Towards Universal Access : Scaling up priority HIV/AIDS interventions in the Health Sector
Most people living with HIV remain unaware of their HIV status
Foreword by (i) Margaret Chan, Director–General WHO, (ii)Peter Piot, Executive Director UNAIDS and (iii) Ann M. Veneman,Executive Director, UNICEF
Two years ago at the United NationsGeneral Assembly High–Level Meeting on AIDS, countries committed toreaching as close as possible to the goal of universal access to HIVprevention, treatment, care and support by 2010. Increased politicalcommitment and allocation of resources are having an effect in the mostseverely burdened countries.
By the end of 2007, nearly 1 millionmore people were receiving antiretroviral therapy than in 2006, and theworld had met the "3 by 5" target of providing antiretroviral therapyto 3 million people in low– and middle–income countries – a target manypeople predicted was unachievable when the initiative was launched in2003. With the unprecedented scale–up of treatment, people living withHIV are living longer and have a better quality of life. More mothershave access to interventions to prevent transmission to their infants,and more children living with HIV are benefiting from treatment andcare programmes.
Despite this progress, much remains to be done.As we look ahead, it is clear that – even at the increased pace ofscaleup – most countries will not meet the goal of universal access by2010.
Most people living with HIV remain unaware of their HIV status. As many as 6800 people are newly infected with HIV every daybecause of poor access to affordable, proven interventions to preventHIV transmission, yet only about 2700 additional people receiveantiretroviral therapy per day.
The HIV/TB co–epidemic, one ofthe most serious consequences of the spread of HIV, has been furthercomplicated by the emergence of multidrug–resistant and extensivelydrug–resistant TB. Despite the substantial progress in access totreatment, more than two thirds of people in need are being leftbehind, while still others are being lost to follow–up after initiatingtreatment.
Three challenges require urgent and concrete action:ensuring the sustainability of the response; building stronger healthsystems; and generating high–quality strategic information. To sustainour efforts, we need more financial and technical resources over thelong term to maintain people on treatment and prevent new HIVinfections.
Countries require strong health systems and skilledhuman resources to deliver services. Expanding HIV programmesrepresents an opportunity to promote innovative models of integratingHIV interventions into the primary health care system and to strengthenthe health system as a whole, including its infrastructure andlaboratory capacity.
Finally, countries need information to monitor their achievements and improve outcomes.
"What gets measured gets done"
Bycommitting to universal access, the international community universalaccess, the international community has embarked on an ambitious,long–term commitment t reducing new infections, disease and mortality.The challenges ahead are daunting, but our collective efforts areshowing positive results. Together, we have an opportunity to turn oneof the greatest public health initiatives in history into a lastingpublic health success.
By the end of 2007, an estimated 33.2million [30.6 million–36.1 million] people were living with HIV, ofwhom 2.1 million [1.9 million–2.4 million] were children. An estimated2.5 million [1.8 million–4.1 million] people were newly infected in2007, and 2.1 million [1.9 million–2.4 million] died from AIDS.
About two thirds of all people with HIV live in sub– Saharan Africa.
Theinternational community has intensified its commitment and efforts toaddress the HIV epidemic in recent years. In 2001, the United Nationsconvened a special session on HIV/AIDS and, for the first time inhistory, agreed to a set of global targets in response to a rapidlyescalating global public health crisis. In 2006, at the second UnitedNations General Assembly High Level Meeting on HIV/AIDS, countriesagreed to work towards the goal of "universal access to comprehensiveprevention programmes, treatment, care and support" by 2010.
Theseglobal commitments complement the health–related United NationsMillennium Development Goals , which established targets to reducechild mortality, improve maternal health and combat HIV/AIDS, malariaand other major diseases by 2015.