing rapidly.
But De Cock said it was difficult to predict whether the world would be able to continue or improve on its current pace of adding 50,000 patients a month.
"It's very difficult to estimate the future," De Cock said. "The easy-to-treat populations are accessed quickly and first and it can actually get more difficult rather than more easy. But we hope that progress will continue at least at the current rate."
The report said that the world spent US$8.3 billion on AIDS last year, up from US$4.7 billion in 2003. Much of the funds came from the US government, the World Bank and the Global Fund to Fight AIDS, TB and Malaria.
Treatment in southern Africa, a focus of the program, has already risen sharply.
"Some countries have done extremely well, like Botswana. They've met their 3 by 5 target," De Cock said. "South Africa has actually scaled up pretty substantially. But they've all got to do better."
Nigeria is a large country that is starting to tackle the problem, he said.
It is easy to look only at Africa, but other regions are also of concern, De Cock said.
"There are some large countries such as India with a large number of infected people and treatment access is still very low," he said.
He said a general goal is to expand testing because most people who have AIDS don't know it.
Testing for children in particular needs to be more widespread so that infected youngsters can be identified quickly and started on treatment, he said. Health workers have to act quickly because about half of AIDS-infected children die before the age of two.
Prevention also must be restressed, De Cock said.
"With the emphasis on treatment, we have paid less attention to prevention," he said.
Even as the WHO was releasing its report, scientists in the US said they think they soon may have a pill that people could take to keep from getting the AIDS virus rather than just controlling the effects as antiretrovirals do.
Two drugs have shown such promise at preventing it in monkeys that officials said they would expand early tests in humans.
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