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The number of people in low- and
middle income countries on antiretroviral treatment tripled from 400,000 in
2003 to 1.3 million in 2005. But millions more people still need
treatment. Brazil, with our support, took the decisive step of
guaranteeing free treatment for all who need it. We worked with the
Clinton Foundation and others to negotiate lower AIDS drug prices, and are
supporting efforts to scale up access to treatment in many countries in
Africa and the Caribbean. Our projects have helped increase the number
of sites that offer treatment in Malawi from 3 in early 2003 to 60 in 2005
and from 3 to more than 110 facilities in Zambia. In Rwanda, we
financed antiretroviral treatment for over 3,000 patients over two years,
and developed a provincial model for scaling up treatment that is now being
funded by PEPFAR and the Global Fund. The Treatment Acceleration
Project works with local and international NGOs in Burkina Faso, Ghana and
Mozambique, testing different models for scaling up antiretroviral
treatment, especially to poor people. Within just a year and a half,
this project has helped provide treatment and care to at least 20,000 people
while maintaining adherence rates of over 95%, and is learning and sharing
crucial lessons about how to expand treatment successfully and responsibly,
promote treatment adherence and prevention, monitor and minimize drug
resistance, and enhance program effectiveness.
Despite lower drug prices,
countries face major human resource, infrastructure and budgetary challenges
in expanding and sustaining treatment. We fund investments to
strengthen health systems, and work with countries to better integrate HIV
into broader national development plans, as one step towards long term,
sustainable, predictable financing. Our analysis with Thailand's
Health Ministry of the costs, benefits and implications of providing ART
helped Thailand decide on affordable and effective treatment regimens and
contributed to a national discussion on the need to reinvigorate prevention
efforts, which will limit future treatment needs. A similar costing
study underway in India will inform decisions on scaling up treatment. |
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