The World Health Organization (WHO) has launched a 3 by 5 strategy to treat three million people with HIV by 2005. The strategy will reflect the highest public health standards and will leverage resources and synergize action among interested stakeholders including Governments, institutions, agencies and programmes working with HIV-related activities at international, regional and local levels.

The 3 by 5 strategy recommends simplified HIV treatment regimens and expanded access to medicines. The strategy will ensure the supply of safe, effective and affordable medicines. WHO will assess the quality, safety and clinical efficacy of HIV medicines as single-drug, two-drug, and three-drug combination treatment through the WHO prequalification Project. A rigorous review process and ongoing quality monitoring will limit the entry of substandard and counterfeit medicines into the supply chain. In addition, the strategy will help build local regulatory and production capacity.

The current situation

HIV is rapidly spreading. It is on the rise again in Western Europe because integrated prevention and treatment programmes have not been sustained. Countries in Eastern Europe are home to the fastest-growing epidemic in the world which is crippling social and economic development. Over 1.5 million people are living with HIV in Eastern Europe and Central Asia, compared to only 30 000 in 1995. In Eastern Europe and Central Asia, only 7000 people receive antiretroviral therapy for HIV, which is 9% of those in need in the region. For many, the treatment is too expensive or simply not available.

WHO has also recently announced a plan to support the 3 by 5 strategy by expanding collaboration between national tuberculosis and HIV/ AIDS programmes to curb the growing pandemic of TB/HIV co-infection, with a principal focus on Africa where 70% of the world’s 14 million people who are co-infected live. A key element will be to rapidly expand voluntary HIV testing and counselling in TB programmes, with the aim of identifying and referring more than half a million TB patients who are HIV positive for treatment in the next two years. With additional training for health workers, TB programmes will also assist in HIV prevention, treatment distribution and patient care. Forty million people are currently infected with HIV, and 5 million more are infected every year. According to WHO, one third of the world’s population is now infected with the TB bacillus, with more than 8 million people developing the active disease and 2 million dying of it each year.

3 by 5 country support

The Initiative will provide assistance to all countries that are committed to scaling up treatment. Ninety percent of those needing antiretroviral medicines are found in just 34 high-burden countries. Much of the work will focus on these countries.

Following a formal request by national authorities to the WHO Country Representative, an emergency fact-finding mission is made to each country. The mission includes WHO and UNAIDS staff, country and global partners. Planning will be carried out through the WHO Country Office, with support from HQ, the Regional Office and local UNAIDS missions to gain country and partner involvement and commitment.

Implementation of the strategy will immediately follow the emergency mission and continue through the years of the initiative and beyond 2005. Keeping 3 by 5 going will take perseverance, public support and international financial aid. A situation room will be built in WHO headquarters to monitor all progress in all aspects of implementation of 3 by 5.

Reference: Information obtained from various documents at http://www.who.int/3by5/en/ and www.who.int/ medicines