Report on AIDS Treatment Access Released Today

Missing the Target A Report on HIV/AIDS Treatment Access from the
Frontlines. The report is available for download at
http://www.aidstreatmentaccess.org/

3 by 5 AIDS Treatment Target Missed Because of Bureaucracy, Stigma,
Poor Management, Inadequate Funding, Report Finds

Frontline Advocacy Group Says 2010 Treatment Goals Will
Not Be Met without Critical Changes

New York and Nairobi, 28 November 2005. The international Treatment
Preparedness Coalition (ITPC), a group of 600 treatment activists
from more than 100 countries, today released a report, Missing the
Target â€" A Report on HIV/AIDS Treatment Access from the
Frontlines, that looks at the status of anti-retroviral treatment
provision in low income countries around the world.

Researched and written by treatment advocates on the frontlines in
six of the countries hardest hit by AIDS â€" Dominican Republic,
India, Kenya, Nigeria, Russia, and South Africa â€" the report
identifies barriers to AIDS treatment and offers concrete
recommendations to overcome them. Among the roadblocks:

• Inadequate leadership at the national level in several countries
• A global system that does not collaborate speedily and efficiently
to address bottlenecks
• A severe shortage of health care workers
• Lack of necessary funding
• Bureaucratic delays that prevent resources from reaching treatment
programs
• Pervasive stigma against people living with HIV/AIDS.

In South Africa and countless other countries, we have been working
for more than a decade to ensure HIV treatment access for people
living with HIV/AIDS. In that time millions of people have died
because of lack of access to drugs, and millions more will die if we
do not achieve universal access by 2010. It is clear that the
status quo will not get us there. ITPC’s report calls for
courageous new leadership from all parties at every level to
confront this monumental task,” said Zackie Achmat, the
Chairperson of the Treatment Action Campaign in South Africa.

The World Health Organization’s (WHO) “3 by 5” target of
treating three million people by the end of 2005 was catalytic,
mobilizing global and national institutions to scale up lifesaving
treatment for AIDS. The world has missed the "3 by 5" target in
part because of these roadblocks, and at least four million men,
women and children around the world are still in desperate need of
treatment. The G8 countries have committed to coming as close as
possible to universal treatment access by 2010, but the world will
not come anywhere near this goal unless changes are made at the
national and global level.

The report found:

• In the Dominican Republic bureaucratic delays and power struggles
between agencies delayed implementation of a Global Fund grant for
months. Many of those initial problems have now been overcome, but
delivery of ARVs is still hampered by lack of political leadership;
stigma and discrimination; supply problems with ARVs, treatments for
opportunistic infections, and CD4 tests; and continued lack of
coordination between programs.

• In India many people seeking care are forced to travel long
distances, and shortfalls in funding and human resources threaten
efforts to expand the response.

• In Kenya there is widespread stigma and discrimination against
women and people living with HIV/AIDS, misinformation, lack of
treatment literacy, and insufficient resources to meet basic
nutrition needs or afford travel to health clinics for care.

• In Nigeria lack of adequate funding and human resources complicate
treatment expansion, and the high costs of CD4 and viral load tests
put these diagnostic tools out of reach of most people in
treatment. Stigma and a lack of treatment literacy programs both
undermine scale up efforts.

• In Russia treatment is hampered by a faulty drug procurement
system, lack of collaboration among providers, absence of a national
treatment protocol, a Global Fund Country Coordinating Mechanism
(CCM) that is widely described as ineffective, and lack of
leadership from government agencies. Further, widespread
discrimination against intravenous drug users inhibits scale up at
an even more fundamental level.

• In South Africa the government continues to drag its feet and
fails to combat misinformation and pseudo-science. Multilateral
agencies have been largely invisible and the CCM is widely
criticized. Many practical problems inhibit scale up as well,
including a severe shortfall of health providers, limited access to
HIV testing, and inadequate availability of drugs.

Will we look back in another five years and see that a continuation
of the same broken systems has led to even more catastrophic
failures of providing treatment, or will we see that a revolution in
global public health has occurred â€" that millions of lives have
been saved and that a new paradigm for global healthcare has been
developed?” said Gregg Gonsalves, Director of Treatment and
Prevention Advocacy at Gay Men's Health Crisis and a member of ITPC.

Russia has the fastest growing AIDS epidemic in the world, and, like
all of the countries surveyed in this report, scale up of treatment
is woefully inadequate to meet current needs. It is our hope that
both the national leaders in Russia and the international agencies
charged with assisting countries with scale up of treatment
provision will take the recommendations in this report seriously and
will pledge to work with ITPC and others to ensure that those who
need treatment receive it,” said Shona Schonning of the Russian
Community of People Living with HIV/AIDS, who headed the country’s
research team.

In every country there are stories of individuals exhibiting
dedication and courage, and of institutions often struggling to be
effective and throw off bureaucratic obstacles that stand in the way
of providing treatment to those who need it. The on-the-ground
experience documented by ITPC's country research teams offers
valuable insights for every organization working to provide
treatment access, and the report includes overarching
recommendations for national and international programs, as well as
detailed recommendations for each country, including:

• UN agencies should work more collaboratively and play a more
active role in identifying national problems and marshalling their
strengths to address these challenges.

• National governments need to honestly assess the problems with
treatment delivery and develop local strategies for resolving them.

• Every level â€" from individuals to village leaders to national
legislators and international policymakers must work systematically
to end stigma.

This report goes beyond the numbers. We took a critical look at the
major barriers to treatment scale up in each country and what must
be done nationally and internationally to overcome them, said Chris
Collins, a member of ITPC.

Missing the Target marks the first time that treatment activists
have come together from every affected continent to publicly address
national and international barriers to universal treatment access.
ITPC's 600 activists without borders have pledged to work
together and with governments, international agencies, NGOs, the
pharmaceutical industry, and others to find solutions to the
problems of lack of treatment access.

We know that AIDS treatment can be delivered speedily and affordably
and that millions are in desperate need of this lifesaving therapy.
Will national governments and the international community rise to
the challenge? The fate of millions of people living with HIV/AIDS
around the world hangs in the answer to that question, said Fatima
Hassan of the AIDS Law Project, who headed the South African
research team.
# # #

About the International Treatment Preparedness Coalition

The International Treatment Preparedness Coalition (ITPC) was born
at the International Treatment Preparedness Summit that took place
in Cape Town, South Africa in March 2003. That meeting brought
together for the first time community-based treatment activists and
educators from over 60 countries. Since the Summit, ITPC has grown
to include over 600 activists from around the world and has emerged
as a leading civil society coalition on treatment preparedness and
access issues.

The report is available online at www.aidstreatmentaccess.org

Additional contacts:


Dominican Republic:
Eugene Schiff
809 274 6252
809 858 1337
1-876-532-754
Eugene.schiff@...

India:
K. K. Abraham
+91 4424329580/1
+91 9840066386
inpplus@...
inpplus@...

Joe Thomas
+61 889 423286
+61 407 345 061
joe_thomas123@...

Kenya:
Elizabeth Owiti
+254 722 430035
lizawiti2002@...

Nigeria:
Olayide Akanni
+234 96721744
+234-802-303-7998 mobile

olayide@...

Russia:
Shona Schonning
+70 959747723
+7 095 577 8664 mobile
s_schonning@...