Response to AIDS Not Keeping Pace With Epidemic, U.N. Report Says

Funding for programs in developing nations substantially increased, according to a U.N. report released Monday.

“Even with recent increases in AIDS spending, the mismatch between need and funding continues to be one of the biggest obstacles in the struggle to control the epidemic,” said the report from UNAIDS, the United Nations’ coordinating group on the disease.

As the U.N. General Assembly gathered Monday to review progress since its 2001 special session on HIV/AIDS, U.N. Secretary-General Kofi Annan urged members to make the fight against AIDS a top priority.

“We cannot claim that competing challenges are more important, or more urgent,” Annan said. “We cannot accept that ‘something else came up’ that forced us to place AIDS on the back burner. Something else will always come up.”

UNAIDS’ 2003 Progress Report on the Global Response to the HIV/AIDS Epidemic outlines shortfalls on numerous fronts in the fight against AIDS, including expanding access to drugs, caring for AIDS orphans, preventing discrimination and preventing mother-to-child transmissions of the HIV virus.

The 2003 report was based on an analysis of surveys from 103 countries that represent more than 90 percent of people living with HIV/AIDS worldwide. It found that the current pace of efforts to combat AIDS will not meet the goals for 2005 that were compiled in the 2001 session. Those goals focus on the rapid expansion of HIV prevention, care and impact alleviation programs and are viewed as a foundation to reaching the U.N. Millennium Development Goal of halting and reversing the epidemic by 2015.

There has been no slowdown in the progression of HIV/AIDS, which affects some 40 million people, about 30 million of them in Africa. Without an improved response to the epidemic, UNAIDS projects there will be 45 million new infections by 2010.

Only 300,000 people in the developing world have access to drugs that can stave off full-blown AIDS in those infected with HIV, even though between 5 million and 6 million individuals need the drugs, the report said. In sub-Saharan Africa, only an estimated 50,000 people receive medication when 4.1 million require them.

At current rates of delivery, less than 1 million people of the 6 million who desperately need drugs in the developing world will have access to proper drugs by the end of 2005. The World Health Organization advocates a “3 by 5” goal to provide drugs to 3 million people by the end of 2005.

The price of AIDS drugs in developing countries has dropped to about $300 to $600 to provide one patient with a year’s worth of drugs. Additionally, people now can take three pills a day compared to 25 pills a few years ago.

The 2001 U.N. declaration resolved that by 2005 at least 80 percent of pregnant women should have access to information, counseling and treatment to prevent HIV transmission to their children. The United Nations says currently, these services remain virtually nonexistent in countries hardest hit by HIV/AIDS.

AIDS has left more than 14 million children under the age of 15 without at least one parent. The 2001 declaration said that by 2003 countries should have developed — and by 2005 implemented — policies to support the orphans. Currently, one-quarter of countries with HIV infection rates of over 1 percent do not have policies to provide support for orphaned children.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, established after the 2001 AIDS meeting, is a major source of money to fund treatment and prevention programs. It has $4.6 billion in pledges through 2008, but only 23 percent of its needs through 2004 are met by those funds.

Paul De Lay, director of monitoring and evaluation at UNAIDS, said there were some glimmers of hope in his agency’s findings. The 2001 declaration required all countries to create national AIDS strategies by 2003, and 93 percent of countries say they have accomplished that goal.