1. Expanding ARV treatment in developing countries: Issues and Prospects
NY /020419VtsimSL001
NY /020419VtsimSL001
Expanding ARV treatment in developing countries: Issues and Prospects
Naisiadet Mason, MPH
Human Rights/Advocacy Adviser
HIV Dept, World Health Organization
April 2004

2. NY /020419VtsimSL001
Although there are drugs that can greatly prolong patients’ lives and well-being, these are not available….
Number of people that SHOULD BE under
ARV treatment in developing countries (end 2003) Total 6 million
Number of people that ARE under
ARV treatment in developing countries (end 2003) Total 400,000
Deficit 5,600,000
AIDS deaths in Total 3.1 million

3. HIV/AIDS has been spreading fast...
NY /020419VtsimSL001
HIV/AIDS has been spreading fast...
Number of people living with HIV/AIDS by Total 42 million
…. and it is getting worse…
People newly infected with HIV in Total 5 million
AIDS deaths in Total 3.1 million

4. Prevention Treatment WHO Policies Human Rights / Ethics UNGASS 2001
NY /020419VtsimSL001
Prevention
Treatment
WHO Policies
Human Rights / Ethics
UNGASS 2001
Goals
3 million by 2005

5. “Lack of access to antiretroviral
treatment is a global health emergency”

6. It is possible to provide ARV treatment in resource-constrained environments...
Examples
Highlights
1. Brazil
( )
80% drop in the nº of hospitalizations per patient
50% drop in mortality
70% drop in morbidity
Net savings of US$ 200 million
2. Medecins sans
Frontiers (MSF) Pilot
Projects in Malawi
Adherence: 94%
Average CD4 gain (18 months): 180
Utilization of nurses and non-medical health workers
Adherence supported by community involvement (accompagnateurs)
Average weight gain: 10,3 kg
Increased demand for counselling and testing after program was introduced
3. Haiti
(Partners in Health)

7. Expand the access to ARV treatment in developing countries
NY /020419VtsimSL001
Expand the access to ARV treatment in developing countries
3,000,000 people under ARV treatment by 2005

8. Resources currently available (outside WHO)
NY /020419VtsimSL001
Resources currently available (outside WHO)
In US$
Regions
GF (Rounds 1,2 & 3) i
World Bank
(MAP and non MAP)
Sub-Saharan Africa
2,073,034,561
774,300,000
Latin America and the Caribbean
458,203,038
61,200,000
Eastern Europe and CIS
365,618,483
Asia, North Africa and Middle East
556,670,093
256,600,000
Total
3,453,526,175
1,092,100,000 i
5 Year Proposals

9. WHO Estimated number of people under ARV
NY /020419VtsimSL001
WHO Estimated number of people under ARV
by 2005 with existing programs
Baseline (Today)
Global Fund (Rounds 1, 2 and 3)
(by 2005)*
Global Fund (Rounds 4 and 5) (+)
(by 2005)*
World Bank (MAP)
(by 2005)*
PEPFAR
(by 2005)
Other initiatives
(by 2005)
TARGETS
* Presuming technical support; (+) funding to be confirmed
Current programs…….…… 935,000
Gap…….…..2,065,000 A B
Goal…… ,000,000

10. Rate of disbursement, Global Fund grants
Rounds 1, 2 and 3 (as of Feb 10th 2004)

11. WHO has developed a strategy focusing on its core comparative advantages...
Simplified treatment guidelines (global standard first and second line treatment regimens) as well as tools to track progress and impact of ARV treatment programmes (including drug resistance surveillance)
Expanded training and capacity development for health professionals, and other cadres, including community support agents (full support to building critical mass of highly skilled trainers)
Establish an AIDS Medicines and Diagnostics Service to assist countries to procure best priced quality drugs in simplest ways
Strengthening health systems to support ART delivery (including drug procurement and distribution, capacity building, regulatory changes etc.)

12. Partners Group NGOs People living with HIV/AIDS Scientists / Research
NY /020419VtsimSL001
Partners Group
NGOs
People living with HIV/AIDS
Scientists / Research
Institutes
Multilaterals (Global Fund, World Bank, UNAIDS, etc)
Foundations
Governments /
Ministries of Health
Private Sector
bilaterals