The United Nations World Health Organization (WHO) and the UN's umbrella AIDS-fighting agency, UNAIDS, today unveiled a detailed plan, the 3x5 initiative, to train tens of thousands of community workers in developing and transition countries to provide anti-retroviral treatment to 3 million HIV-infected people by 2005.
Marking World AIDS Day, WHO Director-General Dr. Lee Jong-wook said, "Preventing and treating AIDS may be the toughest health assignment the world has ever faced, but it is also the most urgent. The lives of millions of people are at stake. This strategy demands massive and unconventional efforts to make sure they stay alive."
Under the "3x5" strategy, WHO and UNAIDS will focus on such critical areas as teaching the use of simplified, standardized tools that deliver antiretroviral therapy and monitor their effects and ensuring a reliable supply of medicines and diagnostics. It also has added lamivudine, stavudine and nevirapine to its fixed-dose, triple therapy combinations.
The Joint UN Programme on HIV/AIDS (UNAIDS) announced last week that 40 million people around the world are infected with HIV. In 2003 alone 5 million people became infected with HIV worldwide and 3 million died - an average of 8,000 deaths per day.
WHO estimates that 6 million people worldwide are in immediate need of AIDS treatment.
"The lack of HIV treatment is without a doubt a global emergency," said UNAIDS Executive Director Peter Piot. "We firmly believe that we stand no chance of halting this epidemic unless we dramatically scale up access to HIV care."
WHO said advisory teams have gone to Kenya, Burkina Faso, Malawi and Zambia, while other teams have done preparatory work in Ukraine and India. Many other countries, including the Russian Federation and Djibouti, have requested assistance, it said.
The 3x5 initiative complements the work of national governments, non-governmental organizations (NGOs), faith-based groups and foundations and the efforts of pharmaceutical companies to reduce the prices for AIDS treatments, it said.
"We know from experience that the availability of treatment encourages people to learn their HIV status and receive counselling," said Dr. Paulo Teixeira, Director of the HIV/AIDS Department at WHO. "We also know that the availability of treatment reduces stigma for people living with AIDS."
Stigma and discrimination keep sufferers out of sight, allowing governments to deny the severity of the crisis and ignore the need to scale up prevention and treatment efforts, UN Population Fund (UNFPA) Executive Director Thoraya Ahmed Obaid said.
Stigma and discrimination also "keep people from seeking to learn their HIV status and receive counselling - essential aspects of prevention - out of fear that they will be ostracized, rejected and even harmed by their communities and families," she said.
One of the most deadly myths is the association of condom use with promiscuity and irresponsible behaviour, Ms. Obaid said. It has led many people to forgo essential protection against sexual transmission of disease and prevented women from negotiating condom use with their partners, including husbands who may be HIV-infected.
To fulfil its mandate on HIV prevention, UNFPA said it focuses on prevention among young people, using the "ABC" model - abstinence, be faithful or use condoms - prevention among pregnant women and comprehensive condom programming.
"All governments have a responsibility to lead an open and inclusive discussion on human rights and HIV/AIDS," Bertrand Ramcharan, Acting High Commissioner for Human Rights, and Paul Hunt, Special Rapporteur on the right to health, said in a joint statement to mark the Day.
"Freedoms of expression and of association are fundamental in the struggle against HIV/AIDS. The inability to talk openly about HIV/AIDS has fuelled the stigma linked to this disease…This can and must be addressed by encouraging discussion about the disease in every quarter."
The UN Food and Agriculture Organization (FAO) said its recent research in selected rural communities in sub-Saharan Africa heavily affected by HIV/AIDS shows complex effects, ranging from a deepening of household debt to forcing children out of school and into the labour force and to changing farming techniques and worsening diet.
Some 8 million agricultural workers have died from AIDS in the 25 most-affected countries since 1985, according to UN figures, and another 16 million could die from the disease by 2020, FAO said.
UN General Assembly President Julian Hunte of St. Lucia said, through his spokeswoman Michele Montas: “Staggering statistics continue to paint a very grim picture. The reality is that whatever progress has been made is simply not enough. We must strengthen our resolve and our strategies must be proactive.”
"It is estimated that 10 per cent of all infections result from unsafe injecting behaviour. It is estimated that there are 12.6 million injecting drug users worldwide," said Antonio Maria Costa, the Executive Director of the Vienna-based UN Office on Drugs and Crime (UNODC).
"In some regions, up to 90 per cent of all injecting drug users are HIV-infected. The prevention of HIV/AIDS associated with drug use is core to the work of the United Nations Office on Drugs and Crime," he added.
A comprehensive package of interventions can prevent and even reverse an HIV/AIDS epidemic among injecting drug users, but in most countries where injecting narcotics use is a significant route of HIV transmission, less than 5 per cent of all injecting drug users are reached with prevention services, he said.
UNAIDS and the Ecumenical Advocacy Alliance has mounted an exhibition at UN Headquarters in New York of posters from 23 countries on living with AIDS. It is called "Signs of Hope, Steps for Change" and is open to the public.
The wife of UN Secretary-General Kofi Annan, Nane, was to address the opening night crowd this evening, including several of the artists, some as young as 9 years old.