The World Health Organization's "3 by 5" initiative to ensure antiretroviral therapy (ARVs) for 3 million HIV patients in developing countries by the end of 2005 was slow to start, ultimately reaching about 1 million people, experts told the 14th International Conference on HIV/AIDS and Sexually Transmitted Infections in Africa in Abuja, Nigeria.

In Africa, the continent most-affected by HIV/AIDS, the gap is even wider, with just half a million or "at best one person out of 10" in need of ARVs actually receiving them by mid-2005, according to UNAIDS.

However, experts said, the initiative begun in 2003 is a promising development for treating the world's poorest HIV/AIDS patients in the future. "We've said for a long time that we're not going to meet 3 by 5," said Jim Yong Kim, WHO's head of HIV/AIDS. "But on the other hand we're extremely excited about what happened after 3 by 5," he said, adding that "we have learned a basic lesson that businesses have known for a long time, the importance of setting a concrete target in a timeframe."

"I think [3 by 5] gave the momentum," said Doctors Without Borders' South Africa Head of Mission Eric Goemaere. "We needed a quantitative objective. It was the best and only way to get people to work on these issues." "I have never seen a sophisticated program like the ARV program kick-start so rapidly," he said. "I don't think there is any precedent in history." Even so, Goemaere noted, the tiny number of patients receiving ARVs "remains a scandal from a moral point of view."

"It's normal it should get off to a slow start, a lot of obstacles have to be overcome," said Donald de Korte, an executive for the U.S.-based drug firm Merck. "You see the same phenomenon across the board in all countries: ARV distribution follows an exponential curve," he said. "I think it's reasonable to suppose that the next 500,000 will be reached by the end of 2006."

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