UNAIDS: The First 10 Years

UNAIDS The First 10 Years224Increasing numbers ofchildren are infected withHIV and yet medicationis not specifi callyformulated for children.This Honduran girlcomplains about having totake too much.Christian Aid/Annabel DavisThus at the end of 2005, when the actual numbers were published – 1.3 million – the generalview was fairly positive. Worldwide, it was estimated that between 250 000 and 350 000deaths had been averted as a result of increased treatment access 21 .WHO and the UNAIDS Secretariat had always considered the “3 by 5” initiative to be anemergency response, an interim milestone on the road to access to prevention, care andtreatment for everyone who needs them.On the whole, the results of the initiative received positive reviews – and praise, rather thancriticism, from activists. An article in The Economist 22 commented: ‘… the initiative may havebeen more successful than the headline figure suggests, since part of the money has gone oninfrastructure. That means building clinics and testing laboratories, but also training doctors(surprisingly many of whom, more than two decades after AIDS was identified, have still notbeen taught how to deal with it) and reorganizing hospital administrations. This sort of workhas spin-offs beyond the treatment of AIDS’.During the two years of the initiative there had been many achievements – not just theincrease in numbers on treatment. Governments, donors and technical agencies had givenhigher priority to strengthening health systems, and “3 by 5” had also challenged the beliefthat antiretroviral therapy could not be provided where only basic health systems existed.Through a new curriculum developed by WHO and its partners – the Integrated Managementof Adult and Adolescent Illness – health and community workers were trained in care that canbe applied to all chronic conditions including HIV. Through such ‘task-shifting’, clinical teamshad been expanded to include trained people living with HIV as counsellors and supportersof people on treatment.21Ibid.22The Economist, 1 April 2007.