On World AIDS Day in 2003, WHO and UNAIDS launched a campaign called the “3 by 5 initiative,” with the objective to “treat three million people with HIV by 2005.” At that time, AIDS treatment was still prohibitively expensive for poor countries, where only a few thousand people had access to treatment. Thanks to President Bush’s creation of the President's Emergency Plan for AIDS Relief (PEPFAR) program that same year, the number of people on antiretroviral therapy (ART) began to rise dramatically. While the total number of people on ART reached only one million in 2005, the objective to reach three million people was attained in 2007, and the numbers have continued to climb. The numbers have now surpassed 11 million in low- and middle-income countries and 13 million worldwide. (See bottom trend line in figure 1.)
CGD Policy Blogs
In November the World Health Organization will select its next regional director for Africa. As we wrote in a previous blog, this position is not posted publicly and is without an independent mechanism in place to recommend, interview, and evaluate the best qualified candidates.
Nigeria’s response to Ebola has drawn high praise now that the concerted effort by government has stopped the disease in its tracks. Nigeria rapidly mobilized domestic resources and used house-to-house information campaigns to educate the populace.
How much is actually being spent on Ebola by donor governments, organizations, and private individuals? The short answer is that we don’t really know.
One of the most important jobs in the world will be decided in early November: the World Health Organization’s (WHO) next regional director for Africa. With an annual budget of more than US$1 billion (about 30 percent of the WHO budget) and responsibility for “leadership in matters critical to health,” the person in charge could make a huge difference for health in Africa where much of the world’s disease burden is concentrated. However, the position has not been posted publicly and there is no independent mechanism in place to recommend, interview and evaluate the best qualified candidates.
It’s too early to know how large the economic impact of Ebola will be on West Africa and the world. Past experience, including the 2002-03 Severe Acute Respiratory Syndrome (SARS) epidemic, suggest it could be very large indeed, especially in the African countries that have been hardest hit. Fortunately, actions that the US and other donor countries take now could help not only to control the epidemic but also to minimize the economic fallout.
There’s no doubt that Treatment as Prevention (TasP) will receive continued emphasis at this year’s International Aids Conference (IAC), as advocates argue for aggressively expanding treatment from the 9 million worldwide currently on antiretrovirals (ARVs) to the 35 million people who are HIV infected. But at the TasP workshop in Vancouver last month the more challenging and novel topic was pre-exposure prophylaxis, or PrEP. A whole array of sessions on PrEP is already on the agenda for next week’s conference in Melbourne, and our bet is that PrEP will generate a lot of buzz – an approach with intriguing potential, but edgy downside possibilities.
Cement is poured, and children in Mexico have less diarrhea. Acetic acid is applied, and cervical cancer claims the lives of fewer women in India. Poor households receive regular cash transfers in South Africa, and girls reduce sexual activity. These are a few cases in which large-scale efforts to improve health in low and middle-income countries have succeeded, and are among a new generation of success stories that CGD and the Disease Control Priorities Network (DCPN) will feature in the third edition of Millions Saved, set for release in 2015.
Saturday was World No Tobacco Day which prompted me to ask: “What’s new?” After looking at the press releases, I decided that the most significant thing that happened last year was that another 30 million young people have started smoking around the world. Of these, 25 million are in low- and middle-income countries and about 12 million of them will die prematurely from disease linked to tobacco – 10% of them because of second-hand smoke. This epidemic is not caused by a virus or spread by mosquitoes. It is intentionally planned and profited from by large tobacco companies – for-profit multinationals as well as state-owned monopolies.