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Please click here for recent action alerts, news, and reports related to universal treatment access.

Did you know?

Millions of People Lack Treatment Access
Today there are at least 6.5 million people in developing countries in urgent need of antiretroviral (ARV) treatment.  But only 1.3 million people—just 20% of those in need—are receiving such therapy.  In sub-Saharan Africa, home to nearly two-thirds of all people with HIV/AIDS, only 11% of those in need are receiving ARVs.  Clearly, existing treatment programs need to be scaled up dramatically, and governments and other decision-makers must be held accountable for achieving concrete results. Click here to subscribe to Essential Action's Global Access to Medicines Bulletin.

Few Children Receiving AIDS Treatment
There are at least 2.3 million children under the age of 15 living with HIV/AIDS, and nearly 2,000 children are infected with HIV each day.  Some 660,000 children—most in sub-Saharan Africa—are in immediate need of antiretroviral treatment, and roughly half of all children with HIV/AIDS die before the age of two.  But while children account for 17% of global AIDS deaths, they make up only about 6% of those receiving ARV therapy.  In hard-hit countries, AIDS accounts for as many as half of all deaths among children under the age of five. 

Treatment Works—and Reinforces HIV Prevention
When antiretroviral medications were first developed, some questioned whether these complex AIDS treatment regimens could be administered effectively in poor countries that lack strong health care infrastructures.  But countless community-based service providers have proven that antiretroviral medicines can be delivered safely and effectively in resource-limited settings. In addition, just a few years ago, global AIDS advocates battled over whether scarce resources should be allocated to prevention or treatment.  Today, public health experts agree that prevention and treatment are both essential to an effective AIDS response—and must be scaled up jointly.  Indeed, evidence clearly shows that expanded treatment access reinforces HIV prevention through increased HIV testing, which in turn can help reduce the stigma and denial that drive the epidemic's spread.

Global Leaders Have Pledged to Achieve Universal Access
With the 2001 Declaration of Commitment on HIV/AIDS, all United Nations member states pledged to progressively provide the highest attainable standard of treatment for HIV/AIDS, including ARV therapy.  Since then, governments, the United Nations system, bilateral donors, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and civil society have increasingly focused on treatment as part of their commitment to scaling up the response to HIV/AIDS, and most countries with national AIDS plans have set specific treatment coverage targets.  In 2005, world leaders at both the G8 Summit and the Millennium Summit officially adopted the goal of ensuring universal treatment access by 2010. 

What needs to be done?

There are numerous obstacles to achieving universal treatment access:

Drug Prices Remain Too High
The cost of antiretroviral drugs remains a major obstacle to scaling up treatment programs.  Achieving and sustaining broad access to ARV therapy will require further declines in the prices of both HIV/AIDS medicines and diagnostic and monitoring technology, which remains far too expensive in many countries.  In addition, generically produced medications are essential to accelerating treatment access.  In early 2005, Doctors Without Borders estimated that roughly half of the 700,000 people receiving ARV therapy in developing countries relied on generic medications produced in India. 

Lack of Pediatric AIDS Medications
A major obstacle to treating children with HIV/AIDS is the lack of pediatric formulations of ARVs in the countries where they are needed most.  Pediatric drugs are considerably more expensive than adult formulations of the same medicines.  But pediatric fixed dose combinations (FDCs), which simply dosing and cut costs, are not available in most of sub-Saharan Africa.  And large agencies like PEPFAR do not purchase pediatric FDCs for use in their treatment programs.

Integrating HIV/AIDS and Sexual and Reproductive Health
For millions of women in developing countries who are now at the center of the HIV pandemic, reproductive health services are the primary point of contact with the health care system, and integrating sexual and reproductive health (SRH) and HIV/AIDS services will be critical to increasing the number of women receiving ARV treatment.  In particular, voluntary counseling and testing and prevention of mother-to-child transmission programs offer a vital pathway to both ARV treatment and reproductive health services.  Click here to learn more about GAA's work to accelerate SRH/HIV integration.

Increased Funding Essential
Increased resources are essential to scale up existing treatment programs, and the US and other G8 nations must be held accountable for providing the funding needed to fulfill their commitments to achieving universal treatment access by 2010.  In addition, wealthy governments and other stakeholders, including the private sector, must provide adequate support for the Global Fund to Fight AIDS, TB and Malaria, which is at the forefront of efforts to expand treatment access.  (The Global Fund will need at least $6 billion per year to meet projected demand, and increased demand from developing countries could raise that figure to $8 billion.  Current pledges for 2008 and beyond total less than $1.4 billion.)

Similarly, innovative financing mechanisms such as the Global Fund's Debt2Health initiative could generate significant resources to accelerate universal treatment access.  Click here to learn more about GAA's work on the Debt2Health initiative.

Eliminate Structural Barriers
Many poor countries have enormous foreign debt burdens that limit the amount they can spend on HIV/AIDS and other health care programs.  Reducing, and ultimately eliminating, this debt burden is critical to scaling up an effective response to HIV/AIDS.  Uganda, for example, was able to nearly triple its spending on primary healthcare as a result of debt relief, with $1.3 million earmarked for the country's national HIV/AIDS plan.  Similarly, Cameroon used part of a $114 million cut in debt service to fund HIV/AIDS programs.  In addition, international financing institutions such as the International Monetary Fund and World Bank need to eliminate health user fees that are a significant barrier to treatment access for poor people worldwide.

Strengthen Health Systems
Poor infrastructure and a lack of trained health workers are major obstacles to scaling up AIDS treatment programs.  Likewise, stronger health systems are needed to control the spread of tuberculosis, including new strains of extremely drug-resistant TB.  (Tuberculosis is actually the leading killer of people with AIDS in many poor countries.)  Importantly, scaling up AIDS services  and improving health systems are not competing priorities.  In fact, as Dr. Paul Farmer pointed out in a recent article in Foreign Affairs, well-designed HIV/AIDS programs can strengthen primary care and the health care infrastructure.

What is the Global AIDS Alliance doing?

The Global AIDS Alliance is committed to accelerating universal treatment access.  In particular, we are working to:

• Hold policymakers accountable for their commitments to ensure that at least 80% of all medically eligible people with HIV/AIDS have treatment access by 2010;
• Promote expanded access to affordable AIDS medications, including generically produced ARVs;
• Support the integration of HIV and sexual and reproductive health (SRH) programs;
• Promote expanded availability of pediatric antiretrovirals; and
• Increase funding for AIDS treatment, including advancing innovative financing mechanisms.

GAA continuously monitors stakeholders such as the Global Fund and the President's Emergency Plan for AIDS Relief (PEPFAR) to track progress toward universal treatment access and identify potential roadblocks.  We work with other advocacy groups to pressure brand-name pharmaceutical companies to reduce drug prices, and to help ensure that India remains an essential source of affordable generic HIV/AIDS medications.  We are pursuing a range of efforts to promote increased Global Fund investments in programs that integrate HIV and SRH services.  GAA's Treat the Children campaign is working to ensure that at least 15% of those receiving ARV therapy are children under the age of 15.  And we remain actively engaged in efforts to ensure that the US and other G8 governments provide adequate financial support for the Global Fund.

The primary impact of these efforts will be to increase the number of people with HIV/AIDS in developing countries who are receiving treatment, and to leverage new resources to enable poor countries to scale up treatment programs.  Ultimately, universal treatment access will be critical to achieving the Millennium Development Goals of reversing the spread of HIV/AIDS (MDG #6) and reducing child mortality (MDG #4) by 2015.  Our efforts to advance innovative financing mechanisms for generating new resources for the fight against global AIDS will also help foster a global partnership for development (MDG #8).

Where can I learn more?

At the bottom of this page, you will find a selection of recent materials related to universal treatment access, including action alerts, news, and reports.  In addition, GAA is working with a broad array of advocacy partners to expand treatment access.  Many of these groups offer additional information about issues related to AIDS treatment, including the following:

Clinton HIV/AIDS Initiative
Doctors Without Borders
Essential Action
Health GAP
International Treatment Preparedness Coalition
Stop AIDS Campaign (UK)
Student Global AIDS Campaign
World AIDS Campaign

Click here for a full list of GAA's advocacy partners.

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