Medicines, money and motivated health workers are key to universal access to HIV/AIDS prevention, treatment care and support
A "borderless society for health" necessary to make greater inroads: WHO Acting Director-General
18 August 2006 | Toronto - Today, Dr Anders Nordström, Acting Director-General of the World Health Organization told delegates at the XVIth International AIDS Conference that "drastic measures" were required to ensure there are enough health workers available to deliver universal access to HIV/AIDS prevention, treatment, care and support by 2010. He also welcomed the broad consensus at the conference that a comprehensive response to HIV/AIDS was essential.
In a speech at Friday's closing session, Dr Nordström stressed that "money, medicines and a motivated, skilled workforce" were key to delivering universal access.
Money – urgent gaps, and long-term support
He underscored that the funds available for HIV/AIDS globally were growing, but, so were the needs. "Worldwide, resources for HIV/AIDS have increased to over US$ 8 billion a year. But that is still not enough. The estimated need in low- and middle-income countries is US$ 15 billion this year, and that will grow to US$ 22 billion in 2008.
"That widening gap must be filled, and commitment sustained. It calls for more than traditional international development assistance."
Dr Nordström praised recent initiatives aimed at providing sustainable financing mechanisms, such as the UNITAID initiative of France, Brazil, Chile, Norway and the United Kingdom, which uses a levy on airline taxes to channel new money to HIV work. He also noted that new potential mechanisms - such as advance market commitments - could provide incentives for research and development into new medicines and vaccines. He stressed that developed countries, including the G8, must live up to their financial and political HIV/AIDS commitments, and that national governments must also spend more on health domestically, and make HIV/AIDS a funding priority.
Medicines - access to drugs remains critical
Dr Nordström noted that "3 by 5" – the WHO and UNAIDS initiative to expand access to antiretroviral treatment to 3 million people in low- and middle-income countries by the end of 2005 - had influenced the HIV/AIDS landscape. He paid tribute to Dr LEE Jong-wook, WHO's former Director-General, and his role in forcing a shift in approach and attitude to access to treatment.
"This is demonstrated through a ten-fold increase in people on treatment in sub-Saharan Africa," he said. “But the challenges in that region also illustrate what still needs to be done. Seventy per cent of the global unmet need for treatment is in Africa.”
He stressed that drug pricing was still an issue - to ensure that both first-line and second-line treatments were affordable. "There is growing momentum for innovation, research and addressing intellectual property issues to ensure maximum access to new products that save lives.
"We need ideas to turn into new drugs and diagnostics that strengthen our ability to safely treat infants and children as well as adults. We also need a vaccine and a microbicide."
Without health workers, universal access not possible
"Universal access must include access to a skilled and motivated health worker," said Dr Nordström. "No improvement in financing or medical products can make a lasting difference in people's lives until the crisis in the health workforce is solved.”
He called for "drastic measures" to urgently strengthen the workforce. WHO's new ‘Treat, Train, Retain’ plan, launched this week at the conference, also demonstrates how ensuring prevention and treatment for health workers in a supportive work environment can help improve working conditions, and critically, keep staff healthy and motivated.
A health system also depends on stronger information and surveillance systems, logistics and distribution systems - all areas that WHO is helping national governments to address, he said.
A borderless society for health
Dr Nordström asked delegates to make universal access possible through "a borderless society for health. One that embraces all who can make a difference, from political leaders, scientists, health workers to young people, persons living with HIV, the poor, sex workers, injection drug users, people in prisons.”
Dr Nordström also stressed the need for a strong gender perspective to ensure that both women and men have equal opportunities.
Finally, Dr Nordström told delegates that, along with treatment, care and support, renewed attention must be paid to the prevention of HIV.
"Too many resources - time, energy and money - have been wasted on the debate over whether prevention or treatment should be the priority. At this conference we have come to a clearer understanding that it is not a case of doing one or the other. Millions have died through lack of both."
WHO’s contribution to achieving universal access to HIV prevention, treatment, care and support focuses on five strategic directions: scaling up HIV testing and counselling; maximizing the health sector’s role in prevention; scaling up treatment, care and support; strengthening health systems and investing in strategic information.
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