[stop-imf] Stephen Lewis on AIDS Treatment - User Fee Emphasized

[robert weissman]

[snip]

It was a good and illuminating report that was released today. It
identifies many of the obstacles and bottlenecks, and with spirited
intelligence suggests, in each case, a way around them. It's a
first-rate blueprint at this point in time.

[snip]


Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa, speaks to a
meeting of civil society organizations on the WHO Report on Access to
Treatment for AIDS:

Nairobi, Kenya, Wednesday, June 29, 2005





The report launched today, by WHO and UNAIDS, as a status update on
where the world stands in the provision of treatment for AIDS is a
predictably fascinating document.



There will be comments aplenty. I have five.



First, the 3 by 5 initiative seems to me to be entirely vindicated. Mind
you, I can even now hear the curmudgeonly bleats of the detractors,
whining that we will fall short of the target of three million in
treatment by the end of this year. Tell that to the million people who
are now on treatment and who would otherwise be dead. The truth is that
the 3 by 5 initiative --- which, I predict, will be seen one day as one
of the UN's finest hours --- has unleashed an irreversible momentum for
treatment. I see it everywhere as I travel through Africa. Governments
are moving heaven and earth to keep their people alive, and nothing will
stop that driving impulse. It is surely noteworthy that 3 by 5 has
ushered the phrase "universal treatment" into the language of the
pandemic, meaning that we're now all fixated on getting everyone who
needs treatment, into treatment, as fast as possible. It is, I readily
admit, both painful and horrifying to see the numbers who are dying as
they wait for treatment to be rolled out, but at least there is hope
amidst the despair.



Second, it becomes irrefutably clear that treatment has been a boon to
prevention. I can recall from many quarters all the caterwauling about
the neglect of prevention as the world began to focus on treatment. But
the detractors were wrong again. Not only do we continue to emphasize
prevention and reinforce it at country level, but the provision of
treatment significantly accelerates testing and counseling, one of the
primary ingredients of prevention. Buried in the report, is the
astonishing statistic from a study of a district in Uganda, showing a
27-fold increase in counseling and testing as a result of the
introduction of treatment!



Third, the G8 certainly has its work cut out for it. What this report
appears to do is to throw many of the financial estimates of resource
needs for Africa into a cocked hat. WHO and UNAIDS categorically assert
that we will need an additional $18 billion dollars, over present
commitments, for the three years 2005-2007. We know from the recent
UNAIDS estimates for 2008, that we will require $22 billion annually,
minimum, from that year forward. In the face of these resource
imperatives, the idea of doubling foreign aid for Africa by 2010, which
would represent another $25 billion per year, is clearly inadequate,
some might say paltry. The $25 billion is supposed to address all of the
Millennium Development Goals; it will barely address the one goal of
defeating communicable diseases. Unless the G8 can do a lot better than
the present calculus, Gleneagles will be much like all the G7/G8 summits
before it: a rhetorical triumph, a pragmatic illusion.



Fourth: the report has one particularly evocative diagram. It's a world
map portraying the twenty countries with the highest unmet treatment
needs ... twenty countries where the estimated number of people in
treatment is pathetically low. Six of those countries --- South Africa,
Zimbabwe, Tanzania, Nigeria, Ethiopia and India --- represent fully half
of the unmet treatment needs. Five of them are in Africa. South Africa
alone has the largest shortfall in the world, some 866,000 people who
should at this very moment be in treatment. The country appears to have
something slightly in excess of 100,000 people in treatment, but that
represents only 10% to 14% of those who are desperately in need. The
numbers for the other African countries, while smaller, are
proportionately even more grim. This is where the international
community must rally urgent support.



Fifth, the report says, without caveat, that treatment should be
provided free at the point where it is given. Finally, we're building a
new consensus around the destructive nature of 'user fees', particularly
as they prejudice the poor. User fees are a sordid relic of the old
economic conditionalities: it will be excellent to see the end of them.



It was a good and illuminating report that was released today. It
identifies many of the obstacles and bottlenecks, and with spirited
intelligence suggests, in each case, a way around them. It's a
first-rate blueprint at this point in time.





--30--





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Gregg Gonsalves

Director of Treatment and Prevention Advocacy

Gay Men's Health Crisis

119 West 24th Street

New York, NY 10011

Phone: 212-367-1169

Mobile: 646-250-8130

Fax: 212-367-1235

Email: greggg@gmhc.org <mailto:greggg@gmhc.org>

gregggonsalves@earthlink.net <mailto:gregggonsalves@earthlink.net>

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