In 2003, the number of people living with HIV/AIDS reached 38 million, 9 million developed tuberculosis (TB), while malaria inflicted 300 million cases of acute illness. Sometimes these diseases combine to deal a double blow: HIV fuels the TB epidemic in ways that were unimaginable 20 years ago.

Roll Back Malaria, Stop TB and, more recently, the 3 by 5 effort to get antiretroviral treatment to 3 million people by the end of 2005, each represent the determination of WHO and its partners to fight back - to slow if not halt the suffering, loss and economic declines caused by these diseases.

Essential medicines underpin these efforts. They prolong and improve quality of life for people living with HIV/AIDS. They cure TB and malaria. But they need to be affordable, of good quality and used properly in the right dosage at the right time.

Knowledge and capacity exist

Twenty-six years of promoting and implementing the essential medicines concept mean that WHO has developed the most diverse and extensive concentration of essential medicines expertise in the world. The organization can advise on getting good-quality medicines to where they are needed, and how to get them administered and taken correctly. This in turn means generating the capacity to implement a national medicines policy, developing expertise in supply chain management, transferring knowledge of pharmaceutical norms and standards, making information on sources and prices freely available, strengthening regulatory capacity, and promoting good prescribing skills.

Yet for far too many people, essential medicines remain unaffordable. Sophisticated counterfeit medicines are a real danger. Confusion remains about what medicines supply systems work best and where. Quality and safety issues threaten treatment regimes and patient health. But as this report shows, solid progress is being made.

Progress is indeed possible as a result of the sustained support and collaboration of WHO's partner agencies, governments and nongovernmental organizations.

More over, the momentum, energy and passion generated around medicines for fighting HIV/AIDS, malaria and TB will be channelled into other ongoing efforts to ensure that all essential medicines reach the people who need them.

LEE Jong-wook
Director-General
World Health Organization