Scaling up HIV/AIDS prevention, treatment and care
A report on WHO support to countries in implementing the "3 by 5" initiative

Reference number: ISBN 92 4 159426 8

When the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched “3 by 5”, the immediate aim was to mobilize global efforts to close the gap that existed in access to antiretroviral therapy for people living with HIV/AIDS who needed it. At the time, only 7% of people who needed treatment had access. The vast majority of people without treatment were in low- and middle-income countries, where providing antiretroviral therapy was generally considered not feasible due to the high cost of treatment and weak health systems. The initiative was launched bearing in mind that HIV/AIDS treatment is part of a com- prehensive package of HIV/AIDS services and that this was an interim target towards ensuring universal access to antiretroviral therapy and other essential HIV/AIDS services.

By the end of 2005, about 1.3 million people worldwide were receiving antiretroviral therapy. Although this number was short of the desired 3 million, this increase represented a threefold increase in people receiving live-saving medicines, and much of the progress was made in very poor areas of the world. “3 by 5” was also instrumental in generating increased financial and technical support for the response to HIV/AIDS. The initiative led to renewed commitment to expanding prevention and strengthening health systems. The key to the achieve-- ments made during “3 by 5” is that countries were at the centre of the response. Political will already favoured the scaling up of HIV/AIDS prevention and treatment programmes in most of the affected countries. Donors and other development partners also enhanced their commitment to increase support to countries to slow down and start to reverse the HIV/AIDS pandemic.

For WHO, “3 by 5” has been a significant learning experience in its work on HIV/AIDS. The Organization was challenged at many levels to meet the expectations of countries and partners in its role as a directing authority and facilitator of global action on health. The lessons of “3 by 5” are important in informing how the Organization repositions itself to best support global and country efforts in the next challenge ahead, the goal of scaling up HIV/AIDS programmes to come as close as possible to universal access by 2010.

This report provides an overview of WHO’s activities in 2004 and 2005 to support countries in realizing the global target of having 3 million people living with HIV/AIDS receiving antiretroviral therapy by the end of 2005 (the “3 by 5” target). The report draws the key lessons learned from country action and discusses the way forward for WHO to support countries in their goal of achieving universal access to prevention, care and treatment.

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