For Immediate Release:	May 24, 2006
For More Information:	Gregg Gonsalves, International Treatment Preparedness Coalition, gregggonsalves@earthlink.net, +1 (212) 367-1169 Chris Collins, International Treatment Preparedness Coalition, ChrisCSF@aol.com, +1 (845) 701 0158 Kay Marshall, International Treatment Preparedness Coalition, kaymarshall@mac.com, +1 (347) 249-6375 Fatima Hassan, International Treatment Preparedness Coalition, hassanf@law.wits.ac.za, + 272 146 75 628
Sponsor Organization:	International Treatment Preparedness Coalition (ITPC)
Updated country-based assessment found limited progress Bureaucracy, inadequate funding, stigma, insufficient national and international leadership delay AIDS treatment scale-up
New York, 24 May 2006 – The world will fall far short of its goal of ‘near universal access to HIV/AIDS treatment by 2010’ unless international leaders at UNGASS make a bold, measurable commitment to AIDS treatment scale-up, the International Treatment Preparedness Coalition (ITPC), a group of 700 treatment activists from more than 100 countries, warned today. In a new update to its November 2005 report on scale-up of AIDS treatment access, ITPC found that despite some progress, serious barriers – including halfhearted national and international leadership, weak management at all levels, sluggish implementation reforms, poor logistics and technical support, and dangerously inadequate funding continue to plague delivery of AIDS treatment in less developed countries. Missing the Target – Off Target for 2010: How to Avoid Breaking the Promise of Universal Access is the first semiannual update to Missing the Target: A Report on HIV/AIDS Treatment Access from the Frontlines. The new report, released as world leaders prepare to meet for the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) next week to reaffirm their commitment to universal access, details actions needed at national and international levels to turn the promises into reality. (Click here for report) “Today, universal access is just a slogan. It cannot be achieved unless we have a coordinated strategy with adequate funding and management,” said Fatima Hassan, author of the South African chapter of the report. “So far the international community has gone out of its way to avoid setting an explicit global treatment target. If the world leaders meeting for UNGASS are serious about universal access to HIV/AIDS treatment they must set a real treatment target and commit to increasing funding and ensuring that national and multilateral agencies accelerate meaningful reforms,” she added. Researched and written by treatment advocates on the frontlines in six of the countries hardest hit by AIDS – Dominican Republic, Kenya, and South Africa and “next wave” countries India, Nigeria, and Russia – the update surveys efforts made in the last six months by individual countries and multilateral institutions to scaleup programs to meet the internationally endorsed treatment goal of near universal access by 2010. Country Update ITPC found that while some progress has been made in every country, most of the barriers identified in the original report remain, including: In the Dominican Republic treatment delivery is expanding but people in some of the poorest areas with the highest rates of HIV are still not being reached. Government and donor agencies are still not collaborating efficiently, scarce resources have been squandered, and second line drugs cost 10 to 20 times more than first line generics. In India, hundreds of thousands of people in need still do not have access to antiretroviral therapy, even though the number of treatment centers has increased. National treatment guidelines need to be reformed and clear action to reach children and ensure greater equity in care is needed. In Kenya, AIDS treatment services have been undercut by growing food shortages in some areas. Stigma and critical shortages of healthcare workers continue to be major problems. Government delays in submitting audit reports held-up the release of Global Fund monies. In Nigeria, more treatment centers have opened across the country, but the suspension of two grants by the Global Fund -- because the country failed to meet targets on drug access and demonstrate transparency -- is potentially devastating to the government’s pledge to make treatment available and free. In Russia, government funding has grown, but these new resources have yet to translate into significant increases in treatment delivery. There is an urgent need for services appropriate for injection drug users, as well better health care worker training, more efficient drug procurement, and comprehensive anti-stigma efforts. In South Africa, the number of people on treatment has increased, but scale-up efforts continue to lag due to inadequate national leadership, government efforts to inhibit civil society participation, pervasive AIDS denialism, and a virtually non-functional Global Fund Country Coordinating Mechanism. Children and men also need greater access to treatment. Swift and dramatic changes are needed in all countries and at the international level to ensure that national treatment goals and universal access will be met. “More than three million people in Nigeria are infected with HIV, which means that we cannot achieve anywhere near universal access unless Nigerians have access to treatment, said Olayide Akanni, of Journalists Against AIDS Nigeria and a member of ITPC. “The cancellation of two global fund grants to our country increases the responsibility of funders, global institutions, and the Nigerian government to quickly find new solutions, change approaches, and ensure scale up continues,” she added. International Organization Update After the release of its initial report, ITPC wrote to the major international institutions – the Global Fund to Fight AIDS, Tuberculosis and Malaria; UNAIDS; WHO; and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) – to ask what they were doing to address the challenges identified in Missing the Target. In responding to ITPC, all of the agencies outlined plans that include working toward a more coordinated, efficient global effort that can better meet the needs of countries; build sustainable systems; and integrate HIV prevention, tuberculosis and other programs with HIV treatment. (Full responses available at http://www.aidstreatmentaccess.org/responses0506.htm) While there is evidence of hard work and noble intentions, change is coming far too slowly. ITPC is calling for a clear global AIDS treatment target that can focus attention on specific outcomes, acknowledge the responsibilities of global institutions as well as countries, and drive accountability. “The international community rightly asserts the importance of country-driven responses,” said Gregg Gonsalves, Director of Treatment and Prevention Advocacy at Gay Men's Health Crisis and a member of ITPC. “But country-driven does not mean leaving countries on their own. Countries that sometimes fail in implementation must not be abandoned. National leaders who fail to address the AIDS epidemic must be challenged by their own citizens and the international community.” “International and bilateral agencies will be judged on their ability to help countries set ambitious treatment and prevention goals and make steady progress on scale up of AIDS services,” he added. ITPC’s country research suggests that integrated TB/HIV activities (such as HIV testing for TB patients and referral and linkages between TB and HIV programs) remain inadequate. Much more work needs to take place in all focus countries to scale up TB/HIV activities in order reduce the impact of TB – the leading infectious killer of PLWHA. Missing the Target – Off Target for 2010 calls for increased funding for multilateral and bilateral agencies responding to HIV/AIDS as well as changes at these agencies, including: The Global Fund needs to identify new strategies to address failing grants and weak Country Coordinating Mechanisms. The WHO must show tangible outcomes in terms of ambitious national plans and resolution of barriers in countries. Funding shortfalls threaten to undermine WHO’s AIDS efforts. Director General JW Lee’s leadership in spearheading the 3x5 initiative put WHO at the forefront of the global treatment response. His successor must be someone with an unwavering commitment to forthright, visible, and sustained advocacy for universal access, who will aggressively seek much greater funding for WHO's HIV/AIDS related work, and who will pro-actively work with countries to set meaningful, measurable national prevention, treatment, and care scale-up targets towards universal access by 2010. UNAIDS needs to show faster progress on UN system collaboration and in developing a true strategic plan for accomplishing universal access. PEPFAR must end counterproductive policy prescriptions that undermine service delivery, and it must do more to build human resources capacity in countries. Missing the Target calls on donor nations to provide adequate funding for the Global Fund and other agencies. “It is irresponsible for the global community to commit to coming close to universal access and then not appropriately fund the major multilateral financing mechanism designed to increase access,” said Joe Thomas, a member of ITPC and co-author of the report’s chapter on India. “Unless there is adequate funding and real change in the way these agencies do business, the pledge to provide universal access by 2010 will be a cruel joke for people living with HIV and AIDS in India and around the world,” he added. “A true commitment to universal access by 2010, with full funding and support for national and multilateral programs would give the world a new paradigm for global healthcare,” said Chris Collins, a member of ITPC. He added, “If the leaders meeting at the United Nations to discuss the AIDS pandemic act now and act decisively, they have the power to save the lives of millions of men, women, and children who will otherwise needlessly die.” Click here for the full report. # # # About the International Treatment Preparedness Coalition The International Treatment Preparedness Coalition (ITPC) was born at the International Treatment Preparedness Summit that took place in Cape Town, South Africa in March 2003. That meeting brought together for the first time community-based treatment activists and educators from over 60 countries. Since the Summit, ITPC has grown to include over 700 activists from around the world and has emerged as a leading civil society coalition on treatment preparedness and access issues. ITPC published its first report, Missing the Target – A Report on HIV/AIDS Treatment Access from the Frontlines, in November 2005. Major recommendations from the first report were endorsed by The Lancet Infectious Disease. More information is available at http://www.aidstreatmentaccess.org.