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Summary: Bureaucracy, poor management and inadequate funding have scuppered a global drive to put 3 million poor people on life-saving AIDS drugs by the end of 2005, activists said on Monday.
[JOHANNESBURG, 28 November 2005] - Bureaucracy, poor management and inadequate funding have scuppered a global drive to put 3 million poor people on life-saving AIDS drugs by the end of 2005, activists said on Monday. At least 4 million people still desperately need anti-retroviral (ARV) drugs, the International Treatment Preparedness Coalition said in a report on the failure of the United Nation's "3 by 5" AIDS initiative. "In South Africa and in countless other countries, we have been working for more than a decade to ensure HIV treatment access," Zackie Achmat, founder of South Africa's Treatment Action Campaign, said in a statement. "In that time millions have died because of lack of access to drugs, and millions more will die if we do not achieve universal access by 2010." The head of the World Health Organization's HIV/AIDS programme on Monday apologized for its failure to meet the global target, but said he believed the programme had highlighted the need for expanding AIDS treatment. "All we can do is apologize," Dr Jim Yong Kim said in an interview with the BBC. "I think we have to just admit we've not done enough and we started way too late." The UN AIDS body UNAIDS said last week that about 40 million people are living with HIV/AIDS, with new infections 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 said bureaucratic bottlenecks and poor political leadership were key factors in slowing provision of ARVs, citing as an example a struggle over funds between different agencies in the Dominican Republic. Lack of a national treatment protocol in Russia, which has one of the fastest growing HIV/AIDS epidemics in the world, hampered the response there, it said. A lack of healthcare workers, inadequate funding and the pervasive stigma surrounding people infected with HIV/AIDS were also blamed for delays in treatment. The vast distances that HIV/AIDS patients must travel to obtain drug treatment in countries such as India were another factor, activists said. South Africa's government, coping with the world's single highest HIV/AIDS caseload with about 5 million infections, "continues to drag its feet and fails to combat misinformation and pseudo-science," the report said. Practical problems and limited drug supplies were also slowing South Africa's treatment programme, it added. The report said efforts to further broaden AIDS drug treatment, with a goal of universal access by 2010, were unlikely to be met without a new approach by policymakers. "The 3 by 5 initiative failed to treat even 50 per cent of the people in need of antiretroviral treatment. 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," the report said. The activists' report said AIDS treatment could be speeded up if various U.N. agencies increased collaboration and national governments "honestly assessed" problems with drug delivery. It added that the fear surrounding AIDS was still the major factor preventing people from obtaining help. "Every level - from individuals to village leaders to national legislators and international policymakers - must work systematically to end stigma," it said.