WHO 3 by 5 progress report

This interim report highlights progress to date in scaling up HIV treatment and prevention in low- and middle-income countries. The momentum achieved has been the result of a broad range of local, national and international efforts including, first and foremost, those of many of the most highly affected countries. These efforts have been reinforced by financial and technical support from many multilateral and bilateral institutions and donors.

The report focuses primarily on understanding the reasons for the successes and failures of scaling up HIV/AIDS interventions in different settings and on the need for sustainable financial mechanisms and improved harmonisation of efforts by partners at country level. A comprehensive report and country-specific analysis of access efforts and obstacles that remain will be released at the end of 2005.

A breakdown on numbers of people on currently receiving treatment is shown in Table 1.

Table 1. Estimated number of people receiving ARV therapy, people needing ARV and percentage coverage in developing and transitional countries by region, June 2005

Geographical region People receiving ARV therapy [low–high], June 2005 (x1,000) People 15–49 years old needing ARVs, 2005 (x1,000) ARV therapy (%) coverage People receiving ARVs [low–high], December 2004 (x1,000)
Sub-Saharan Africa 500 [425–575] 4,000 11% 310 [270–350]
Latin America & Carib. 290 [270–310] 425 62% 275 [260–290]
East, South & SE Asia 155 [125–185] 1,200 14% 100 [85–115]
Europe and Central Asia 20 [18–22] 150 13% 15 [13–17]
North Africa & Middle East 4 [2–6] 55 5% 4 [ 2–6]
Total 700 [630–780] 5,800 15% 700 [630–780]

The report is available electronically in English, French and Japanese.

Executive summaries are available in Spanish and Russian.

WHO ‘3 by 5’ progress report, December 2004


The goal of 3 million people on treatment from low- and middle-income countries will not be met by the end of the year, but this is still the world’s largest scale up for treatment of a chronic disease programme. One of the most useful comments in the context of this report is from Stephen Lewis who noted that while the goal won’t be met it ‘has unleashed an irreversible momentum for treatment’.

When launched in 2002 many people thought the target was too ambitious – and many more that the target was by definition too little – that everyone who needs treatment should be the only goal to fix on. Universal treatment itself is now on the political agenda and a recent Labour Party statement recommended this as a goal by 2010.

This will depend on support from G7/G8 countries and the outcome from the summit held in Edinburgh as this issue of HTB went to press. Funding is still a central problem, both now and in the future – it will cost an estimated at $22 billion annually to sustain. Access to second-line treatments and management of toxicity such as peripheral neuropathy due to the choice of drugs that are now rarely used in Western countries are also highlighted as new concerns for the programme.

In press calls to the launch of this report, Dr Jim Kim said that the WHO will focus on extending and building on the current programme. The call discussed both the difficulty and accuracy of the systems used to gather these updated figures and the increased access to treatment since the last progress report in December 2004, most of which has occurred in South East Asia and Africa.

Figures from UNAIDS showed that 2004 had the highest number of new infections and the highest numbers of deaths (5 and 3 million respectively), and it is unclear where the treatment programme will impact on this. The number of people who need treatment now is estimated at over 6.6 million, and this now includes 650,000 children who are included for the first time in the figures.

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