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WORLD AIDS DAY 2004
Doctors Without Borders / Médecins Sans Frontières (MSF), Campaign for Access to Essential Medicines, Access to AIDS Care Increasing at Fatally Slow Pace
New York/Geneva, November 30, 2004 - Donor governments and countries hardest hit by HIV/AIDS must take immediate steps to address today's treatment deficit emergency and the gaps in research and development to fight the pandemic, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) urged on the eve of World AIDS Day 2004.
Out of the six million people needing antiretroviral (ARV treatment in developing countries, only 440,000 currently have access to it. MSF currently provides antiretroviral treatment to more than 23,000 people living with HIV/AIDS in 27 countries in Asia, Africa, Latin America, and Eastern Europe.
"MSF has succeeded in making a difference to our patients and their families, but we have not seen massive scale-up efforts in most of the countries where we work," said Dr Rowan Gillies, president of MSF International. "Everyone now agrees on the urgent need for increased access to treatment, but actual progress remains at a snail's pace. Outside the few clinics offering antiretroviral treatment, the treatment landscape is a desert. The imperative to fund and manage treatment programs is still being neglected."
Yet several important lessons about expanding AIDS treatment have been learned in MSF and other treatment programs in the past few years that have enabled sharp increases in patient enrollment. First is the use of simplified treatment regimens. "Although they are not the final answer to AIDS, triple drug cocktails literally allow people to rise from their deathbeds, and live normal, longer lives," said Dr Arnaud Jeannin of MSF's AIDS program in Malawi. More than 75% of new patients within all MSF projects start treatment on these affordable one-pill-twice-a-day formulations produced by generic companies. Clinical and biological results have been excellent with overall probability of survival at 85.3% after 24 months of treatment.
Another significant factor leading to good treatment results is program design: MSF offers treatment free of charge, and provides support and education to help people take their medicines correctly and consistently. This has led to adherence rates that rival or exceed those seen in the West, a factor considered essential in slowing the onset of resistance.
Overall, the AIDS pandemic remains undefeated. The lack of pediatric formulations of antiretroviral medicines and the need for reliable diagnostic tests to detect tuberculosis, the number one AIDS-related opportunistic infection, in HIV-positive individuals. "Research and development efforts leading to practical advances in treating the poorest communities most affected by HIV/AIDS should be prioritized as part of a comprehensive response to AIDS," said Daniel Berman, coordinator of MSF's Campaign for Access to Essential Medicines.
MSF AIDS programs are run in diverse settings ranging from hospitals in the capitals to city slums to remote rural areas. Activities include prevention efforts, voluntary testing and counseling, nutritional and psychosocial support and treatment of HIV and opportunistic infections.