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One Year After "3 by 5" AIDS Treatment Campaign, International Advocacy Group Warns Effort Is Stagnating
Without Immediate Action, Pledge to Provide "Universal Access" to AIDS Drugs Will Fall Five Million People Short by 2010

November 28, 2006

"The international community must now finally keep its word"

-- Stephen Lewis, UN Envoy on HIV/AIDS in Africa

Cape Town and New York -- The International Treatment Preparedness Coalition (ITPC), a group of 800 treatment activists from more than 125 countries, today released a new analysis of the global AIDS treatment scale up effort titled, Missing the Target #3: Stagnation in AIDS Treatment Scale Up Puts Millions of Lives at Risk. The report finds that the urgency and energy that marked treatment scale up efforts from 2003 to 2005 is dissipating in the absence of clear goals and an all-out mobilization by country governments and international agencies.

"The time for incremental efforts is over," said Stephen Lewis, UN Envoy on HIV/AIDS in Africa, whose Special Assistant Anurita Bains joined report authors on a media teleconference to release the report. "There is new evidence the AIDS epidemic is worsening. The international community must now finally keep its word and mobilize for global AIDS treatment delivery. By scaling up AIDS treatment we will be saving millions of lives, transforming communities and advancing HIV prevention. It is a moral imperative that global leaders and institutions keep their promises and scale up AIDS services with urgency and increased resources."

The new ITPC report, which calls for specific and immediate action to avoid massive shortfalls on global AIDS commitments, is available at

Missing the Target, ITPC's third analysis of global treatment access, was researched and written by civil society leaders on the frontlines in six of the countries hardest hit by AIDS -- Dominican Republic, India, Kenya, Nigeria, Russia, and South Africa. It is being released one year after the end of the World Health Organization's "3 by 5" campaign, which aimed to focus global efforts on significantly increasing treatment access in low and middle-income countries. As that campaign was ending, the G8 countries and a special United Nations session on AIDS pledged to come "as close as possible to universal access" to treatment and prevention by 2010. Missing the Target finds that while there is progress to report, the deadline-driven urgency of 3 by 5 is missing, and scale up is proceeding slowly and unevenly. As a result, millions are now threatened with imminent sickness and death.

Universal Access: A Slogan or a Plan?

"The G8 and UN universal access pledge is in danger of becoming a slogan rather than a plan of action," said ITPC member Chris Collins. "This World AIDS Day, everyone engaged in the response to AIDS has a decision to make. Will we launch a full mobilization or settle for incremental gains that fall millions of lives short?"

Although the international community has not clearly defined what universal access means, a UNAIDS report from May 2006 quantified it as 9.8 million people on treatment by 2010.1 "At the current rate, the world will miss the 2010 universal access goal by five million people," Collins added.

Integrated Approach to Treatment and Prevention Needed

Missing the Target #3 was written by people working to both treat those who are living with HIV and to prevent new infections in their communities.

"AIDS treatment scale up is a unique opportunity to change the status quo in global health. But we need a renewed and real commitment to an integrated approach," said Gregg Gonsalves, programme director for the AIDS and Rights Alliance for Southern Africa and a member of ITPC.

"Recently, some have argued that effective treatment scale up is impossible without a hugely expanded prevention effort. While that is absolutely true, prevention will also ultimately fail without a greatly expanded treatment response," Gonsalves said.

"We need to be building sustainable health systems that can deliver both HIV treatment and HIV prevention, as well as TB and other services," said Fatima Hassan of the AIDS Law Project, who headed the South African research team.

"In South Africa and every other country, we need to be reaching people in both rural and urban areas, the marginalized as well as the privileged, and children as well as adults. This will require a tremendous amount of work in our communities, and our countries, and globally, but it can and must be done," Hassan added.

Immediate Action Required

To reverse the current stagnation in HIV treatment scale up, ITPC calls for the following actions by June 2007:

Country Level Progress and Needs

The report describes progress made in each of the six countries covered in the report and calls for specific national-level actions by June 2007. While each country situation is unique, their end stories are similar: treatment coverage is rising, yet the modest gains are dwarfed by the number of people who need ART, are not getting it, and thus face imminent death. Missing the Target #3 finds that:


  1. UNAIDS, Report on the global AIDS epidemic, UNAIDS, Geneva, May 2006, pp. 227-228.

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