AIDS: "Three by Five" goal shadowed by funding shortfall, says WHO PARIS (AFP) - The World Health Organisation (WHO) said that access to AIDS therapy was spreading fast in many poor countries but warned its vision of reaching three million infected people by year's end needed further efforts and more cash. In an update on its "Three by Five" initiative, the WHO said that at the end of 2004, around 700,000 people in developing countries and transitional economies were receiving antiretroviral drugs. That tally was in line with targets and marked a big gain from six months earlier, when only 440,000 people had access to the treatment, the UN agency said. Even so, fewer than one in four are getting the drugs out of the three million badly-infected poor people the WHO hopes to reach by December 31 2005. And that three million is little more than half of the 5.8 million poor people who are in urgent need of treatment, it admitted. "The figures speak for themselves," the WHO said bluntly. "Global progress towards the 'Three by Five' target can only be made if major progress is made in the countries with the greatest unmet need for treatment." The agency estimated the costs this year of meeting "Three by Five" in 49 countries at between 3.1-3.8 billion dollars (2.4-2.9 billion euros), on the basis of a drug cost of 304 dollars (233 euros) per person. So far, only 1.55 billion dollars (1.19 billion euros) have been pledged or committed from national resources, international agencies and private and government donors, it said. "This would leave a shortfall of more than two billion dollars (1.53 billion euros)," the WHO said, adding though that the gap would narrow if the cost of buying and administering the drugs could be brought down further. WHO Secretary General Lee Jong-wook noted the agency had met its interim objective of reaching 700,000 people by the end of 2004, but a long road still lay ahead. "Against the expectations of many, national leaders and the global community have started a major change in the world. The challenge is to see it through," he said at a press conference at the World Economic Forum in Davos, Switzerland. The WHO update made these points: - Of the 700,000 now getting the drugs, 220,000 of them are in Latin America, led by Brazil, which has a well-regarded AIDS programme and is a big producer of cheap generic drugs. - In sub-Saharan Africa, the number getting the treatment has doubled in six months, to 310,000. Botswana, Kenya, South Africa, Uganda and Zambia have made the best progress. But another 3.7 million infected Africans face a death sentence without early access to the drugs. - In Asia, Thailand is leading the way. Every district now has antiretroviral therapy facilities, and each day more than more than 3,000 people are started on treatment. - HIV-infected people who get the drugs are getting "dramatic" benefits. After one year of therapy, the survival rate is more than 90 percent, falling back to 80 percent after two years. These rates are the same as in rich countries. - Fears that antireviral drugs are inappropropriate for poor-country settings are wrong, according to the evidence. "Adherence to regimens is as high as 90 percent," the report says. Antiretroviral drugs are complex medications which can cause toxic side-effects. Several pills have to be taken several times a day -- and for life, as there is no cure for HIV. The present generation of drugs became available in the mid-1990s, and immediately became credited with handing a lifeline to those whose immune systems had been badly damaged by the AIDS virus. But high prices placed the drugs out of reach of poor countries until 2003, when voluntary cuts by pharmaceutical companies and competition from generics started to drive down the cost. The WHO nailed its colours to the "Three by Five" target on September 22 2003, shortly after Lee was named to the agency. Poor countries are bearing the brunt of the global epidemic, especially in Africa, which is home to nearly two-thirds of the 39.4 million people with AIDS or the human immunodeficiency virus (HIV) which causes it.

Japan's AIDS experts alarmed as HIV infections hit record high TOKYO (AFP) - The number of Japanese people who were infected with HIV or developed AIDS topped 1,000 for the first time in 2004, officials said, voicing concern the virus could be spreading more quickly due to a lack of awareness. New HIV infections in 2004 jumped 17 percent year-on-year to 748, the highest figure since Japan registered its first AIDS patient in 1985 although still low by global standards, a health ministry survey showed. The number of HIV patients who developed AIDS last year also hit a record high of 366, up 8.9 percent from a year earlier, it said. The new infections bring to 6,528 the number of people in Japan who have tested positive for HIV, the virus that leads to AIDS, with 3,258 of them living with AIDS. But health ministry official Masanori Suzuki said the government estimated the true figure of HIV-positive Japanese was around 14,000 as many people never came in for diagnosis. "It is very alarming. We must launch more aggressive and vigorous campaigns to make people aware of AIDS issues," Suzuki said of the 2004 figures. "Since AIDS has a long latency period, people just don't realize their HIV infection. Early detection is a key to effective AIDS prevention," he said. Of the 748 newly infected people, men accounted for 90 percent and over 60 percent of them were infected through gay sex, the survey said. "The number of infected people is rising too fast. We are particularly alarmed by the indifference among young people toward AIDS. We really need to educate them," said Yorimasa Nagai, director of Japanese Foundation for AIDS Prevention. Japan offers free and anonymous AIDS tests at public health care centers and Nagai said the foundation and the government must urge more people to take the examinations. But despite the alarm, the AIDS epidemic is far lower in Japan than in most parts of the world. The United States, with about twice Japan's population, has seen an average of 40,000 HIV infections annually over the past 10 years, according to the UN AIDS body. Japan is also out of global norms in that gay men dominate the new infections, with heterosexuals making up most new cases in other parts of the developed world. Activists warn that the relatively low HIV rate has led Japanese people to be unconcerned about using condoms and taking other preventive measures, meaning that the country is vulnerable to a sudden rise in HIV infections. According to health ministry data, domestic sales of condoms have sunk 43 percent from the peak in 1980 of 737 million to 419 million in 2003. Other parts of Asia have far larger populations with HIV, with both unprotected sex and needle use attributed as causes. China estimates some 840,000 people were infected with HIV in 2003, but international AIDS experts say the actual number is much higher. India had an estimated 5.1 million people infected with HIV in 2003, more than any other country except South Africa.

Brown to top Gates with vaccine donation By Sumeet Desai LONDON (Reuters) - Chancellor Gordon Brown will today propose giving $1.8 billion (960 million pounds) over the next 15 years to a campaign to get life-saving vaccines to millions of children in poor countries. The Global Alliance for Vaccines and Immunisation (GAVI) already received a $1 billion boost on Tuesday from Microsoft founder Bill Gates and the Norwegian government which the donors had hoped would kick-start similar pledges. Britain is now calling for $4 billion extra to be committed over the next 10 years through a pilot of Brown's brainchild -- the International Finance Facility (IFF) -- which would frontload the aid commitments by issuing bonds against them. Brown will tell a development seminar on Wednesday that such a move could save the lives of an additional 5 million people between now and 2015, according to Treasury officials. Brown, who is hosting a meeting of Group of Seven finance ministers in London next week, will also say that concerted and coordinated action is needed if the world is to realise the Millennium Development Goals of halving global poverty. The Chancellor will set out a five-point plan for the British presidency of the G7 rich nations club this year, covering debt relief, aid, trade, education and health. London wants to help set the world back on course to meet the U.N. targets first agreed in New York in 2000. First, Brown wants to complete the debt reduction process by matching 100 percent bilateral debt relief with financing 100 percent relief of the debt owed by the poorest countries to the World Bank, the IMF and the African Development Bank. Next, Brown will try win support to establish his IFF which he reckons would double aid spending to $100 billion a year by securitising donor countries' annual aid budgets. On health, Brown wants not only to raise money for vaccination programmes, but also to launch a comprehensive plan to tackle HIV and AIDS, and to establish an advance purchase agreement to help get new malaria and AIDS drugs to market. He also wants to deliver a new plan for schooling by 2015 for the 110 million children currently going without education and to set up an infrastructure to help poorer countries improve their capacity to trade.

Chris Smith is HIV positive

Sat Jan 29, 2005 10:53 PM ET

Chris Smith, one of the first British politicians to come out publicly as gay in 1984, told the Sunday Times he decided to announce his condition after the former South African President Nelson Mandela said his son had died from AIDS.

"What Nelson Mandela said very much struck a chord with me," Smith, 53, said. "He spoke about how nobody should be ashamed of HIV and said that it should be regarded just like any other illness. He was brave and right."

Smith, who was Culture Secretary from 1997-2001, said he did not inform Prime Minister Tony Blair about his condition.

He plans to retire as a member of parliament for the ruling Labour Party at the next election expected in May.

"I didn't feel the need to tell people except for a very, very few as it was not in any way affecting my work," he said.

He was first diagnosed in 1987.

"When I first heard about it, I was really worried because there was hardly any treatment, but I was lucky and fairly early on I was put on AZT (drug)," he said, adding that he had kept healthy through a combination of drugs and diet.

Mandela announced his only surviving son, 54-year-old Makgatho, died of AIDS on January 6. The 86-year-old Nobel Peace laureate urged a stronger fight against the disease.

Chirac Calls for Global Tax to Fight AIDS

Wed Jan 26, 2005 07:37 PM ET

By Ben Hirschler

DAVOS, Switzerland (Reuters) - French President Jacques Chirac called for a tax to fund the global fight against AIDS Wednesday, as new figures showed a modest rise in the number of patients receiving life-saving drugs in poor nations.

The experimental levy, which could be raised on international financial transactions, could generate $10 billion a year, Chirac told the World Economic Forum.

His appeal for a radical rethink of AIDS funding comes at a time when the roll-out of antiretroviral therapy (ARV) in the developing world is finally gathering momentum.

The number of people receiving treatment in poor countries has jumped 75 percent in the past year, U.N. agencies said. ARVs are now getting to 700,000 patients, up from 440,000 six months ago, meeting the World Health Organization's interim target.

But the figure only amounts to 12 percent of the 5.8 million people who officials estimate will die in developing countries if they do not receive medicine within two years.

A further $2 billion is needed in 2005 alone to hit the target of getting medicines to 3 million by the end of the year.

"I propose today moving forward through the creation, in an experimental way, of a levy to finance the fight against AIDS," Chirac told delegates in Davos in a speech delivered by video link-up.

Chirac said the levy could be imposed on a fraction of all financial transactions without hampering markets, but it could also be raised by taxing fuel for air and sea transport, or by levying $1 on every airline ticket sold in the world.

His ideas are likely to meet strong opposition from the United States and most other rich nations, as well as financial markets and airlines, but will be popular with anti-globalization campaigners and AIDS awareness groups.

HUMANKIND'S BIGGEST CHALLENGE

Chirac said the money raised would be used not only to make medicines available to far more sufferers but also to finance research into a vaccine and develop prevention campaigns.

Richard Feachem, executive director of the Global Fund to Fight AIDS, TB and Malaria, welcomed his idea which he said could help move the treatment of AIDS in the developing world to a new level after a "strong but modest start."

"It is by far the biggest challenge humankind has ever taken on," he told reporters.

Four years ago, the idea of treating people in the developing world with sophisticated ARVs costing $10,000 a year -- which must be taken for life under close medical supervision -- was widely viewed as impossible.

Since then, however, the cost has tumbled by more than 90 percent, as Western pharmaceutical companies, responding to intense pressure, have slashed prices, while Indian, Brazilian and Thai generic firms introduced cheap copycats versions.

Peter Piot, head of UNAIDS, the United Nations lead agency on HIV/AIDS, said the global response to AIDS was entering a new era of action rather than talking.

Enormous barriers remain, however. Aside from the extra cash needed, the "Progress Report" on the U.N. initiative known as "Three by Five" highlighted other key bottlenecks.

These include the high cost of second-line ARV treatment, which is needed when patients develop drug resistance, and the price of diagnostic tests. There is also a lack of affordable formulations of ARVs for children.

Overall, the price of ARVs averages at least $300 per person per year, according to U.N. agencies, which are seeking a price of $50-200 by end-2005.

About 38 million people worldwide, including 25 million in sub-Saharan Africa, are living with HIV/AIDS.

Lee Jong-Wook, director-general of the World Health Organization, said the number of people receiving treatment in Africa had doubled in the past six months and Uganda, Botswana and Namibia now have 25 percent coverage.

The biggest laggards were South Africa, India and Nigeria, he added. The three countries account for 41 percent of the overall "unmet need" of 5.1 million adults.

Patients receive drugs through national programs, aid agencies, the private sector, the Global Fund, the U.S. President's Emergency Plan for AIDS relief, the World Bank and other partners. (Additional reporting by Paul Taylor)

But when you live in townships like Old Naledi, Broadhurst and Bontleng and are surrounded by stigma, poverty, death and disease, all these grim statistics and AIDS messages can leave you fatalistic.

On a hot, dry Monday afternoon in Old Naledi, the largest township in the capital, Gaborone, a group of young people sit under a tree. This is the weekly meeting of the township's youth taskforce - advisors to the Urban Youth Project (UYP), a sexual and reproductive health campaign targeting unemployed youth, commercial sex workers, orphans and street children.

Theatre group leader Emmanuel (last name withheld) admitted that talking to young people about HIV/AIDS was like "trying to fight a dead animal".

Botswana has all the ingredients for turning the epidemic around: political leadership, optimal use of existing resources and an established treatment plan.

The recent Botswana AIDS Impact Survey (BAIS) found that 89 percent of Batswana know how to prevent HIV infection, 84 percent believe a woman can negotiate safe sex and 41 percent have no misconceptions about the disease.

"Young people are swimming in a pool of information, but none of this automatically translates into behaviour change," Robert Letsatsi, project coordinator of the Centre for Youth of Hope (CEYOHO), an NGO for young people who are HIV-positive, told IRIN.

Back under the tree in Old Naledi, a 30-year-old taskforce "pioneer", Roy Mafunga, who was recently elected a local councillor, raised some of the issues affecting the country's youth.

Alcohol abuse is widespread in Botswana. "Bars and shebeens are a form of recreation, especially when you are unemployed and have nothing to do - you don't even have to wait for the weekend now, it's happening every day," Mafunga noted.

The heavy drinking is fuelled by the conditions in townships like Old Naledi, as a large proportion of the country's population continue to live in poverty despite Botswana's economic success.

Inevitably, young people were "at the bottom of the food chain", as there had been "very little" investment in them, Letsatsi said.

But these realities were ignored by existing youth prevention efforts. "They need to come to the people ... it's hard to educate someone about AIDS when they are hungry because they won't listen," Mafunga added.

Which is why the UYP is "not just about sex and HIV/AIDS," project manager Magdeline Madibela pointed out. Young people are encouraged to set goals and take control of their lives through income-generation projects, peer-education training and the promotion of youth-friendly health clinics.

Local groups for sports, music, theatre and traditional dances are also involved in the UYP, which forms part of the 'Southern African Youth' (SAY) initiative, a campaign funded by the United Nations Foundation to sponsor youth projects in seven AIDS-affected countries in southern Africa.

The project is also driven by young people - each township has a taskforce, who are responsible for setting the project's agenda, along with the health ministry, NGOs, community groups and the United Nations, Madibela said.

With almost half of all new infections occurring among young Batswana, the reality of the generational crisis could no longer be ignored, she added.

Twenty-nine-year old Alice Manthe is a petite, soft-spoken peer educator and member of CEYOHO - one of the UYP's implementing partners. She found out she was HIV-positive five years ago and has been taking antiretrovirals (ARVs) for the past three years.

Despite the availability of free ARVs, Alice has found that young people living with the virus are reluctant to get help - most young Batswana were "too scared to take the drugs," and not prepared to make such a drastic lifestyle change.

"They tell me that alcohol is better than ARVs - it helps them forget, and they are too young to be living on pills 24/7," Alice added.

Fear of stigma and discrimination makes disclosure of their HIV-positive status even more difficult - only four CEYOHO members out of over 300 have gone public with their status, Letsatsi said.

Nevertheless, as organisers of the popular Miss HIV Stigma Free beauty pageant, a contest designed to fight discrimination, CEYOHO is trying to motivate more youth to come forward and be tested.

"We need to create a comfortable space for young people," Letsatsi said. "Instead of bombarding them with meaningless information, create ways to talk about sex - not in a weird way, but a culturally appropriate [way]."

Aids group welcomes drug approval

The US government only buys Aids drugs approved by the FDA.

"The 3 by 5 goal is a solemn promise made to the most desperate people in the world, and we cannot allow a gap of $2bn to stop this encouraging progress," stated Dr Paul Zeitz, executive director of the Global Aids Alliance.

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