Transcript Slide 1

Treat
3 million
by 2005
Naisiadet Mason
HIV/AIDS Department, WHO, Geneva, Switzerland
CCIH, May 2004
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
What is the "3 by 5" Target?
• 40,000,000 are infected with HIV/AIDS worldwide
• 6,000,000 need treatment every year
• 3,000,000 die because they do not get it
•
400,000 people living with AIDS have access to treatment today
• Antiretroviral Therapy (ART) keeps people with HIV/AIDS
alive and healthy. It is not a cure
The Goal: Provide access to treatment for all
The Target: Treat 3 million HIV sufferers by 2005
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
High burden countries in
need of ART, Nov 2003
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
Countries that have appealed for WHO Technical Assistance, Feb 2004
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
Yearly deaths as a factor of total in 1995
Widening Gap of AIDS Treatment
2.0
Source: Adapted from WHO/UNAIDS Statistics & HIV/AIDS Surveillance in Europe,
End-year report 2001, No 66, CESES
AIDS Deaths
in Africa
1.5
1.0
AIDS Deaths in
Western Europe
0.5
Introduction of Highly Active Antiretroviral
Treatment (HAART)
0.0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
What ARVs Can Do
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
Pillars of the "3 by 5" Strategy
• Global leadership, strong partnership and advocacy
• Urgent, sustained country support
• Simplified treatment
• Effective supply of medicines and diagnostics
• Learn by doing
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
A Simple Two-Pronged Approach
WHO Strategy to Support Global
Efforts to Scale Up Treatment
Country Driven
Simplification
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
A Simple Two-Pronged Approach
Country Driven
• Scale-up & treatment happens in country. It is country driven
• Governments are responsible for the care and treatment of their citizens,
including the poor and marginalized
• Multiple actors are involved in ART and with scale-up
• WHO provides technical support to governments
• Focus on UNAIDS "three ones" approach
 One National Plan
 One Coordinating Body
 One Monitoring and Evaluation System
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
A Simple Two-Pronged Approach
Simplification
• Fixed Dose Combination (FDC) drugs simplify drug regimen to just one
pill twice a day
• WHO has established an AIDS Medicines and Diagnostics Service (AMDS)
to help countries streamline procurement and supply
• AMDS links with the WHO Procurement, Quality and Sourcing Project
(pre-qualification), assessing products and manufacturers, facilitating
procurement
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
The AMDS in Focus
A project of UNAIDS, WHO, UNICEF the World Bank and other partners
Activities of the AMDS:
• Strategic information
• Stockpiles and pooled procurement
• Product selection
• Demand forecasting
• Market intelligence on sources, prices, raw materials
• Technical support for product selection, procurement,
supply-management and local production
• Prequalification of ARVs and diagnostics
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
What is "3 by 5" Building On?
Opportunities
• Increased global political commitment and resources
• Simplified treatment and testing
• Cheaper drugs and generic competition
• Build on lessons from developing and developed countries
• Use ART to strengthen health systems and accelerate prevention
Partners
Experience
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
What is "3 by 5" Building On?
Opportunities
Partners
• UN and international agencies, governments, donors,
non-governmental organizations including faith based organizations,
researchers, people living with HIV/AIDS, private sector, charitable
foundations, and communities
Experience
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
What is "3 by 5" Building On?
Opportunities
Partners
Experience
• Lessons learned by WHO in dealing with SARS, Polio, TB will be applied in
addressing the world's worst health crisis: HIV/AIDS
• Lessons learned from partners, e.g. MSF in Khayelitsha, Partners in
Health in Haiti, MTCT in Burkina Faso and treatment programs in the
private sector
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
Funding for Treatment Scale-up
Budget requirements through to December 2005:
Countries
•$5.5 billion to scale-up treatment to reach the target of 3 million people
WHO
• $218 million for WHO technical assistance, 85% to be spent in country
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
Achievements to date & next steps
• Dec 1st 2003 - Launched "3 by 5" strategy and simplified treatment
guidelines
• Feb-April 2004 - 42 WHO staff deployed to 26 countries to help draw
up 4th round GFATM proposals and national AIDS plans
• May-July 2004 - Technical assistance to countries ready for immediate
scale-up
• Aug-Dec 2004 - Continued technical assistance to countries
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
Key dates
• July 2003 - Access to ART for all made WHO/UNAIDS core policy
• Sept 2003 - HIV/AIDS declared Global Health Emergency, UN General
Assembly
• Nov 2003 - First partners meeting on proposed Strategy
• Dec 2003 - WHO UNAIDS "3 by 5" strategy launched
• Feb-June 2004 - WHO Technical Assistance in countries for GFATM
proposals and development of National AIDS scale up plans and roll out
• May 2004 - WHA to consolidate political commitment and action.
Second partners meeting on Operational Planning
• July 2004 - Bangkok AIDS Conference – WHO Business plan and report
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
Milestones for December 2005
50 countries request WHO support
60 countries establish ARV target
60 countries develop national implementation plans
50 countries use AMDS
50 countries use WHO-based certification of competence
$50 to $200 yearly cost of ARV treatment
20,000 service outlets providing VCT
10,000 service outlets providing ART
100,000 health providers and community treatment supporters
30,000 partnerships with treatment outlets and community groups
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
The Time to Act is Now
“To deliver antiretroviral treatment to the millions
who need it, we must change the way we think
and change the way we act.
“Business as usual will not work. Business as
usual means watching thousands of people die
every single day.”
LEE Jong-wook, Director-General, WHO
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5
World Health Organization
"3 by 5" Initiative
http://www.who.int/3by5