Countries most affect by the HIV pandemic are struggling to place enough people on treatment and to implement the best science and prevention strategies to fight the disease, Médecins Sans Frontières (MSF) has warned.

The caution comes in response to the latest Joint United Nations Programme on HIV/AIDS (UNAIDS) Together we will end AIDS report released on Wednesday and shortly before the start of the 2012 International AIDS Conference in Washington on Sunday.

"As leaders and scientists prepare to discuss the latest initiatives needed to scale up treatment to such a high level it could potentially end the epidemic, seven million people still require urgent access to anti-retroviral (ARV) treatment. While UNAIDS estimates that 1,4-million more people were put on antiretroviral therapy in 2011, this pace will have to double to reach the global goal of 15 million people receiving treatment by 2015. At the same time, international discourse is increasingly urging Africans to find their own domestic solutions to the HIV emergency," the international medical humanitarian organisation said.

"It would be outrageous to assume that African states could combat this emergency alone, given their current limited resources," said Dr Eric Goemaere, MSF's HIV/AIDS senior regional advisor for southern Africa.

"This is just a cynical excuse for donors to scale back on their earlier commitments of putting an end to this disease. It will have catastrophic consequences for patients."

In Democratic Republic of Congo (DRC), less than 15 percent of patients who need anti-retroviral therapy receive it, 11 percent of health facilities offer treatment, and less than 6 percent of HIV-positive mothers have access to ARV drugs to prevent their children from becoming infected.

"We receive critically ill patients who have desperately searched for ARV treatment," said Thierry Dethier, MSF's advocacy manager in DRC. "For too many, their disease has progressed so far that they are literally dying on our doorstep."

MSF praised several governments for taking important and courageous steps to address the HIV pandemic.

Zimbabwe and Malawi have made major progress in broadening treatment programs in recent years. Malawi was the first country in Africa to implement prevention of mother to child transmission protocols, which foresee lifelong treatment for HIV-positive expectant or lactating mothers.

Mozambique recently recommended a similar protocol, prescribing better first line treatment and monitoring treatment progress by using viral load testing.

Yet, plans for scaling up treatment and improving quality of care risk being scrapped entirely as international support stagnates, with donors turning a blind eye to their earlier commitments. Important institutions in fighting the pandemic like the Global Fund are facing major funding shortfalls due to waning donor interest.

"In Malawi we're committed to implementing programmes based on recent scientific progress," said Stuart Chuka, national ART programme officer from the Malawi Ministry of Health. "Yet just as success is within reach, we're up against a great financial squeeze. I truly believe that we can end AIDS. But we can't do it alone."