Missing the Target #5: Improving AIDS Drug Access ... - CD8 T cells

Executive SummaryAt the G8 meeting in Gleneagles in 2005 and again at the United NationsUNGASS session in 2006, world leaders promised to come as close as possible toproviding universal access to AIDS treatment and prevention by 2010. Estimates ofHIV incidence and prevalence will change, but by any account, today several millionpeople in desperate need of AIDS treatment do not have access to it. And at thecurrent pace of growth in treatment delivery, several million will not have access bythe end of 2010. Broken promises will mean millions of deaths.Scale up of AIDS treatment is driving unprecedented expansion of health deliveryand, in the process, identifying critical challenges to health systems as well aspractical solutions to address them. This report identifies many ways in whichgovernments and global agencies must act to correct systems essential to deliveryof health. In the area of antiretroviral drug access—a special focus of this report—our research found that in many countries drug registration, procurement, andsupply management systems are inadequate, drug stock-outs are common, andmost people are not being treated with ARV regimens that are consistent withrecent WHO recommendations for improved first-line and standardized second-linetreatment combinations.On-the-ground research by civil society advocates from 17 countries also revealsthe close interconnection of AIDS services with other health and social supports.The lessons for successful AIDS treatment are true for all health services:appropriate delivery includes adequate nutrition, clean water, trained healthworkers, accessible health clinics, integration of prevention and treatment, andfree provision of drugs, diagnostic and monitoring tests, and other commodities.Mobilization around AIDS has raised new resources, built consumer-engagementin providing health care, marshaled enduring public support, and promoted thedevelopment of results-oriented approaches to global health. Building on thesefoundations should be a central strategy in developing comprehensive systems ofhealth care. In Haiti and Rwanda, for example, providers are demonstrating howto deliver AIDS treatment as part of a comprehensive program that includes HIVprevention and a wide range of health services. 1 2 3We cannot allow responses to AIDS and other chronic health issues to becomebogged down in simplistic dichotomies: prevention vs. treatment; horizontal vs.vertical programming; disease-specific funding vs. strong health systems. There isonly one appropriate approach: We must do everything, better, for more people,and in an increasingly coherent way.1 Global Fund to Fight AIDS, Tuberculosis and Malaria. Partners in Impact: Results Report. 2007: 36.http://80.80.227.97/en/files/about/replenishment/oslo/Progress%20Report.pdf2 Farmer, P, From “Marvelous Momentum” to Health Care for All, January 23, 2007,www.foreignaffairs.org/special/global_health/farmer3 Partners in Health. Rwanda scales up PIH model as national rural health system. October 2007.www.pih.org/inforesources/news/Rwanda_Scale-up.html1