World Health Organization 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

World Health Organization 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

Countries that have appealed for WHO Technical Assistance, Feb 2004 World Health Organization "3 by 5" Initiative http://www.who.int/3by5

Widening Gap of AIDS Treatment World Health Organization Yearly deaths as a factor of total in 1995 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

Pillars of the "3 by 5" Strategy World Health Organization 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 World Health Organization 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 World Health Organization 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 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

World Health Organization 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

World Health Organization 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 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 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