South Africa: AIDS activists say poor funding, mismanagement contribute to missed treatment goal

Mismanagement, bureaucracy and inadequate funding have kept the world from meeting a goal to provide treatment to 3 million HIV-infected people by year's end, AIDS activists said in a report issued Monday. The goal, set by the World Health Organization in 2003, would be missed by about 1 million people, according to the 90-page report by the International Treatment Preparedness Coalition.

The report blamed inadequate leadership at the national level, inefficient collaboration on a global scale, severe shortages of health workers, lack of funding, bureaucratic delays and a pervasive stigma against people living with HIV/AIDS.

"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," Zackie Achmat, the head of the Treatment Action Campaign in South Africa, said in a statement. "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."

The report focused on six of the countries hardest hit by the pandemic _ the Dominican Republic, India, Kenya, Nigeria, Russia and South Africa, the coalition said.

Coalition spokesman Chris Collings, speaking from New York on an international teleconference, said the report was not meant to highlight the failure to meet the WHO goals, but to open serious discussions with governments, the United Nations and groups providing treatment on how to improve access to treatment.

Less than 50 percent of people needing antiretroviral treatment have received it, the report said. In most countries, a widespread stigma against people living with HIV, the virus that causes AIDS, hampered treatment efforts, as did insufficient resources and a lack of knowledge about treatment.

In the Dominican Republic, bureaucratic delays and power struggles between agencies delayed implementation of a Global Fund grant for months, while delivery of antiretrovirals is still hampered by a lack of political leadership, the report said.

In India, many seeking care are forced to travel long distances, and shortfalls in funding and resources threaten efforts to expand treatment, it said. Treatment in Russia was hampered by a faulty drug procurement system and a lack of collaboration among providers, the AP reports.

Fatima Hassan, who works with the AIDS Law Practice in South Africa, said both President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang had been accused of not showing enough leadership on the issue. South Africa has rolled out an AIDS treatment campaign in each of its provinces, but the results have been uneven, Hassan said.

A.M.