***HIV/AIDS has already killed more than 20 million people thereby making it the most serious global public health concern. The report says that today, an estimated 3446 million people are living with HIV/AIDS. In 2003,3 million people died and 5 million others became infected***
The World Health Report 2004 has been released by WHO, Geneva on 11 May for public reading. The overview of the report begins on a positive note with the following story, which is reproduced below in brief for our readers.
"JosephJeuneisa26-year-old peasant farmer in Lascahobas, a small town in central Haiti. In March 2003, his parents had already bought his coffin. Suffering from the advanced stages of AIDS, Joseph Jeune probably had only weeks to live. But after
six months, he gained 20 kg and transformed after receiving treatment for HIV/AIDS and tuberculosis (TB) coinfection. There are millions of people like Joseph Jeune around the world. For most of them, HIV/AIDS treatment is still beyond reach, but Joseph shows what can be achieved. He receives care at the small clinic in his home town. The clinic’s HIV/AIDS and TB treatment programmes are part of a wider initiative to strengthen the health service infrastructure across much of Haiti's central plateau. The effort involves NonGovernment Organisations, the
public sector and communities, with major support from the Global Fund to Fight AIDS, Tuberculosis and Malaria."
The World Health Report 2004 stressed the fact that if the same treatment regimen that saved Joseph Jeune could be brought to the doorsteps of millions of others in poor and middleincome countries it would bring about the desired results in the fight against AIDS.
Against the underlying threat in the projection by health experts that about 6 million people in developing countries will die of AIDS in the near future if they fail to have access to treat-
ment, it is scary news that only a piteous number of 400000 are currently receiving treatment. The lack of access to AIDS treatment with antiretroviral medicines has been declared a global health emergency by WHO, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Global Fund. But these organisations did not just declare the global health emergency and sit back. They launched an initiative to provide 3 million people in developing countries with antiretroviral therapy by the end of 2005. This came to be known as the 3 by 5 initiative, a major global public health project ever conceived.
What is the best strategy to deal with the people living with HIV?
The World Health Report 2004 says "a comprehensive HIV/AIDS strategy links prevention, treatment, care and support for people living with the virus. Until now, treatment has been the most neglected element in most developing countries. Yet among all possible HIV-related interventions it is the treatment that can most effectively drive health systems strengthening, enabling poor countries to protect their people from a wide range of health threats." In fact, this report shows how individual national governments, the private sector and communities along with international organisations can work together to expand HIV/AIDS treatment, evolve HIV prevention strategy and strengthen health systems in countries where these are not in good shape at the moment. Already advocacy initiatives by WHO and its partners for more global investment in health are bringingresults.
The resolve of WHO and partners to treat 3 million people in developing countries with antiretroviral drugs by the end of 2005 is no doubt a step closer to the cherished goal of universal access to antiretroviral therapy and HIV/AIDS care for all who are infected with HIV. Experts are of the opinion that the 3 by 5 initiative will start the process of effective collaboration among all stakeholders, linking national governments, international organisations, the private sectors, civil society groups and communities.
"This report shows WHO's commitment to work closely with national health authorities, the private sectors, communitybased organisations and others in delivering comprehensive HIV/AIDS programmes on the ground."
Here is a chapter-wise look at the World Health Report 2004 Chapter 1. A global emergency: a combined response
This chapter gives the current epidemiological state of HIV/AIDS epidemics around the world. It clearly spells out that the world is not fully equipped to handle the impending health, social and economic catastrophe.
"The chapter explains why WHO, along with its partners, believes an emergency global and comprehensive response is essential and must embrace prevention, treatment and longterm care.
Chapter 2. The treatment initiative
This chapter elaborates the imperatives of linking prevention, treatment, research, and long-term care and support for people living with HIV/AIDS.
Chapter 3. Community participation: advocacy and action
It has been identified that involvement of state leadership, communities and civil society groups, particularly groups of people living with HIV/AIDS, is crucial to treatment and comprehensive HIV/AIDS control. This participation will include both advocacy and the involvement of community members in delivering services and support to patients.
Chapter 4. Health systems: findingnew strength
In countries with a high burden of HIV/AIDS, health systems are mostly under-equipped and often dysfunctional for various reasons. HIV/AIDS only puts additional burdens on these fragile health systems.
"The 3 by 5 initiative has the potential to strengthen health systems in a number of ways, by, for example, attracting resources to the health system in addition to those required for HIV/AID, stimulating investment in physical infrastructure, developing procurement and distribution systems of generic application, and fostering interaction with communities which can benefit a wide range of health interventions."
Chapter 5. Sharing research andknowledge
This chapter reviews the importance of research into other important areas of HIV/AIDS prevention, treatment and care. Four broad categories of challenges facing researchers have been discussed elaborately in this chapter.
Health officials, policy makers and researchers will be immensely benefitted in their fight against HIV/AIDS from reading the World Health Report 2004. Visit http://www.who.int