world health organization "3 by 5" initiative whot/3by5

World Health Organization

"3 by 5" Initiativehttp://www.who.int/3by5



Treat 3 million

by 2005

Treat 3 million

by 2005Naisiadet Mason

HIV/AIDS Department, WHO, Geneva, Switzerland

CCIH, May 2004



• 40,000,000 are infected with HIV/AIDS worldwide

• 6,000,000 need treatment every year

• 3,000,000 die because they do not get it

• 400,000 people living with AIDS have access to treatment today

• Antiretroviral Therapy (ART) keeps people with HIV/AIDS

alive and healthy. It is not a cure

The Goal: Provide access to treatment for all

The Target: Treat 3 million HIV sufferers by 2005

What is the "3 by 5" Target?What is the "3 by 5" Target?





High burden countries in need of ART, Nov 2003

High burden countries in need of ART, Nov 2003





Countries that have appealed for WHO Technical Assistance, Feb 2004

Countries that have appealed for WHO Technical Assistance, Feb 2004



Yearl

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act

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l in

1

99

5

0.0

0.5

1.0

1.5

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Introduction of Highly Active Antiretroviral Treatment (HAART)

AIDS Deaths in Africa

AIDS Deaths in Western Europe

19921991 19991993 19951994 1996 1997 20011998 2000

Source: Adapted from WHO/UNAIDS Statistics & HIV/AIDS Surveillance in Europe, End-year report 2001, No 66, CESES

Widening Gap of AIDS Treatment

Widening Gap of AIDS Treatment





What ARVs Can DoWhat ARVs Can Do



Pillars of the "3 by 5" StrategyPillars of the "3 by 5" Strategy

• Global leadership, strong partnership and advocacy

• Urgent, sustained country support

• Simplified treatment

• Effective supply of medicines and diagnostics

• Learn by doing





A Simple Two-Pronged Approach




Country DrivenCountry Driven SimplificationSimplification

WHO Strategy to Support Global Efforts to Scale Up Treatment







Country Driven

• Scale-up & treatment happens in country. It is country driven• Governments are responsible for the care and treatment of their

citizens, including the poor and marginalized• Multiple actors are involved in ART and with scale-up• WHO provides technical support to governments• Focus on UNAIDS "three ones" approach

One National Plan One Coordinating Body One Monitoring and Evaluation System





Simplification



• Fixed Dose Combination (FDC) drugs simplify drug regimen to

just one pill twice a day• WHO has established an AIDS Medicines and Diagnostics

Service (AMDS) to help countries streamline procurement and

supply• AMDS links with the WHO Procurement, Quality and Sourcing

Project (pre-qualification), assessing products and manufacturers,

facilitating procurement



The AMDS in FocusThe AMDS in Focus

A project of UNAIDS, WHO, UNICEF the World Bank and other

partners

Activities of the AMDS:• Strategic information• Stockpiles and pooled procurement• Product selection• Demand forecasting• Market intelligence on sources, prices, raw materials• Technical support for product selection, procurement,

supply-management and local production• Prequalification of ARVs and diagnostics



What is "3 by 5" Building On?What is "3 by 5" Building On?

• Increased global political commitment and resources• Simplified treatment and testing• Cheaper drugs and generic competition• Build on lessons from developing and developed countries• Use ART to strengthen health systems and accelerate

prevention

OpportunitiesOpportunities

Partners

Experience






Opportunities

PartnersPartners

• UN and international agencies, governments, donors,

non-governmental organizations including faith based

organizations, researchers, people living with HIV/AIDS, private

sector, charitable foundations, and communities

Experience






Opportunities

ExperienceExperience

Partners

• Lessons learned by WHO in dealing with SARS, Polio, TB will be

applied in addressing the world's worst health crisis: HIV/AIDS• Lessons learned from partners, e.g. MSF in Khayelitsha, Partners

in Health in Haiti, MTCT in Burkina Faso and treatment programs

in the private sector





Funding for Treatment Scale-up

Funding for Treatment Scale-up

Countries •$5.5 billion to scale-up treatment to reach the target of 3 million

people

WHO• $218 million for WHO technical assistance, 85% to be spent in

country

Budget requirements through to December 2005:





Achievements to date & next steps

Achievements to date & next steps

• Dec 1st 2003 - Launched "3 by 5" strategy and simplified

treatment guidelines

• Feb-April 2004 - 42 WHO staff deployed to 26 countries to

help draw up 4th round GFATM proposals and national AIDS

plans

• May-July 2004 - Technical assistance to countries ready for

immediate scale-up

• Aug-Dec 2004 - Continued technical assistance to countries





• July 2003 - Access to ART for all made WHO/UNAIDS core

policy

• Sept 2003 - HIV/AIDS declared Global Health Emergency, UN

General Assembly

• Nov 2003 - First partners meeting on proposed Strategy

• Dec 2003 - WHO UNAIDS "3 by 5" strategy launched

• Feb-June 2004 - WHO Technical Assistance in countries for

GFATM proposals and development of National AIDS scale up

plans and roll out

• May 2004 - WHA to consolidate political commitment and

action. Second partners meeting on Operational Planning

• July 2004 - Bangkok AIDS Conference – WHO Business plan and

report

Key dates Key dates



Milestones for December 2005Milestones for December 2005

50 countries request WHO support

60 countries establish ARV target

60 countries develop national implementation plans

50 countries use AMDS

50 countries use WHO-based certification of competence

$50 to $200 yearly cost of ARV treatment

20,000 service outlets providing VCT

10,000 service outlets providing ART

100,000 health providers and community treatment

supporters

30,000 partnerships with treatment outlets and community

groups



The Time to Act is NowThe Time to Act is Now

“To deliver antiretroviral treatment to the

millions who need it, we must change the

way we think and change the way we act.

“Business as usual will not work.

Business as usual means watching

thousands of people die every single day.”

LEE Jong-wook, Director-General, WHO



world health organization "3 by 5" initiative whot/3by5

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