Campaign to deliver AIDS drugs to 3 million will miss end of year targ
http://www.100md.com
《英国医生杂志》
The ambitious goal of providing antiretroviral treatment to three million people living with HIV/AIDS in low and middle income countries by the end of 2005 is not likely to be met, an interim report says. The report, published this week by the World Health Organization and UNAIDS, estimates that a million people currently are receiving the treatment. This is an increase from 400 000 when the initiative began in December 2003 but short of the milestone of 1.6 million.
Estimates are that 6.5 million people worldwide would benefit from getting anti-HIV treatment. "We are going to get to three million, though it will take a little longer than we had wanted," said Jim Yong Kim, director of the WHO Department of HIV/AIDS, said in an interview.
He recalled that, when the programme began, there was still debate on whether or not to treat HIV in developing countries. "We have contributed to fundamentally changing that paradigm; it is now a question of how to get the job done. This will be seen as one of the most extraordinary public health achievements in history."
Latin America and the Caribbean have 62% of the estimated 465 000 people who would benefit already receiving treatment; followed by East, South, and South East Asia (14% of 1.1 million); Europe and Central Asia (13% of 160 000); sub-Saharan Africa (11% of 4.7m); and North Africa and the Middle East (5% of 75 000).
The heaviest burden of disease is in sub-Saharan Africa and that is where the scale-up has been most rapid and encouraging. The report notes that a half million people in the region are now receiving treatment, a threefold increase in the past 12 months, and the pace seems to be accelerating.
Although one impediment to delivering cheap drugs was recently resolved, another has now emerged. The US government had said that its funds could only be used to purchase drugs that were approved by the Food and Drug Administration, which seemed, at first, as though it was going to exclude many generic antiviral drugs. But the agency recently gave its approval to generic HIV products by two Indian manufacturers.
However, Aspen Pharmacare, the South African company that was first to receive the FDA抯 imprimatur for generic HIV drugs, has been told by the governments of Nigeria, Uganda, Ethiopia, and Tanzania that FDA approval is not sufficient. They have told Aspen that its products must be certified by WHO before they can be used in their countries.
Dr Kim said that they are in discussions with the FDA and hope to resolve issues of certification "in a matter of weeks." Sustainable funding remains an ongoing concern. Donors have committed $27bn (?5bn; �22bn) toward the initiative over the next three years. Some of those pledges have yet to be delivered, however, and even if they were, the total would fall short of meeting the projected need by at least $18bn.(Washington Bob Roehr)
Estimates are that 6.5 million people worldwide would benefit from getting anti-HIV treatment. "We are going to get to three million, though it will take a little longer than we had wanted," said Jim Yong Kim, director of the WHO Department of HIV/AIDS, said in an interview.
He recalled that, when the programme began, there was still debate on whether or not to treat HIV in developing countries. "We have contributed to fundamentally changing that paradigm; it is now a question of how to get the job done. This will be seen as one of the most extraordinary public health achievements in history."
Latin America and the Caribbean have 62% of the estimated 465 000 people who would benefit already receiving treatment; followed by East, South, and South East Asia (14% of 1.1 million); Europe and Central Asia (13% of 160 000); sub-Saharan Africa (11% of 4.7m); and North Africa and the Middle East (5% of 75 000).
The heaviest burden of disease is in sub-Saharan Africa and that is where the scale-up has been most rapid and encouraging. The report notes that a half million people in the region are now receiving treatment, a threefold increase in the past 12 months, and the pace seems to be accelerating.
Although one impediment to delivering cheap drugs was recently resolved, another has now emerged. The US government had said that its funds could only be used to purchase drugs that were approved by the Food and Drug Administration, which seemed, at first, as though it was going to exclude many generic antiviral drugs. But the agency recently gave its approval to generic HIV products by two Indian manufacturers.
However, Aspen Pharmacare, the South African company that was first to receive the FDA抯 imprimatur for generic HIV drugs, has been told by the governments of Nigeria, Uganda, Ethiopia, and Tanzania that FDA approval is not sufficient. They have told Aspen that its products must be certified by WHO before they can be used in their countries.
Dr Kim said that they are in discussions with the FDA and hope to resolve issues of certification "in a matter of weeks." Sustainable funding remains an ongoing concern. Donors have committed $27bn (?5bn; �22bn) toward the initiative over the next three years. Some of those pledges have yet to be delivered, however, and even if they were, the total would fall short of meeting the projected need by at least $18bn.(Washington Bob Roehr)