The World Health Organization on Wednesday announced that the number of HIV-positive people in developing countries who are taking antiretroviral drugs "jumped" during the second half of 2004 but warned that "enormous barriers" remain if the agency's 3 by 5 Initiative -- which aims to treat three million people with antiretrovirals by the end of 2005 -- is to be successful, Reuters reports. According to the December 2004 "3 by 5 Progress Report," the initiative experienced "dramatic" progress in the second half of 2004 -- 700,000 people in developing countries were on antiretroviral drugs at the end of 2004, compared with 440,000 as of June 2004 -- but only about 12% of an estimated 5.8 million HIV-positive adults in developing countries who need antiretrovirals are receiving them (Reuters, 1/26). WHO estimated that between $3.1 billion and $3.8 billion in funding would be needed to meet 3 by 5 goals in 49 countries, on the basis of an average annual drug cost of $304 a person; however, only $1.55 billion has been pledged so far, leaving an approximately $2 billion funding gap, according to AFP/iafrica.com. "The figures speak for themselves," the report said, adding, "Global progress towards the 3 by 5 target can only be made if major progress is made in the countries with the greatest unmet need for treatment" (AFP/iafrica.com, 1/26). According to the report, "good progress" has been made in sub-Saharan Africa and parts of Asia, but the situation was "less satisfactory" in Eastern Europe, central Asia, North Africa and the Middle East, BBC News reports (BBC News, 1/26). HIV-positive people in South Africa, India and Nigeria account for 41% of the "unmet need" for antiretroviral drugs, according to the report (Reuters, 1/26).

Facts and Figures
The report also found that:

• The survival rate among HIV-positive people taking antiretroviral drugs in developing countries is more than 90% after one year and about 80% after two years, which is about the same rate as developed countries.
  


• The adherence rate to antiretroviral treatment regimens is as high as 90% (AFP/iafrica.com, 1/26).
  


• Approximately 65% of HIV-positive people in Latin America are receiving antiretroviral drugs, approximately 8% of HIV-positive people in African and Asian countries are receiving the drugs, and about 10% of HIV-positive people in developing nations in Europe and the former Soviet Union are receiving the drugs (BBC News, 1/26).
  


• The number of HIV-positive people receiving antiretroviral drugs in sub-Saharan Africa and Asia more than doubled between June and December 2004, from about 100,000 to about 410,000 people.
  


• Ten Latin American countries and Botswana have reached the 3 by 5 target of providing treatment to at least half of the HIV-positive people in the countries who need the drugs, and Thailand and Uganda are expected to reach the goal by the first half of 2005.
  


• Cambodia, Cameroon, Kenya and Zambia have made good progress in increasing the number of antiretroviral therapy sites throughout their countries (WHO fact sheet, 1/26).
  

World Economic Forum Reaction
"In 2001, when the U.N. held a special session on AIDS, people could not even agree on whether to support drug treatment in developing countries," UNAIDS Executive Director Peter Piot said during a speech at the World Economic Forum in Davos, Switzerland, adding that "2004 was the year that we moved from tens of thousands in treatment to hundreds of thousands." However, Piot said that "treatment will have to continue to accelerate" if the 3 by 5 goals are to be met, London's Financial Times reports (Beattie, Financial Times, 1/26). Richard Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said, "Collaboration over the past year has shown that several initiatives can work in tandem to achieve real acceleration. While today's figures are encouraging, the work so far has been laying the groundwork for a much larger expansion in the months and years to come." WHO Director-General Jong-Wook Lee, added, "We salute the countries who have now shown us that treatment is possible and can be scaled up quickly, even in the poorest settings" (WHO release, 1/26).

U.S. Reaction
Randall Tobias, head of the U.S. State Department's Office of the Global AIDS Coordinator, said that in addition to providing antiretroviral drugs in developing countries, "[g]overnments and pharmaceutical companies must work together to make sure the incentives are there to develop the next generation of drugs" (Financial Times, 1/26). He said that the "limiting factor" of HIV/AIDS treatment is not the money to pay for antiretroviral drugs, but the "lack of doctors, nurses and laboratories" (LaFraniere, New York Times, 1/27). Tobias added that 155,000 people in 15 countries currently are receiving antiretroviral drugs under the five-year, $15 billion President's Emergency Plan for AIDS Relief (Reuters, 1/26).

HIV/AIDS Advocates Reaction
HIV/AIDS advocates said that treatment programs in developing countries need to be "scaled up even faster," USA Today reports. "We need to step on the gas if we're going to extend treatment to everyone who needs it, especially children," Mark Isaac, vice president of the Elizabeth Glaser Pediatric AIDS Foundation, said, adding, "Children are being overlooked" (Sternberg, USA Today, 1/26). Paul Zeitz, director of the Global AIDS Alliance, said, "Donor governments must also do more," adding, "No one has any explanation about where the missing $2 billion will come from, and that is deeply troubling" (Cage, AP/South Florida Sun-Sentinel, 1/27).

"The World" -- a production of BBC World Service, PRI and WGBH Boston -- on Wednesday reported on the WHO report. The segment includes comments from Tobias, Zeitz and WHO HIV/AIDS Program Director Jim Yong Kim (Baron, "The World," PRI, 1/26). The complete segment is available online in Windows Media.

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