The number of patients who have access to antiretrovirals in countries that have negotiated agreements with pharmaceutical companies has increased over 18 months, although the total numbers are still only a small fraction of those in need of the medicines. Moreover, 72 countries worldwide have already indicated their interest in the "Accelerating Access" process and 14 have signed agreements, including 10 in Africa. Prices of some antiretroviral drugs have been cut on average by 85% in sub-Saharan Africa in countries where agreements have been negotiated through "Accelerating Access."

"This is just the beginning. But the results so far show that significant progress can be made in accelerating access to ARVs in the countries that need it the most," said Dr Tomris Türmen, Executive Director in charge of HIV/AIDS at WHO. "The biggest challenge remains bringing broad based care and support, including antiretrovirals, to as many people as possible living with HIV/AIDS."

"Accelerating Access" represents a redoubling of efforts to assist countries in implementing comprehensive packages of care for people living with HIV/AIDS. It includes advocacy and policy guidance on HIV care at the global level and also involves "fast track" support for those developing countries who have formally indicated that they wish to significantly expand access to HIV care, support and treatment, and who want assistance from the UN system. The initiative emerged out of a partnership between the United Nations (the UNAIDS Secretariat, UNICEF, UNFPA, WHO and the World Bank) and five pharmaceutical companies (Boehringer-Ingelheim, Bristol-Myers Squibb, F. Hoffmann - La Roche, GlaxoSmithKline, and Merck & Co., Inc.) which has since been broadened to include other members of the industry.

A number of encouraging approaches are now being developed. Regional pricing, for example, allows the process to move more quickly and may favour lower drug prices through regional procurement. In addition, the creation of regional networks allows countries improved access to technical support that underpins their programmes.

"Challenges remain, however, and the greatest lies in reaching not thousands, but millions of people. With 95% of the world's 40 million HIV-infected people living in developing countries, better and faster access to care is essential. The challenge now is to improve access to care, including treatments for opportunistic infections and antiretroviral therapy, in the hardest-hit regions of the world," said Dr Türmen.