The number of people receiving HIV antiretroviral therapy in sub-Saharan Africa has surpassed the one million mark for the first time, but much work remains to be done to reach the goal of providing universal access to prevention, treatment and care by 2010, said a UN health care agency official at the International AIDS Conference in Toronto today.
The one million figure represents a tenfold increase since December 2003, according to the World Health Organization (WHO). Sub-Saharan Africa still accounts for 70 per cent of the global unmet treatment need, however, and 95 per cent of the 38.6 million people living with HIV/AIDS live in the developing world, where countries face tremendous challenges in dealing with the epidemic.
"In many ways we are still at the beginning of this effort," said Dr. Kevin De Cock, WHO's HIV/AIDS Director. "We have reached just one quarter of the people in need in low and middle-income countries, and the number of those who need treatment will continue to grow."
The WHO notes that many nations are suffering "crippling" shortages of HIV-related health workers, many of whom are either becoming infected themselves or leaving for better-paying jobs in larger cities and wealthier countries.
"The shortage of health workers is devastating public health systems, particularly in the developing world," said Dr. Anarfi Asamoa-Baah, Assistant Director-General of WHO. "It is one of the most significant challenges we face in preventing and treating HIV."
Some 57 countries, mostly in sub-Saharan Africa and Asia, need more than four million HIV-related health care workers to fill the gap, the WHO estimates. To confront the problem, the agency has launched, in collaboration with the International Labour Organization and the International Organization for Migration, a new plan called "Treat, Train, Retain".
The initiative is aimed at providing health care workers themselves with access to HIV/AIDS services while at the same time helping countries increase the number of health workers, maximize their efficiency and retain them.
Meanwhile, the United Nations Population Fund (UNFPA) is calling attention to the fact that millions of people still lack access to the most basic and available method for preventing HIV - the male and female condom.
"People are getting infected now," said Steve Kraus, Chief of the HIV Branch of UNFPA, in a statement. He noted that promising new technology is on the horizon but will not be widely available for years. "The condom already exists and it hasn't been delivered. It works and represents the best tool we have in the fight against HIV/AIDS."
The UNFPA points out that, in sub-Saharan Africa, men have access to only 10 condoms on average per year, while the eight to 10 million condoms being used in low- and middle-income countries represent only half of the total need.
At the same time, the UN World Food Programme (WFP) is highlighting food and nutritional support as an essential, and often overlooked, part of essential care for people living with and affected by HIV.
The WFP cites a new study by HIV Medicine, which found that such people most often list food as their greatest need and that patients who start new antiretroviral therapy while malnourished are six times as likely to die.
The WFP estimates that nearly one sixth of the people enrolled in antiretroviral programmes in 2008 will need some kind of nutritional support, which could be provided for a mere 65 cents (US) per patient per day.
"We cannot win the battle against AIDS by focusing on drugs alone," said Robin Jackson, Chief of WFP's HIV/AIDS Service, at a press conference in Toronto today. "Funding antiretrovirals with no thought to food and nutrition is a little like paying a fortune to fix a car but not setting aside money to buy gas."