Developing and implementing a package for HIV prevention

At the UN World Summit in September, the General Assembly followed the example set by the G8 leaders, by committing themselves to:

"Developing and implementing a package for HIV prevention, treatment and care with the aim of coming as close as possible to the goal of universal access to treatment by 2010 for all those who need it"⁸⁷

Russian President Vladimir Putin promised that his country would allocate at least 20 times more money to fight HIV and AIDS in 2006 than it did in 2005. The President said that AIDS in Russia was a "serious problem", and that current spending of $5 million per year was "practically nothing for Russia on the scale of things".^{88 89}

In September the antiretroviral drug zidovudine (AZT) reached the end of its patent period in the US. This meant that any pharmaceutical company could now produce the drug legally and cheaply for the US market without having to pay royalties to the patent owner, GlaxoSmithKline. The FDA immediately approved four generic forms of AZT for sale within America.⁹⁰

Zimbabwe, one of the countries worst affected by AIDS, was suffering from a severe economic crisis made worse by droughts and the government's controversial land redistribution programme. One consequence was a sharp rise in the price of AIDS drugs in the public sector, from $7.70 per month in July to $46 per month in October. At the same time the state-run treatment programme was handicapped by a lack of foreign assistance, due to Western opposition to land reform and reported violence and intimidation during elections.

"People are giving up [their] drugs - they have to choose between feeding and educating their kids or taking ARVs" ⁹¹

Zimbabwean President Robert Mugabe was accused of further worsening the AIDS crisis in his country through his slum clearance campaign, which left thousands of families homeless. But UNAIDS announced that Zimbabwe's HIV prevalence rate had fallen over the previous five years, from around one in four to around one in five infected.^{92 93}

In 2005 skepticism about the cause of AIDS was still thriving in South Africa. The Democratic Alliance gave a list of the country's twelve most influential "AIDS dissidents" (people who question the theory that HIV causes AIDS), whom it said had an "ongoing and bizarrely powerful" influence on national HIV/AIDS policy. The list was headed by attorney Anthony Brink, the convenor and national chairperson of the Treatment Information Group and spokesperson for the Dr Rath Health Foundation, an organisation dedicated to promoting the use of vitamin supplements rather than antiretrovirals to treat AIDS. Also featured were President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang.

"South Africa has become a safe haven for AIDS denialists and is the AIDS denialist capital of the world... Were it not for the influence of dissidents, South Africa would long ago have been able to take the steps that countries like Brazil and Thailand have taken to stop new AIDS infections, provide appropriate education and offer meaningful treatment to those already infected."Democratic Alliance health spokeswoman, Dianne Kohler-Barnard -⁹⁴

A London bus covered with hundreds of hand-written messages from campaigners appealing for universal access to AIDS treatment, on World AIDS Day 2005.

By late 2005, it was clear that the World Health Organisation's 3 by 5 plan would fail to achieve its goal of 3 million people on treatment in resource-poor countries by end of the year. With refreshing honesty, the head of the WHO's HIV/AIDS programme admitted as much and said sorry.

"All we can do is apologise. I think we just have to admit we’ve not done enough and we started way too late."Dr Jim Yong Kim

However, Dr Kim said the initiative should certainly not be deemed a failure:

"Before Three by Five, there was not an emphasis on saving lives... Many leaders in the world were saying we just have to forget about this generation of people who are infected, we're really thinking about the next generation... So something has happened that's extraordinary."⁹⁵

The WHO estimated that expanded access to treatment had saved between 250,000 and 350,000 lives during 2005. However, their estimates also revealed there were more new HIV infections and more AIDS deaths in 2005 than in any previous year.