The Newsletter of the Pan American Health Organization CONTENTS
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45TH DIRECTING COUNCIL PAHO Seeks Fast Track for ART The number of people getting treatment for HIV/AIDS in the Caribbean increased nearly 25 percent in six months during 2004, said Carol Vlassoff, head of the HIV/AIDS program at the Pan American Health Organization, in a briefing for ministers of health gathered for PAHO's 45th Directing Council meeting in September. An increase of some 1,240 Caribbean patients between February and July of this year has put the subregion on track to meet the goal of providing antiretroviral treatment (ART) to all those who need it by the end of 2005, Vlassoff noted. The region of the Americas as a whole is seeking to provide antiretroviral treatment to an estimated 600,000 people—the total number believed to need such treatment—by 2005. The goal was established by the region's heads of state in the Declaration of Nuevo León at the Americas Summit in Monterrey, Mexico, in January, and falls within the framework of the World Health Organization's global "3 by 5" initiative, which aims at putting 3 million people in the developing world on treatment by 2005. In her briefing, Vlassoff said that some 2 million people are currently living with HIV/AIDS in Latin America and the Caribbean. An estimated 200,000 became newly infected during the past year, with the greatest increases among women and young people aged 15 to 24. The Caribbean has the second-highest rates in the world, after sub-Saharan Africa, with an estimated 2-3 percent of adults infected. Central America has seen a steady increase in infections, primarily through heterosexual transmission and sex between men. In the Southern Cone, intravenous drug use is a significant factor in new infections. Throughout the region, the epidemic has taken its heaviest toll on the poor and vulnerable. Despite these developments, efforts to control the epidemic are showing results, Vlassoff said. In Brazil, new cases, hospitalizations and deaths have been declining since the late 1990s in response to prevention and treatment programs. Similar efforts in Barbados have brought a drop in death rates and new cases, and Bahamas has seen a decline in hospitalizations and death rates, though new cases continue to climb. Multicountry negotiations spearheaded by PAHO and UNAIDS have produced agreements with pharmaceutical manufacturers to lower the prices of antiretroviral drugs by as much as 90 percent in the region. As of late 2003, PAHO estimated that 210,000 people were receiving treatment in both Latin America and the Caribbean, or 55 percent of those believed to be in need of the drugs. Scaling up treatment involves more than reducing drug prices, however. Countries also must increase testing, counseling, monitoring and evaluation, and prevention efforts, including condom and sex education programs. PAHO's support for the region's efforts to scale up treatment has included:
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