WP Editorial: Action on AIDS

December 6, 2003

Washington Post

Action for AIDS

Saturday, December 6, 2003; Page A18

THE WORLD HEALTH Organization this week released details of its " 3 by 5 " plan --

by which it means to put 3 million HIV-infected people on anti-retroviral drugs

by the end of 2005. Eight thousand people a day die of AIDS. Even if the WHO

accomplishes its ambitious goal, it will reach only about half the people who

urgently need the drug therapies that can convert HIV from a death sentence into

a manageable chronic condition. Still, the WHO program -- along with the Bush

administration's commitment to spend $15 billion over the next five years and

the efforts of the Global Fund to Fight AIDS, Tuberculosis and Malaria -- is a

critical and belated response to a disease that is ravaging sub-Saharan Africa.

The problem of AIDS in Africa is so daunting that it has long paralyzed

policymakers. Africa's health care infrastructure is meager. Drugs are

expensive. AIDS patients cannot simply be cured and sent home; they have to be

treated for life. The principal accomplishment of the WHO plan is providing

manageable standards for delivering care to large numbers of patients in

settings that have long been considered too difficult to reach. The plan jumps

the high hurdles by simplifying everything: delivering a standardized package of

anti-retroviral therapies, for example, and training community health care

workers in dispensing them and providing related services. Drug prices are

expected to come down as more doses are purchased. Infrastructure will be

created. The document provides, for the first time, the outlines of a strategy

for attacking a global problem on a global level.

The estimated $5.5 billion needed to make this happen is meant to come from

various sources: governments in affected countries, the Global Fund, donor

nations. There is enough money in hand at least to get started. Congress is

poised to appropriate $2.4 billion, including $550 million for the Global Fund

-- significantly more than Mr. Bush requested -- and the Global Fund is ramping

up spending as well. But over the longer term, there is still a significant gap.

Despite having the second-largest economy in the world, Japan has contributed

less to the Global Fund than has the Bill & Melinda Gates Foundation. Australia

has not given a cent, and the oil-rich Gulf states have collectively pledged a

mere $10 million. The world's resource commitment must be generous, broad-based

and, as long as AIDS remains incurable, ongoing. The WHO has produced a kind of

road map for making care available, but a map is only useful if people are

willing to follow it.

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