Nothing changes - AIDS drug goal defeated by bureaucracy

A recent report on the failure of the United Nations "3 by 5" AIDS initiative, says that because of bureaucracy, poor management and inadequate funding, a global drive to put 3 million poor people on life-saving AIDS drugs by the end of 2005, has been defeated.

In a report the International Treatment Preparedness Coalition says that at least 4 million people still desperately need anti-retroviral (ARV) drugs.

Zackie Achmat, founder of South Africa's Treatment Action Campaign, says that in South Africa and in other countries, they have been working for more than a decade to ensure HIV treatment access, and in that time millions have died because of lack of access to drugs, and millions more will die if universal access is not achieved by 2010.

Dr Jim Yong Kim, the head of the World Health Organisation's HIV/AIDS programme has this week apologised for failing to meet the global target, he says he believes the programme has not done enough and started too late, but it has highlighted the need for expanding AIDS treatment.

According to UNAIDS, a UN body, about 40 million people are living with HIV/AIDS, and new infections are increasing at one of the fastest rates since the first reported case in 1981.

The activists' report examined delays in HIV/AIDS treatment in six countries hit hard by the global pandemic: South Africa, the Dominican Republic, India, Kenya, Nigeria and Russia.

It found that bureaucratic bottlenecks and poor political leadership were slowing provision of ARVs, and gave as an example a struggle over funds between different agencies in the Dominican Republic.

In Russia, which has one of the fastest growing HIV/AIDS epidemics in the world, the lack of any national treatment protocol has hampered the response.

Also to blame for delays in treatment, was a lack of political leadership along with lack of healthcare workers, poor funding and the stigma surrounding people infected with HIV/AIDS.

The report says that South Africa's government, trying to cope with the world's single highest HIV/AIDS caseload with more than 5 million infections, 'continues to drag its feet and fails to combat misinformation and pseudo-science'.

Also slowing South Africa's treatment programme, were practical problems and limited drug supplies.

According to the report efforts to broaden AIDS drug treatment, with a goal of universal access by 2010, were unlikely to be met without a new approach by policymakers especially in bodies such as UNAIDS, the World Health Organisation and the Global Fund to fight AIDS, Tuberculosis and Malaria.

The report says the initiative has failed to treat even 50 percent of the people in need of antiretroviral treatment, and if the organisations responsible for carrying out this programme are to accomplish an even greater goal in five years' time it will take courageous new leadership.

Chris Collins, a member of the treatment research group, says that coordination among various U.N. agencies was crucial and that UNAIDS, which is convening a meeting on treatment options in January, should lead development of a global response to the treatment issue.

"Institutional turf battles be damned, somebody has to stand up and do it, and I think UNAIDS is well placed to do it", says Collins.