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 Nations General Assembly High–Level Meeting on AIDS, countries committed to reaching as close as possible to the goal of universal access to HIV prevention, treatment, care and support by 2010. Increased political commitment and allocation of resources are having an effect in the most severely burdened countries.
By the end of 2007, nearly 1 million more people were receiving antiretroviral therapy than in 2006, and the world had met the "3 by 5" target of providing antiretroviral therapy to 3 million people in low– and middle–income countries – a target many people predicted was unachievable when the initiative was launched in 2003. With the unprecedented scale–up of treatment, people living with HIV are living longer and have a better quality of life. More mothers have access to interventions to prevent transmission to their infants, and more children living with HIV are benefiting from treatment and care programmes.
Despite this progress, much remains to be done. As we look ahead, it is clear that – even at the increased pace of scaleup – most countries will not meet the goal of universal access by 2010.
Most people living with HIV remain unaware of their HIV status. As many as 6800 people are newly infected with HIV every day because of poor access to affordable, proven interventions to prevent HIV transmission, yet only about 2700 additional people receive antiretroviral therapy per day.
The HIV/TB co–epidemic, one of the most serious consequences of the spread of HIV, has been further complicated by the emergence of multidrug–resistant and extensively drug–resistant TB. Despite the substantial progress in access to treatment, more than two thirds of people in need are being left behind, while still others are being lost to follow–up after initiating treatment.
Three challenges require urgent and concrete action: ensuring the sustainability of the response; building stronger health systems; and generating high–quality strategic information. To sustain our efforts, we need more financial and technical resources over the long term to maintain people on treatment and prevent new HIV infections.
Countries require strong health systems and skilled human resources to deliver services. Expanding HIV programmes represents an opportunity to promote innovative models of integrating HIV interventions into the primary health care system and to strengthen the health system as a whole, including its infrastructure and laboratory capacity.
Finally, countries need information to monitor their achievements and improve outcomes.
"What gets measured gets done"
By committing to universal access, the international community universal access, 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 are showing positive results. Together, we have an opportunity to turn one of the greatest public health initiatives in history into a lasting public health success.
By the end of 2007, an estimated 33.2 million [30.6 million–36.1 million] people were living with HIV, of whom 2.1 million [1.9 million–2.4 million] were children. An estimated 2.5 million [1.8 million–4.1 million] people were newly infected in 2007, 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.
The international community has intensified its commitment and efforts to address the HIV epidemic in recent years. In 2001, the United Nations convened a special session on HIV/AIDS and, for the first time in history, agreed to a set of global targets in response to a rapidly escalating global public health crisis. In 2006, at the second United Nations General Assembly High Level Meeting on HIV/AIDS, countries agreed to work towards the goal of "universal access to comprehensive prevention programmes, treatment, care and support" by 2010.
These global commitments complement the health–related United Nations Millennium Development Goals , which established targets to reduce child mortality, improve maternal health and combat HIV/AIDS, malaria and other major diseases by 2015.