Supporting Countries in "3 by 5"

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1. Identification of countries

WHO responds to and provides assistance to all countries that are committed to scaling up treatment. But over 90 % of all people needing ART are in just 34 high-burden countries. National authorities should make appeals for urgent assistance to close the treatment gap to the Director General of WHO, through the respective WHO Country Representative (WR).

2. Country missions

Following a formal request, an emergency fact-finding mission is made to each country. The mission includes WHO and UNAIDS staff, country and global partners. Planning will be carried out through the WHO Country Office, with support from HQ, Regional Office and local UNAIDS missions to gain country and partner involvement and commitment. An emergency fact-finding mission will then be conducted, depending on the specific country situation.

The mission:

  • Advocates for setting national ART scale up goals and priorities in line with "3 by 5".
  • Determines the current status of ART implementation.
  • Identifies constraints and opportunities.
  • Mobilizes national and international partner support for the country's emergency scale up plan.
  • Defines the desired composition and structure of the in-country emergency response team.
  • Formulates recommendations to start a rapid "3 by 5" scale-up.
  • Produces a report to identify key issues, short- and long-term actions including the specific input expected from WHO and other partners.

3. Support to ongoing implementation of the scale up process

Support to implementation will immediately follow the emergency mission, and will continue through the years of the initiative, and beyond 2005. Keeping the initiative going will take perseverance, public support and international financial aid. On-going implementation support from WHO will include:

  • Development of a national emergency scale up plan for reaching 3 by 5.
  • Establishment of a 3 by 5 country team.
  • Initiation of specific scale up actions, such as training programmes and increasing multiple entry points for patients.
  • Provision of seed funds to such start up activities.
  • Identification of national and regional solutions to the problems of medicine and diagnostics purchase and procurement, with AIDS Medicines and Diagnostics Service (AMDS).
  • Establishment and maintenance of global, regional and country databases of experts working on HIV/AIDS.
  • Strengthening of the countries’ physical and human resources (see document Human capacity-building plan for scaling up HIV/AIDS treatment).
  • Creation of a method for sharing successes and building on lessons learned.
  • Responsiveness to specific priority areas of attention identified by the country missions.

One person will be identified in each focus country as the "3 by 5" Country Officer. Support to countries will be coordinated by the "3 by 5" Country Support Teams in the respective WHO Regional Offices (AFRO, AMRO, EMRO, EURO, SEARO and WPRO) working closely with the "3 by 5" Regional and Country Cooperation team at WHO headquarters.

4. The monitoring process

Tracking progress of implementation of country programmes is an important element for the success of the "3 by 5" initiative. It will involve the monitoring of process indicators such as number of countries with emergency plans, numbers of people being trained, new treatment sites opened, size of financing gaps, among others. Monitoring systems will be established at country, regional and global levels. Country systems will be integrated into existing national Health Management Information Systems.

A helpdesk/situation room is set up in WHO headquarters to monitor progress in all aspects of implementation.

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