Academic journal article Bulletin of the World Health Organization

WHO's HIV/AIDS Strategy under the Spotlight: Dr Jim Yong Kim, Director of WHO's HIV/AIDS Department, Talks to the Bulletin about "3 by 5"-The Global Strategy Which Aims to Provide Three Million People in Developing Countries with Antiretroviral Treatment by 2005

Academic journal article Bulletin of the World Health Organization

WHO's HIV/AIDS Strategy under the Spotlight: Dr Jim Yong Kim, Director of WHO's HIV/AIDS Department, Talks to the Bulletin about "3 by 5"-The Global Strategy Which Aims to Provide Three Million People in Developing Countries with Antiretroviral Treatment by 2005

Article excerpt

About "3 by 5":

Since its introduction in 1996, highly active antiretroviral therapy (ART) has enabled people with HIV/AIDS in industrialized countries to live healthier, longer lives and to continue to contribute to the social and economic well-being of their families and societies. However, although 95% of the world's 40 million HIV-positive people are living in developing countries, only about 400 000 of the six million people requiring treatment actually received it in 2003.

To address this treatment gap, at the UN General Assembly Special Session on HIV/AIDS in 2001, UN Member States unanimously committed to scaling up ART within their national HIV/ AIDS programmes. In late 2003, WHO and UNAIDS declared the inequity in access to HIV/AIDS treatment a global public health emergency and launched the initiative, dubbed "3 by 5", which aims to treat three million people living with HIV in developing countries by the end of 2005. In a special interview with the Bulletin, WHO's Director of HIV/ AIDS explains the principles behind the strategy, describes the challenges to its success and recounts the progress made towards achieving the target to date.

Bulletin: Why has WHO chosen HIV/ AIDS for the signature initiative of the current Director-Generalship?

JK: "There are many reasons. One of the reasons is that for certain areas of the world the threat of HIV/AIDS is more severe than almost any other disease that we've seen for many hundreds of years. This is not to say that other diseases are not important but HIV/AIDS is clearly the disease that could define our generation. It is killing a particular portion of the population which is the most important for social viability: young men and women in the prime of their fives, people who are key to a community's social and economic structure. It is an enormously serious problem, as the World Bank points out, when a country loses people in whom so much has already been invested and who must in turn invest in the next generation, if societies are to be sustained.

"By choosing to focus on the HIV/ AIDS treatment gap, WHO's Director-General, Dr LEE Jong-wook, recognized that WHO has an important role to play in combating this epidemic. This is because scaling-up treatment for HIV in developing countries requires a public health approach. Until now, the only way H[V could be treated was in a very clinical, hospital-based, first-world type approach, where physicians were the only ones who could treat HIV patients. In order to quickly and equitably roll out HIV treatment in resource-poor settings, we could not take a one doctor, one patient approach. We had to develop ways of treating many thousands of people within a population using standardized regimens and simple treatment algorithms.

"WHO has been saying for years that we need to invest more in health and in some ways, we have been successful--the world is investing more in health but almost all of the new investment is for HIV. The world has voted--presidents and prime ministers have voted--to put their, money into the fight against HIV/AIDS. For WHO to turn its back on HIV/AIDS would therefore be tantamount to a dereliction of duty. It's an opportunity we cannot afford to miss. WHO must therefore help the world achieve its goals but at the same time make sure that those goals contribute to broader social development."

Bulletin: Is there more to "3 by 5" than treatment?

JK: "Yes. In providing HIV treatment, we can achieve many other things at the same time. For example, by increasing access to ART, we have learnt that we can reduce the stigma associated with HIV infection. In the first world, the availability of ART--which can dramatically transform dying people back into healthy, productive individuals--was a critical factor in reducing the stigma associated with HIV and in enabling people to resume their lives.

"Secondly, providing HIV treatment also strengthens prevention. …

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