First Word
Together, for Universal Access
In comparison with Africa, the Western Hemisphere's AIDS epidemic is relatively limited. To be sure, Haiti and other countries in the Caribbean have been hard hit by the disease. But according to UNAIDS, throughout the Americas (from Canada to Argentina) an estimated 91,000 to 138,000 people died of HIV/AIDS, compared with 2.2 million to 2.4 million in Africa the same year. "Only" 156,000 to 234,000 in our region became newly infected, compared with more than 3 million Africans. In the Americas, the overall HIV infection rate is 0.5–0.7 percent, compared with 7.5 percent or more in sub-Saharan Africa, where the epidemic is at its worst.
But tell this to any of the estimated 3 million people living with HIV in the Americas. For them, and for those charged with caring for them, HIV/AIDS is a life-or-death issue, and the difference between life and death eventually boils down to access to antiretroviral drugs.
What could be simpler? Yet behind this stark simplicity is a host of complicating factors that shape a very mixed picture of access to antiretroviral treatment in Latin America and the Caribbean. In Brazil, where public health officials have taken a bold and comprehensive approach to the epidemic, virtually everyone who needs antiretroviral treatment today can get it. Other countries—including Argentina, the Bahamas, Barbados, Bolivia, Chile, Costa Rica and Mexico—have achieved nearly universal access as well. But not all the region's countries have fared so well. An estimated 170,000 people today lack access to the drugs they need and thus to their best hope for survival.
But as our article "Casting the AIDS Lifeline" shows, this is changing. We at the Pan American Health Organization (PAHO), in partnership with the World Health Organization (WHO) and our 35 member countries, recently embarked on an ambitious new effort to provide access to antiretroviral drugs to all those who need treatment in Latin America and the Caribbean by the end of next year. This high-priority effort falls within WHO's "3 by 5" initiative, which aims to provide treatment to 3 million people in the developing world by 2005. It also supports the United Nations' Millennium Development Goals and answers the call by heads of state at the recent Summit of the Americas to reach 600,000 HIV/AIDS patients throughout the Americas with treatment by 2005.
To meet our target, we are focusing our efforts on raising political commitment, mobilizing partnerships and community participation, strengthening health systems and services, ensuring reliable supplies of medicines and equipment, linking treatment with preventive services, and gathering and applying strategic information and lessons learned. Today, with the Global Fund for AIDS, Malaria and Tuberculosis, the U.S. President's Emergency Plan for AIDS, and other private and public funding sources, we have unprecedented resources to commit to the goal of universal access to treatment. For the Americas, this goal is clearly within reach, and by sharing our experiences, we can pave the way for others in the developing world.
As we work toward this goal, we must continue to count on—not resist—the pressure brought by those men and women in our region who are living with HIV/AIDS. Without their ardent activism, it is doubtful we would have made what progress we have in providing antiretroviral treatment. Nor would we have arrived at the now widespread consensus that access to AIDS treatment is a basic human right and should be guaranteed to everyone who needs it, regardless of ability to pay. Indeed, this type of activism—combined with more traditional forms of community participation and support—should be applauded. We can only hope for the day when people march in the streets demanding access to vaccines, maternity and prenatal care, screening for chronic diseases, and other services that are essential to public health.
Mirta Roses Periago
Director