World Health Organisation Admits Targets on AIDS Drugs May be Unrealistic

In its World Health report 2004, the World Health Organisation (WHO) said that AIDS was the leading single cause of death among adults aged 15-59 around the world and that in 2003, three million people died of AIDS related diseases and five million became infected with HIV.

WHO said funds were sufficient to cover the $5.5 billion needed to achieve its stated goal of getting antiretroviral drugs to three million people with HIV in poor countries by the end of 2005 (the three by five target) but admitted it still had a long way to go. By the end of 2004 WHO will have achieved only 25% of the 'three by five' target. "The stakes are high: rapid expansion of antiretroviral treatment is a large, complex and difficult undertaking" said WHO's director general, Dr Lee Jong-wook, in an introduction to the report which calls for an unprecedented level of international coordination. "It certainly cannot be done by one agency working on its own. Partnerships are indispensable for a task of this magnitude" said Dr Lee, who is staking his reputation on achieving what he admitted may be an unrealistic goal.

Since antiretroviral treatment was introduced in Europe and North America in the 1990s, death rates from AIDS related diseases have dropped by 80%. In contrast AIDS death rates elsewhere and particularly in southern Africa have shot up. In South Africa and Botswana, the AIDS epidemic has nearly halved life expectancy over the past decade from about 60 years to 35 years. One in 12 Africans have HIV infection and as many as nine out of 10 people do not know they are infected.

The report states that expanding antiretroviral treatment would cost $35 to $40 per capita. Once that was done, more people would volunteer to test for HIV.

The trends in HIV prevalence among pregnant women attending the same antenatal clinics since 1997 show that the epidemics in the countries of southern Africa are much larger than elsewhere in sub-Saharan Africa and that the gaps seem to be widening. In eastern Africa there is evidence of a modest decline. "In western Africa prevalence is now roughly one-fifth of that in southern Africa and no rapid growth is occurring. These striking differences are supported by data from population based surveys and research studies" the report says.

For further information see; Fleck. F (2004): WHO admits its target on AIDS drugs may be unrealistic. BMJ volume 328, 15th May, News, pp 1151

¹The report can be accessed at www.who.int/whr2004