quarta-feira, março 29, 2006
10 by 10
Washington, March 28 -- Today WHO released a major new report on the progress to date on AIDS treatment in developing countries.
Response by Dr. Paul Zeitz, Executive Director, Global AIDS Alliance:
This report shows that setting an ambitious goal can catalyze bold action. 3x5 is not a failure. Without the challenge of 3x5 we would never have been able to get this far. The pace is clearly picking up, and we are laying the groundwork for even faster progress.
The impressive expansion of treatment sites, even in very poor countries like Malawi, shows that significant progress is possible, even in difficult settings. This is the kind of build-up in health care systems that will make possible major strides in the expansion of treatment by 2010.
Now the world needs to focus on a clear, numerical goal once again, which is clearly linked to people's lives. This goal should be 10 million people on treatment by 2010, or '10 by 10.' We need a clear goal to keep the pace up and maintain momentum. This report shows it is feasible and that, with enough resources, we can quickly expand health delivery systems and reach this goal.
The report is right to back innovative financing, including the International Finance Facility and the Airline Solidarity Contribution. We need these to be implemented as soon as possible. More countries are urgently needed to take part in moving these proposals forward.
Innovative financing should support the Global Fund, since without it we cannot maintain this momentum. Yet, the Fund is facing a financial crisis and may have to postpone additional grantmaking this year. That would be major setback to progress. The report notes that, worldwide, TB is among the most common causes of morbidity and mortality among people living with HIV/AIDS. This is another reason why we must ensure the Global Fund can proceed this year with additional grantmaking.
This report also shows that much more needs to be done to meet the needs of children living with HIV/AIDS. The world is failing children. An estimated 660,000 children younger than 15 years needed treatment in 2005, representing slightly more than 10% of the total number of people in need. Yet the report states that children comprise only about 7% of all people receiving treatment in sub-Saharan Africa and about 4% in Asia, and in Latin America and the Caribbean the median value of nine countries is 8%.
Several countries in Africa, including a number that are PEPFAR focus countries, such as Nigeria, are providing treatment to as few as 3% of the children who need it. Vietnam, another PEPFAR focus country, is providing treatment to only 4% of the children who need it. PEPFAR has clearly failed to focus adequately on quickly meeting the needs of children.
The report states there is no evidence of a systemic gender bias in access to treatment, and that is good news. However, it is very troubling that in a few cases the WHO report shows far fewer women are gaining accessing treatment than what would be expected given the extent of need. In Ethiopia, for instance, just over 30% of the adults on treatment are women, while the expected percent based on need would be closer to 55%.
The report also documents a far too slow increase in access to PMTCT. The report states fewer than 10 percent of HIV-positive women in developing countries got antiretroviral therapy during pregnancy and childbirth between 2003 and 2005, despite a tripling of overall access to the drugs in that period.