Self-Satisfaction in the World Health Organization's (WHO) « 3 by 5 » Progress Report Masks Its Inability to Reach Objectives
Médecins Sans Frontières (MSF) is opposed to the self-satisfied and congratulatory tone in the WHO's progress report of the "3 by 5" initiative, which aims to provide treatment to 3 million people living with HIV/AIDS by the end of 2005. While the WHO said there had been a "spectacular increase" and "extraordinary drive" in the efforts to fight the AIDS pandemic, only 700,000, or 12%, of the 6 million people in urgent medical need of anti-retroviral (ARV) treatment have access to it. MSF finds little reason to draw satisfaction from this shocking fact. Our experience in providing ARV treatment to more than 25,000 patients in 27 countries brings us to the exact opposite conclusion.
The pace at which people living with HIV/AIDS have access to treatment is still far too slow. Since July 2004, only 260,000 additional patients benefit from ARV therapy. At this pace, how long will the 6 million patients about to die have to wait to get treatment? "3 by 5" seems to be little more than a slogan as the pandemic continues: every day 8,000 people die from AIDS and every year an additional 5 million people become infected with HIV.
Perspectives for the future are all the more alarming as the already weak response against the pandemic is being strangled by a series of obstacles and pressures on generic medicines. Yet it is generic competition that triggered a decrease in prices from USD$10,000 to USD$300 per patient per year for first-line ARVs, thus enabling treatment to start in some impoverished countries.
Since January 1, 2005, India has had to enforce WTO requirements, and the country's generic medicines manufacturers, who have provided the bulk of affordable generic ARVs, will no longer be authorized to produce generic versions of newly developed drugs. As resistance grows to first-line treatments, second generation medicines will be critical for the survival of patients already on therapy. The lack of access to these second generation medicines could lead to a medical apartheid, where patients who cannot afford new treatments will be condemned to death.
Moreover, governments and brand-name pharmaceutical companies continue to wage a disinformation campaign to discredit already-available generic medicines, thereby preventing their use and making their production illegal.
Instead of congratulating itself, the WHO should be ringing alarms and urging governments, the pharmaceutical industry, and international organizations to radically change their approach so that there is an urgent increase in the number of patients on ARVs and new treatments are available to all patients.