Universal access to anti-retroviral (ARV) medication for HIV/AIDS is the clarion call of the WHO/UNAIDS 3 by 5 Initiative. Treatment coverage, however, remains highly uneven. This sharpens the question of who exactly is accessing ARVs and whether access is challenging inequality or reinforcing it. Issues of distributive justice have long been debated in health policy, but the practical challenges of ARV distribution are relatively new. In exploring what a more equitable process of ARV distribution could involve, this article draws on a human rights framework using case study material from Zambia.
Equity and HIV/AIDS
On a never-ending waiting list: Toward equitable access to anti-retroviral treatment? Experiences from Zambia
Scaling-up ART and the health system in southern Africa
This note, prepared for a UNAIDS workshop on Vulnerability and AIDS, provides a number of observations and opinions on the feasibility of scaling up anti-retroviral treatment (ART) in sub-Saharan Africa. The document reviews lessons learned from various hospitals and health centres delivering ART in southern Africa, and highlights considerable human resource constraints. For instance, in South Africa, it is estimated that for every 500 ART patients, they need as many as 10 permanent staff. Other pilots have similar staff/patient ratios.
Global Fund withdraws support for loveLife in South Africa
The Global Fund to fight HIV/AIDS, Tuberculosis and Malaria has pulled the plug on financing loveLife, a controversial South African youth-targeted HIV/AIDS campaign. In a statement the Global Fund board said it had found that loveLife "was deemed to not have sufficiently addressed weaknesses in its implementation". Global Fund spokesman Jon Liden said it had become difficult to measure how the prevention campaign was contributing to the reduction of HIV/AIDS among young people.
New drugs urgently needed in Africa
The lack of newer AIDS drugs in Africa could jeopardise the lives of people already receiving the treatment, medical humanitarian organisation Medecins Sans Frontieres (MSF) has warned. With many countries on the continent embarking on national programmes to provide antiretrovirals (ARVs), the first-line drug regimen has become cheaper and widely available. But as resistance to the basic drugs inevitably builds up, there will be a need for a second generation of drugs within a few years.
South Africa: The impact of AIDS - new report
An AIDS epidemic as severe as the one plowing through South Africa will change society. But how and along what lines? Buckling: The impact of AIDS in South Africa, a new publication by Hein Marais, tackles the question in distinctive and critical-minded fashion – and arrives at disquieting and surprising conclusions. A detailed, multidisciplinary review of research evidence, this short book adopts a unique perspective which reveals more clearly the contingency and complexity of the epidemic's effects. It shows how conventional conceptions of AIDS impact (and programme responses) tend to reflect dominant ideological fixations – particularly the overriding emphasis on productive processes and economic growth, governance and security – and how the wellbeing of humans typically is refracted through those preoccupations.
Further details: /newsletter/id/31245
Steady progress as ARV rollout gathers momentum in Mozambique
When Maria (last name withheld), 35 years old and HIV-positive, reflects on the past year she gives an answer that a growing number of Mozambicans living with HIV/AIDS would probably echo. "The year 2005 has been good for my health. It has got so much better because this year I started taking ARVs (antiretroviral drugs)," she told PlusNews. Maria is one of 17,000 people now accessing ARVs of a national target to treat 20,000 people by the end of 2005.
WHO '3 by 5' target missed in Zimbabwe
Zimbabwe has failed to meet the World Health Organization (WHO) target of providing anti-AIDS drugs to at least 120,000 HIV-positive people by the end of 2005, local newspaper The Daily Mirror reported on Tuesday. The lack of adequate foreign currency to purchase medicines and the low numbers of people being tested for the virus prevented the country from even reaching its own target of 55,000 people receiving the life-prolonging medication by the end of 2005.
Africa: Beyond ABC - The challenge of prevention
In theory, preventing HIV/AIDS seems simple enough: give people information on how the disease is spread, and the desire for self-preservation will, naturally, make them adopt safer sexual behaviour. The reality has proved much more complex. Almost 30 years after it was first diagnosed, ignorance about HIV/AIDS still persists. According to the UNAIDS Epidemic Update for 2005, [www.unaids.org] "there is new evidence that prevention programmes initiated some time ago are currently helping to bring down HIV prevalence in Kenya and Zimbabwe" but, overall, prevention efforts have a poor track record, particularly in sub-Saharan Africa, which is home to two-thirds of all people living with HIV.
Africa: Global ARV Needs Far Short of Targets
The world's need for antiretroviral drug (ARV) access is "far from met" due to funding shortfalls, Richard Feachem, executive director of the Global Fund, has said following the release of a UNAIDS epidemic update. Stressing that the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria was still in need of US $3.3 billion to meet its 2006 and 2007 goals, Feachem said the UNAIDS report was an affirmation that global investments and commitment could have an impact on the devastation of the pandemic.
HIV transmission still on the up, says UN report
There is new evidence that adult HIV infection rates have decreased in certain countries and that changes in behaviour to prevent infection - such as increased use of condoms, delay of first sexual experience and fewer sexual partners - have played a key part in these declines. A new UN report - Aids Epidemic Update - also indicates, however, that overall trends in HIV transmission are still increasing, and that far greater HIV prevention efforts are needed to slow the epidemic. Kenya, Zimbabwe and some countries in the Caribbean region all show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya from a peak of 10% in the late 1990s to 7% in 2003 and evidence of drops in HIV rates among pregnant women in Zimbabwe from 26% in 2003 to 21% in 2004. In urban areas of Burkina Faso prevalence among young pregnant women declined from around 4% in 2001 to just under 2% in 2003.