Access to good quality antiretroviral treatment has transformed the prognosis for people with AIDS in the developed world. Although it is feasible and desirable to deliver antiretroviral drugs in resource poor settings, few of the 95% of people with HIV and AIDS who live in developing countries receive them. The World Health Organization has launched a programme to deliver antiretroviral drugs to three million people with AIDS in the developing world by 2005, the "3 by 5" initiative. This article identifies some of the challenges faced by the initiative, focusing on delivery of care.
Equity and HIV/AIDS
Barriers to better care for people with AIDS in developing countries
Book to mobilise politicians to fight HIV/AIDS in Lesotho
In an effort to mobilise leaders to fight HIV/AIDS, the parliament of Lesotho and the UN Children's Fund (UNICEF) have launched a publication called "What Parliamentarians can do about HIV/AIDS Action for Children and Young People". The publication provides parliamentarians with guidelines for responding to the challenge of protecting children and young people through laws, policies, advocacy, education and providing these vulnerable groups with tools to empower them.
Child AIDS research 'critical' for regional development in Southern Africa
The South African social services and population development minister, Zola Skweyiya, has said research into the effect of HIV/AIDS on children is critical for the region's future development. Skweyiya told his southern African counterparts at a recent meeting in Cape Town that the virus was devastating communities and families, and aggravating poverty by killing society's most productive members. According to the South African Press association, he urged that the pandemic be tackled "more vigorously, in an integrated manner".
Equity and access to HIV/AIDS treatment: getting the balance right in southern Africa
All people with HIV/AIDS should have equal opportunity to access effective and appropriate treatment. However, in the context of existing social and health inequities, widespread poverty, high rates of new HIV infections, famine and budgetary constraints, increasing access to HIV care and treatment must be organised in a manner that balances HIV prevention and treatment efforts; HIV interventions and the broader strengthening of the health system as a whole; and HIV care and treatment with other public health and social needs.
Fighting HIV/AIDS in Namibia
A giant bright yellow condom was the centre of attraction in Namibia's capital, Windhoek, in November. Namibian civil society organisations - united in the fight against HIV/AIDS - had kicked off a series of activities in the run-up to World AIDS Day on 1 December. "By December 2003 over 100,000 HIV/AIDS cases were [officially] reported in Namibia," deputy health minister Dr Richard Kamwi told the crowd assembled around the condom. "Although these figures are extreme, it should be noted that it is only the tip of the iceberg."
Monitoring the response to antiretroviral therapy in resource-poor settings
The Malawi model
With assistance from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), Malawi is scaling-up the delivery of antiretroviral (ARV) therapy to HIV-positive eligible patients. The country has developed National ARV Treatment Guidelines, which emphasize a structured and standardized approach for all aspects of ARV delivery, including monitoring and evaluation. This paper describes the standardized ARV treatment regimens and the treatment outcomes to assess the impact of treatment, the registration and monitoring systems and how the cohort analyses are carried out.
World Aids Day: The clock is still ticking
AIDS. It killed roughly 3 million people last year, most of them poor, and most of them in Africa. Between 34 and 42 million people are living with HIV. Absent antiretroviral therapies, AIDS will have killed the vast majority of them by 2015. In such a world, time can seem a luxury, and the rigours of critical enquiry an indulgence. We need things done now, yesterday, last year. Indeed, an overdue sense of urgency has taken hold in the past five years - much of it thanks to relentless AIDS advocacy efforts. Along with sets of received wisdoms, a more or less standardized framework for understanding the epidemic and its effects has evolved, and a lexicon for expressing this knowledge has been established. All this has helped put and keep AIDS in the spotlight. It has popularized knowledge of the epidemic, countered the earlier sense of paralysis or denial, helped marshal billions of dollars in funding and goad dozens of foot-dragging countries into action. It has worked wonders. But alongside these achievements are some troubling trends.
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Aids policy in Lesotho
By the end of 2001, the number of HIV/AIDS infected adults stood at 180,000, while children orphaned by the death of their AIDS-infected parents numbered around 73,000. With a total population of just under two million, the situation in Lesotho is clearly severe. Added to this pandemic is a poorly performing economy, unable to generate the necessary finances to implement a comprehensive strategy to tackle this disease. This paper looks at Lesotho's policy response to the HIV/AIDS pandemic, and looks at the capacity the country has for meeting the challenges posed by the disease.
Botswana AIDS drug roll out bearing fruit
Health experts have attributed fewer AIDS-related deaths in Botswana to the government's steadily progressing rollout of anti-AIDS drugs. In a new report Botswana's health ministry and the World Health Organisation said the overall mortality of patients on treatment was less than 10 percent.
South African AIDS group continues legal battle with government
South African AIDS NGO, Treatment Action Campaign (TAC), has dismissed claims that its dropped legal action against the health department. The department said that TAC had decided to withdraw its action for the provision of certain annexes to the government's Comprehensive Plan for Management, Care and Treatment of HIV/AIDS. TAC spokesman Mark Heywood said on Monday the group's action remained as the health department was legally bound to have an AIDS implementation plan and to make it public.