AIDS efforts are stagnating: accountability is key

AIDS efforts are stagnating: accountability is key

Newsdesk HIV/AIDS efforts are stagnating: accountability is key For more information on UNAIDS data see http://www. 2006Globa...

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HIV/AIDS efforts are stagnating: accountability is key

For more information on UNAIDS data see http://www. 2006GlobalReport/default.asp For more information on the ITPC Missing the Target 3 report see http://www.

Alon Skuy/AP/Empics

For more information on the Millennium Development Goals see PLoS Med 2006; 3: e455; doi:10.1371/journal. pmed.0030455

25 years after the first cases of AIDS, the global HIV/AIDS epidemic continues to grow, and internationally, efforts to prevent infections and provide universal access to treatment are failing in many areas. However, this view, voiced on World AIDS Day, Dec 1, 2006, is countered by the fact that prevention programmes are getting better results when focused on those most at risk and adapted to changing national epidemics. In the most comprehensive report ever on HIV/AIDS, UNAIDS states that despite an annual expenditure of over $8 billion, prevention programmes still reach a minority of those who need them, only about one in five people who need antiretrovirals are receiving them, and mother-to-child transmission has reduced by only 10% between 2001 and 2005. An estimated 39·5 million people are now living

Children form a symbolic ribbon on World AIDS Day in Johannesburg, South Africa

with HIV. 4·3 million new infections occurred in 2006—in eastern Europe and central Asia, infection rates may have risen by more than 50% since 2004. “It is imperative that we continue to increase investment in both HIV prevention and treatment services to reduce unnecessary deaths and illness from this disease”, said WHO acting director-general, Anders Nordström. The International Treatment Preparedness Coalition (ITPC) has released an analysis of six heavily affected countries. Missing the Target 3 suggests that without immediate action, efforts towards universal treatment access will fall 5 million people short by 2010. “We need to be building sustainable health systems that can deliver both HIV treatment and HIV prevention, as well as tuberculosis and other services”, said coauthor Fatima Hassan (AIDS Law Project, South Africa). Gregg Gonzales, report coordinator, emphasised that “prevention will fail without the build up of health care and service infrastructure that treatment will provide. In communities on the ground, treatment and prevention go hand in hand, they’re inextricably tied together”. In particular, available treatment is a key reason why individuals might come forward for HIV testing. HIV/AIDS will make it difficult, if not impossible, for many countries

to reach the 2015 Millennium Development Goals, reported Robert Hecht and colleagues (International AIDS Vaccine Initiative and EASE International). According to UNAIDS, “some countries have made great strides in expanding access to treatment, but have made little progress in bringing HIV prevention programmes to scale, whereas other countries that are now experiencing a reduction in national HIV prevalence are making only slow progress to ensure that treatment is available to those who need it”. In particular, the effects of the epidemic on women and children “need continued and increased attention”, said Peter Piot, UNAIDS director. The issue now is accountability: “If we are to reach the targets that countries have set for themselves then, now more than ever, we need to make the money work”. UN secretary-general Kofi Annan declared: “Accountability—the theme of this World AIDS Day—requires every president and prime minister, every parliamentarian and politician, to decide and declare that ‘AIDS stops with me’. It requires them to strengthen protection for all vulnerable groups”, but he added, accountability “requires every one of us to help bring AIDS out of the shadows, and spread the message that silence is death”.

Kelly Morris

Drugs prices still on rise 5 years after Doha International groups campaigning for access to medicines have complained that the 2001 Doha Declaration has failed to protect public health and reduce prices of medicines as promised. “5 years after the Doha Declaration, drug prices are on the rise again. If developed countries do not grant compulsory licences for production 10

and export, we are going to be back to where we started from in no time and all progress to date will be lost”, Ellen ‘t Hoen, of charity Médecins Sans Frontières, explained. The Doha Declaration on the TRIPS Agreement and Public Health, adopted by a ministerial conference in Doha, Qatar, on Nov 14, 2001, says

that poor countries must be able to use public-health safeguards included in the World Trade Oragnization’s intellectual property rules called Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS). The Declaration also ensures that governments may issue compulsory licences on patents for medicines, Vol 7 January 2007