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Poor funding, mismanagement leading to delay: Activists

The report was compiled by coalition activists in six of the countries hardest hit by the pandemic _ the Dominican Republic, India, Kenya, Nigeria, Russia, and South Africa.

india Updated: Nov 29, 2005 18:59 IST

AIDS activists said Monday that mismanagement, bureaucracy and inadequate funding have kept the world form meeting the goal of providing treatment to 3 million people infected by HIV/AIDs by the end of the year. The International Treatment Preparedness Coalition, in a 90-page report, said the goal fell short by at least a million people. The United Nations has acknowledged that the goal set by its World Health Organization will not be met.

Inadequate leadership at the national level, a global system that does not collaborate efficiently, a severe shortage of health care workers, lack of necessary funding, bureaucratic delays in allocating resources and a pervasive stigma against people living with HIV/AIDS all contributed to the failure, according to the International Treatment Preparedness Coalition.

"In South Africa and countless other countries, we have been working for more than a decade to ensure HIV treatment access for people living with HIV/AIDS. In that time millions of people have died because of lack of access to drugs, and millions more will die if we do not achieve universal access by 2010," Zackie Achmat, the head of the Treatment Action Campaign in South Africa, said in a statement accompanying the report.

The report was compiled by coalition activists in six of the countries hardest hit by the pandemic _ the Dominican Republic, India, Kenya, Nigeria, Russia, and South Africa.

Coalition spokesman Chris Collings, speaking from New York on an international teleconference, said the aim of the report was not to highlight the failure to meet the WHO goals but to open serious discussions with the governments, the United Nations and groups providing treatment on how to improve access to treatment. "G8 leaders have pledged a new goal of coming as close as possible to universal AIDS treatment access by 2010. This will be a hollow promise unless governments and international agencies learn the lessons of the early years of treatment delivery and dedicate increased resources, capably address barriers, collaborate more effectively, and hold themselves accountable for steady, measurable progress," the report said.

It said the drive to treat 3 million people by the end of the year failed to treat even 50 percent of the people in need of antiretroviral treatment.

"If the organizations responsible for carrying out this program are to accomplish an even greater goal in five years time, it will take courageous new leadership from all parties," the report said. The report gave specific examples of the problems in six of the hardest-hit countries.

In the Dominican Republic, bureaucratic delays and power struggles between agencies delayed implementation of a Global Fund grant for months, it said. Delivery of antiretrovirals is still hampered by a lack of political leadership.
In India, it said many people seeking care are forced to travel long distances and shortfalls in funding and resources threaten efforts to expand treatment.

A widespread stigma against people living with HIV/AIDS hampered treatment efforts in most countries as did insufficient resources and a lack of knowledge about treatment.

In Russia, treatment was hampered by a faulty drug procurement system and a lack of collaboration among providers. "In South Africa the government continues to drag its feet," the report said.

Fatima Hassan, who works with the AIDS Law Practice in South Africa, said both President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang have been accused of not showing enough leadership on HIV/AIDS issues.

South Africa has rolled out an AIDS treatment campaign in each of its provinces, but the result, Hassan said, has been patchy. "There is a huge gap between those who need treatment and those who are receiving it," Hassan said the teleconference.

First Published: Nov 30, 2003 20:25 IST