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World overview

UNAIDS/WHO estimates that nearly 40 million people were living with HIV at the end of 2004. A person who is HIV positive is likely to ultimately become sick with an AIDS-related condition, but if treated with antiretroviral (ARV) medication, their life can be prolonged, often for many years.

At the end of 2004, UNAIDS/WHO estimated that 5.8 million people in developing and transitional countries urgently needed this life-saving ARV medication. Of these only 700,000 - 12% - were accessing ARV drugs. In Africa, only 8% of those who needed treatment were receiving it. These numbers - still shockingly small - do show a considerable improvement on figures from a year earlier. At the UN General Assembly Meeting on HIV/AIDS on September 22nd 2003, the WHO, UNAIDS and the Global Fund declared the lack of access to HIV treatment a global health emergency.¹

The percentages of HIV+ people accessing ARV treatment in richer countries make much better reading. In high-income areas, such as Western Europe, treatment is available to almost everybody who needs it. However, even in the USA, the richest country in the world, some of the poorest people who do not have health insurance are missing out on treatment. The cost of the drugs in high-income countries is now much higher than the prices being offered to developing countries, and there have been concerns that public healthcare services will not be able to shoulder the burden of paying for new expensive drugs.

There are some notable exceptions in the developing world, where people are receiving sustainable and free/cheap treatment. Brazil has been providing its citizens with ARV drugs for many years, and African countries such as Uganda and Botswana are in the process of expanding ambitious ARV distribution programmes. Other countries have made commitments to start providing free treatment, such as India. As well as countrywide initiatives, global organisations and funding bodies are rolling-out plans to increase ARV coverage.

Never before in the history of the epidemic has so much money been available to finance treatment and care for HIV+ people, and never before have antiretroviral medicines been made so cheaply and plentifully available. But still, every day, 8,000 people are dying from a disease which can be treated, but which all too often isn't.

Who sets what targets?

In December 2003, the World Health Organisation (WHO) announced a strategy aiming to bring ARV treatment to 3 million people living with HIV in developing and transitional countries by 2005. Calling this strategy the "3 by 5" initiative (3 million people by 2005), the WHO said it hoped to see 700,000 people on ARV therapy by December 2004, 1.6 million people by June 2005 and 3 million by December 2005. This 3 million represents 50% of the number of people expected to be in need of treatment at the end of 2005.

The WHO is not intending to actually purchase and supply the ARVs themselves. They will be working in partnership with global organisations such as UNAIDS; The Global Fund to Fight AIDS, Tuberculosis and Malaria; the US Presidential Emergency Plan for AIDS Relief; and The World Bank, as well as national governments and Non-Governmental Organisations (NGOs) already working in developing countries, to implement the new guidelines and targets, and to provide support and expertise.

Essentially, whilst they won't actually be buying drugs, they will help governments in badly-affected countries to set up a comprehensive national response to HIV and AIDS. As regards treatment, they will advise on issues such as :

• How to go about applying for funding to buy drugs
• How to actually purchase a regular supply of high-quality, affordable medicines
• How to train medical staff
• How to get drugs to the people who need them.

The exact 3 by 5 targets are :

By June 2004 there should be

• 20 countries using the AIDS Medicines and Diagnostics Service (AMDS) service
• 25 countries with national implementation plans
• 35 countries establishing ARV therapy targets
• 200 additional WHO staff deployed to country offices
• 1,500 partnerships between ARV therapy outlets and community-groups
• 10,000 health providers trained to provide ARV therapy
• 500,000 people receiving ARVs in developing countries.

By December 2004 there should be

• 30 countries using the AMDS service
• 35 countries with national implementation plans
• 50 countries establishing ARV therapy targets
• 400 additional WHO staff deployed to country offices
• 3,000 partnerships between ARV therapy outlets and community-groups
• 30,000 health providers trained to provide ARV therapy
• 700,000 people receiving ARVs in developing countries.

By June 2005 there should be

• 40 countries using the AMDS service
• 60 countries with national implementation plans
• 60 countries establishing ARV therapy targets
• 440 additional WHO staff deployed to country offices
• 9,000 partnerships between ARV therapy outlets and community-groups
• 70,000 health providers trained to provide ARV therapy
• 1,600,000 people receiving ARVs in developing countries.

By December 2005 there should be

• 50 countries using the AMDS service
• 60 countries with national implementation plans
• 60 countries establishing ARV therapy targets
• 480 additional WHO staff deployed to country offices
• 30,000 partnerships between ARV therapy outlets and community-groups
• 100,000 health providers trained to provide ARV therapy
• 3,000,000 people receiving ARVs in developing countries.

In December 2004 there were

• an unknown number of countries using the AMDS service (there were 29 in June 2004, and 37 countries were provided with drugs by UNICEF, a member of AMDS, in the eighteen months up to the end of 2004)
• 40 countries with national implementation plans
• 30 countries establishing ARV therapy targets
• 112 additional WHO staff deployed to country offices
• an unknown number of partnerships between ARV therapy outlets and community-groups
• an unkonwn number of health providers trained to provide ARV therapy (15,000 in June 2004)
• 700,000 people receiving ARVs in developing countries (440,000 in June 2004).

Despite falling short of the June 2004 target, the number of people on treatment was back on track at the end of 2004. However, an enormous effort will be required to meet the goal of 3 million by the end of 2005. Having said in November that this target was unlikely to be met², the Director-General of WHO wrote in January 2005 that "many real challenges must still be overcome, but they are not insurmountable".

The Director-General has also pointed out that, even if 3 by 5 doesn't succeed within the intended timeframe, this doesn't mean that it should be given up as a failure. Much of 3 by 5's work has been to set up structures by which medication can be delivered to those who most need it. Once the structures are in place, the delivery of medication should begin to accelerate, and the project should ultimately be able to help more than the three million people it was originally intended to.

It should be remembered that treatment for these 700,000 people was not funded by the 3 by 5 initiative itself. The drugs may be paid for by donors such as PEPFAR and the Global Fund; by the affected countries; by employers; or by the recipients themselves.

One of the main players in getting ARV medication to people around the world is US President George Bush. The President's Emergency Plan for AIDS Relief, (PEPFAR) proposed by President Bush in early 2003 was to commit US$15 billion over a five-year period. The money was to be spent on financing the fight against AIDS in low- and middle-income countries. About US$9 billion of this is new money, the remainder made up of money already allocated for overseas aid. About US$1 billion of this money has been pledged for the Global Fund.

Much of the PEPFAR funding is aimed at treating people with free AIDS drugs. PEPFAR backs the use of the expensive brand-name drugs from the big multinational pharmaceutical companies which invented them - and which stand to make considerable profits if they are bought in large quantities for developing countries. It has therefore been accused of directing vast sums of money to these American manufacturers at the cost of the health and lives of many people in African countries. However, in January 2005 the US FDA did for the first time approve two generic ARV drugs, which may now be bought with PEPFAR funds.

PEPFAR has a goal of having 2 million people on ARVs by 2008. It began spending the money in 2004 and allocated US$2.4 billion for the first year. By the end of September 2004, PEPFAR had helped to provide ARV therapy for 155,000 people in the focus countries (63% of total provision in those countries) and 17,000 elsewhere.³ The next target will be to have 200,000 people receiving ARV medication by June 2005. Included in PEPFAR statistics are one third of all people assisted by the Global Fund, since the US provides one third of Global Fund money.

AVERT.org has pages devoted to discussion of PEPFAR and the Global Fund, and another looking at TRIPS, AIDS and generic drugs .

Targets and results around the world

When the 3 by 5 initiative started, in December 2003, some 400,000 people were already accessing drugs. By June 2004, this global figure had risen by 40,000, meaning that 8% of all people in need were receiving treatment. Half of these people were living in Latin America and the Caribbean, where coverage was 54%, while just 4% of needy Africans had access.

At the end of 2004, an estimated 700,000 people were being provided drugs. Coverage had reached 65% in the Americas but all other regions had still not exceeded 10%.

The 3 by 5 target is for half of all people in need of ARV drugs to be receiving them. This is not the same as each individual country reaching 50% coverage. Many of the worst affected nations had very low rates of provision when the intitiative was launched, and access will remain unequal even if the December 2005 goal is achieved. Crucial to 3 by 5 success will be the progress of South Africa, India and Nigeria. At the end of 2004, these three nations between them accounted for 41% of unmet need. However, there are many countries which have severe HIV epidemics but whose achievements will have little effect on the total figures. The profiles below present a range of situations from around the world.

Africa

Africa has been hit by the HIV epidemic much harder than any other region. Large variations exist between individual countries in Africa, but UNAIDS/WHO estimates that 25.4 million people were living with HIV in the Sub-Saharan region at the end of 2004, out of a global total of 39.4 million. Across Africa, UNAIDS/WHO estimate that 310,000 (8% of those in need) were accessing ARV treatment at the end of 2004.

Botswana

There were estimated to be 350,000 people living with HIV in Botswana at the end of 2003. This gives Botswana a prevalence rate of 37% - the second highest in the world. Of all African countries, Botswana is doing the most to provide its citizens with improved healthcare and prevention and, perhaps most importantly, it was the first country in Sub-Saharan Africa to start to offer ARVs to all who need them through its public health system. The project aims to improve awareness, education, testing and counseling. As this progresses, the aim is to implement and significantly expand HIV treatment and care.

Implementation of the ARV programme started at Princess Marina Hospital in 2001, and has since expanded to at least twenty-three sites. Alongside this government/private partnership are initiatives set up by employers to provide education and treatment for their employees. About one quarter of people receiving treatment do so through private facilities.

At the end of 2004, around half (36,000-39,000) of the 75,000 people needing treatment were receiving it. This represents more than a doubling of access within six months. Free public sector provision rose gradually from a few hundred people at the start of 2002 to nearly 5,000 in September 2003, before soaring to above 18,000 one year later. The government target is to have 47,500 on treatment (public and private sector) by the end of 2005.

Find out more about HIV & AIDS in Botswana .

Uganda

At the end of 2003, there were 530,000 people living with HIV in Uganda, according to UNAIDS data. The country has had great success in reducing adult HIV prevalence from above 30% in the early 90s to 4.1% in December 2003. Uganda's actions have been widely praised and are seen by many as providing a model for other nations.

Uganda ran one of the first pilot ARV programmes in Africa. It began in 1998 and aimed to see how an ARV programme could be set up and run in a resource-poor country. The 399 patients involved were responsible for paying for their treatment, and bought their drugs at negotiated reduced prices. At the end of the two-year pilot, patients reported good adherence to treatment and virological and immunological responses to ARVs were similar to those found in Western countries.⁴ The Ugandan Ministry of Health has since incorporated the essential elements of the scheme into its National Strategic Framework for HIV/AIDS.

In Uganda, programmes are being designed to bring ARVs to the wider impoverished public sector. There are also some private initiatives starting, spurred on by the reducing costs of drugs and the perceived benefits to employers from having healthy staff. At the end of 2004, UNAIDS/WHO estimated that 40,000-50,000 people were being treated. This represents great progress towards the government target of 60,000 on treatment by the end of 2005. However, it is estimated that at least 114,000 people are in need of drugs.

Take a closer look at HIV & AIDS in Uganda .

Malawi

Malawi has an HIV prevalence rate of 14%, which translates to 900,000 people infected. Of these, it has been estimated that at least 170,000 are in need of HIV treatment. At the end of 2004, just 6% (10,000-12,000) of these needy people were receiving drugs through the public sector, as well as treatment initiatives run by aid agencies like Medecines Sans Frontieres. Although this is still a small number, progress has been made since reports of 3,760 people on treatment in June 2004.

The government did come up with an ambitious plan to treat all 300,000 people who needed it and wanted to submit the US$1.62 billion plan to the Global Fund for HIV, TB and Malaria. However, after discussions about whether Malawi would be able to implement such an ambitious plan, the final accepted plan was scaled down to just 25,000 people, totalling US$196 million over five years. In the first two years of the five-year project, it was hoped that 70% of HIV positive pregnant women would be receiving Nevirapine and 10,000 patients would be on ARVs. Malawi has had two-year approved funding for its HIV/AIDS programme of nearly US$42 million. An appraisal of the healthcare infrastructure by WHO however, has confirmed that 50,000 could be treated in the public sector in the near future. In February 2004, the president of Malawi announced details of the first national HIV/AIDS policy. Its focus is to be on sustaining a multisectoral approach, promoting HIV/AIDS prevention, treatment, care and support.

The government now plans to provide free treatment to 80,000 by the end of 2005, thus exceeding their 3 by 5 target of 68,000. Progress towards this ambitious goal will be aided by Malawi's experience in implementing the DOTS strategy for TB control. The number of sites providing ARV therapy grew from three in January 2003 to more than twenty in September 2004.

South Africa

Nelson Mandela talks to a child who is receiving treatment in the MSF funded Khayelitsha Clinic in the Cape township of Khayelitsha.

The case for access to ARVs in South Africa has been the most high profile of all African countries. Data from the UNAIDS July 2004 report shows that 5.3 million people were living with HIV at the end of 2003, which gives a prevalence rate of 21.5%. This means that South Africa has more HIV+ people that any other country in the world.

As 2005 began, there was still very little public healthcare access to ARVs in South Africa. There is Post Exposure Prophylaxis (PEP) available for rape survivors and victims of sexual abuse. This has been the case only since April 2002. There is also a national Nevirapine distribution programme for HIV+ pregnant women to help prevent vertical transmission of HIV from mother to child.

Not until November 19th 2003 did the government finally gave approval to a plan to provide free ARVs to all who need them.

The Health Minister Manto Tshabalala-Msimang stated there would be one ARV 'service point' in each of the country's 53 health districts within a year, increasing to one service point in every local municipality within five years. In the same week, it was announced that HIV/AIDS funding was to be increased from R3.3 billion to R12 billion (US$1.8 billion). The executive director of the Medical Research Council Anthony Mbewu said the cost of implementing the plan would be US$45 million for the remainder of 2003/04 rising to US$700 million in 2007/08. It was estimated that 400,000 people will fulfil the criteria for starting treatment.

In December 2004, the WHO estimated that 42,000-67,000 were receiving drugs which, given the estimated 837,000 people in need, is a very small figure indeed. Furthermore, more than half of these people were accessing treatment through the private sector. Personal reports suggest that, at a local level, there is a significant gap between the actual proportion of people who are receiving treatment and the much higher published figure.

Find out more about HIV & AIDS in South Africa.

Asia

Access to public health provided ARV treatment is still scarce in Asia, though Thailand is leading the way in providing the drugs. Some countries have committed to providing treatment in the near future, with India and China being by far the most significant, due to their massive population and consequently the potential for many millions to become infected and therefore need treatment.

Thailand

In Thailand, the Ministry of Health began providing ARV monotherapy in 1992 and dual therapy in 1995. In 2000, the Ministry began promoting triple therapy as the norm, using mainly branded drugs. However, since then the use of generic copies has widened. The Government Pharmaceutical Organisation (GPO) produces seven ARV preparations, which are two to twenty-five times cheaper than the cheapest brand equivalents. Before 2000, the cost of a year's treatment of ARVs (2 NRTIs and a Protease Inhibitor) was US$600; by 2002 this had dropped to US$150. When cheap generic versions of ARVs became available in Thailand, the triple combination of d4T/3TC/nevirapine dropped to B1200 (US$18) per month, a price a lot of Thais could afford.

The use of generics allowed the treatment programme to expand more than eight-fold between 2001 and 2003 with only a 40% increase in budget.⁵ The ARV budget of Baht300 million for 2003 then increased to Baht800 million for 2004.

The Thai Red Cross and the Ministry of Public Health supply all HIV-positive women with AZT and nevirapine during pregnancy, and milk formulas after the birth of their infant. ARVs are available through at least 914 public hospitals in the country, and may require part-payment by the patient.

It is thought that 45,000-55,000 people were receiving ARVs at the end of 2004, so the government target of 50,000 may have been reached. More than twice that number - 114,000 - are estimated to be in need. Thailand has also improved availability of CD4 testing and viral load testing, in conjunction with expanding access to ARVs.⁶

Find out more about HIV & AIDS in Thailand .

China

The Chinese government for many years denied the existence of HIV in the country. After years of denials, the government is now publicly addressing the problem. UNAIDS estimates that 840,000 people are living with HIV/AIDS. With a population estimated at over 1.2 billion, China has the potential to become the worst affected country in the world, and UN forecasts state that as many as 10 million could be infected by 2010.

In November 2003, the health minister Ga Qiang promised to expand the policy of 'four frees': free HIV testing, free ARVs, free care for HIV+ mothers and free education for AIDS orphans. Signs are hopeful that the government will indeed take the problem seriously, and on World AIDS Day 2003, the prime minister visited an AIDS care centre and shook a patient's hand, a highly symbolic move in a country still plagued by attitudes of stigma and discrimination. Whether these words are put into action will have to be seen, but with an estimated 122,000 in need, treatment cannot come soon enough.

Around 7,500-9,500 (7%) of those in need were receiving drugs in December 2004. As with most estimates about China, the size of the population makes it difficult to be clear on any exact figures. What is clear is that there are many more people in need of drugs than are actually receiving them.

Find out more about HIV & AIDS in China.

India

India has the second highest number of people living with HIV in the world, at 5.1 million. In December 2003, the government announced a US$43.6 million plan to offer free ARVs through the public health system, beginning April 2004. The drugs are expected to be provided by the three large generic drug manufacturers in India, who are currently making cheap ARVs for other developing countries. The plan by the government was to initially treat 100,000 people in the first year, beginning with HIV+ pregnant women, all children under 15 and eventually all people with an AIDS defining illness in the six states with the worst rates of infection.

The plan has however been criticised by non-governmental organisations as too ambitious. Problems which have yet to be overcome include the government agreeing to reduce tax rates on drugs produced to reduce the overall cost of the drugs, financing the whole initiative and improving laboratory monitoring and improving healthcare systems. In January 2004, the head of Cipla, one of the manufacturers involved, said that "if the government wants to buy, they must let us know for how many, when, and do they have the money"⁷. Another problem to be overcome is the issue of the generic drugs losing their patent protection from 2005, when the WTO agreement on intellectual property rights comes into effect^{8, 9}. About 20,000-36,000 people were receiving drugs at the end of 2004 (mostly through the private sector), out of an estimated 770,000 who needed them.

At the moment, despite the fact that India is a major producer of cheap generic copies of many HIV/AIDS drugs that are being sold to many countries all over the world, they are affordable to a tiny fraction of people in need of treatment in India.

Find out more about HIV & AIDS in India.

Latin America and the Caribbean

Of all developing and transitional regions, Latin America and the Caribbean has by far the most comprehensive ARV treatment coverage, with 65% of those in need receiving drugs. More than a third of those being treated live in Brazil, which is a world leader in providing ARVs free to its population, achieved mainly through in-country production of cheap generic ARVs. Progress in other countries varies widely.

Brazil

In 1988, Brazil began to offer drugs to treat opportunistic infections. Then, in 1991, Zidovudine began to be offered. In November 1996, the government agreed to start providing free ARVs. The government does purchase some drugs from abroad, but the programme is based upon the domestic producers being able to supply cheap generic copies of branded ARVs. The government has said that the logistics of their programme are threatened by the high prices of bought-in ARVs, but they persist in the plan because deaths have been reduced, and quality of life has greatly improved for those living with HIV. It was estimated in 2003 that 660,000 people were living with HIV, 60% of whom were unaware of their infection.¹⁰

In 1997, an estimated 35,900 people were receiving treatment. This increased to 55,600 in 1998; 105,000 in 2001; and 140,000 in June 2004. At the end of 2004, between 154,000 and 160,000 people were receiving treatment, of an estimated 179,000 in need. Spending on ARVS has followed the same pattern, increasing from US$34 million in 1996 to US$232 million in 2001¹¹. In January 2004, it was announced that the government had reached a deal with pharmaceutical companies to reduce the price of AIDS anti-retroviral drugs by around a third. Health Minister Humberto Costa said the deal would save the government about US$100 million during the year. The price cuts brought the total annual cost of Brazil's AIDS treatment programme to its lowest level since 1999 - US$180m - while cutting the average cost per patient to a new low of US$1,200¹². The government proudly stated that they had halved the number of AIDS-related deaths since 1996, when the distribution of free drugs began.

Cuba

Cuba set up its National Commission on AIDS in 1983, three years before its first case was diagnosed. It has since had a 'strong-arm' approach to dealing with HIV, quarantining those diagnosed, having strict partner tracing programmes, as well as having compulsory 8 week education programmes for those diagnosed and providing ARVs for all pregnant women. Just a handful of children have ever been born HIV+ on the island. Cuba consequently has one of the lowest prevalence rates in the world, at 0.1%. At the end of 2003, there were 3,300 people living with HIV.

No ARVs were available in Cuba up until 2001 because of the US trade embargo. However, in 2001, Cuban laboratories began making generic ARVs and now Cuba is one of only a few developing countries producing their own supplies of the drugs to all people living with HIV who need treatment¹³. Latest available data records 1,500-2,000 people receiving ARVs in Cuba, which is more than the number thought by UNAIDS/WHO to be in immediate need. The island's mortality rate from AIDS has now dropped to as low as 7% of patients with AIDS. Because of it success in providing ARVs for its own population, Cuba is now looking to export generic drugs to other developing countries.

Haiti

It is estimated that 280,000 people are living with HIV in Haiti, which gives the country a prevalence rate of 5.6%. The yearly total health budget is US$15 million, so the government could not have provided ARV treatment unassisted. Treatment began in 1998 in rural Haiti through a US organisation called Partners in Health. The Global Health Fund, USAID and the Bush Presidential Emergency Relief Fund all later pledged money for Haiti.

The Global Fund was the first international donor to provide money for ARV purchasing. In conjunction with the Haitian Ministry of Public Health, money has been used to provide HIV prevention and treatment throughout the country; in Port au Prince at GHESKIO centres and in central Haiti by Partners in Health's HIV Equity Initiative. Providing a comprehensive treatment programme has necessitated revitalising the public health infrastructure, and this has subsequently improved basic healthcare for all.^{14, 15, 16}

At the end of 2004, an estimated 3,000-4,000 people were using ARVs, out of 42,500 in need. It seems certain that the government failed to meet their target of 5,000-10,000 people on treatment by the end of 2004.

AVERT.org has more information about HIV & AIDS in Latin America and the Caribbean.

High-income countries

Access to ARVs in high-income countries has been less of an issue than in other parts of the world, as funds have been available to purchase and distribute the drugs. These countries are not included in 3 by 5 statistics.

The epidemic has been established in many high-income countries since the 1980s, including the USA and Western Europe. These countries had already established medical and care facilities so that people living with HIV could immediately access care and treatment. Providing ARVs has not been without its problems, though. The price of the drugs is very high; at US$20,000 per person per year, the cost of the new fusion inhibitor T20 are by far the highest for any ARV ever produced, and it was announced in January 2004 that the price of Ritonavir was to be increased by 500% in the USA.

United Kingdom

It is estimated that 49,500 people are living with HIV in the UK, one third of whom are undiagnosed. The year 2003 saw the highest ever annual number of diagnoses. The introduction of combination therapy in 1996 led to a big decrease in the number of AIDS-related deaths. It also meant higher costs for treatment and care, as everyone who is HIV+ and legally entitled to reside in the UK is entitled to free healthcare. The combination of more people living longer and needing treatment and increasing numbers of new infections meant that costs were ever increasing to cover the costs of ARVs. In 2000, it was estimated that the average lifetime treatment cost for someone living with HIV would be between £135,000 and £181,000.¹⁷ This figure is for all treatment, including hospital costs, not just the price of the drugs.

According to the National Association of NHS Providers of AIDS Care and Treatment (PACT), the cost of managing a patient with HIV is £15,000 per year. The total cost of treatment and care in 2002-03 was £345 million.¹⁸ According to SOPHID data, there were 23,031 people accessing anti-retroviral therapy in England, Wales and Northern Ireland in 2003.¹⁹

United States of America

The first AIDS drugs were developed in 1987, four years after HIV was first identified. Since the mid-1990s, when combination therapy was introduced, US AIDS deaths have dropped about 70%. In 2003, the number of people living with AIDS in the USA was 384,906.

Most people in the US access their care and treatment through privately bought health insurance, as there is no country-wide state provision of healthcare. However, not all people can afford insurance. Instead they use Medicaid or Medicare, programs that pay for medical assistance for certain individuals and families with low incomes and resources. These programs provide medical long-term care assistance to people who meet certain eligibility criteria.

Since 1987, AIDS Drug Assistance Programs (ADAPs), which are federally and state-funded and state-run, have made treatments available primarily to low-income HIV patients who do not qualify for Medicaid. Currently, ADAPs buy around 20 percent of the HIV drugs prescribed in the United States, enough for 92,000 people.²⁰ So far, 11 states have been forced to close ADAP enrolment for new patients. Others have tightened income-eligibility criteria. In April 2004, 1,263 people nationwide were waiting to access any kind of treatment through ADAPs.²¹ There are, even in America, people who die for want of AIDS drugs.²²

AVERT.org has more information on HIV & AIDS in high-income countries.

Stop AIDS, keep the promise

There is no quick-fix solution to the AIDS epidemic. Political momentum is building and governments around the world are showing their willingness to help alleviate the suffering. Definite targets have been set which are both ambitious and entirely attainable. The theme of World AIDS Day 2005 is 'Stop AIDS, Keep the Promise'. If the promises that have been made thus far have been kept then a real difference will have been made to millions of people's lives.

More information about numbers of people around the world receiving and needing ARV treatment can be found in our drug access table, and AVERT.org has a page discussing the issues involved in treatment provision.

Last updated March 2, 2005

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