Challenges in delivering universal access

Challenges in delivering universal access

Obstacles to scaling up HIV treatment persist in most countries, including funding shortages, limited human resources, and weak procurement and supply management systems for HIV drugs and diagnostics and other health systems bottlenecks. One third of countries reported at least one or more cases when supply of HIV medicines had been interrupted in 2009.

Prevention efforts to reach most-at-risk populations such as sex workers, drug users, and men who have sex with men are limited. For example, only about one third of injecting drug users in reporting countries were reached with HIV prevention programmes in 2009.

Availability and safety of blood and blood products continue to be a concern for HIV prevention, especially in low-income countries. While 99% and 85% of blood donations in high- and middle-income countries, respectively, were screened in a quality-assured manner in 2009, in low-income countries the comparable figure was 48%.

Results from population surveys in ten countries showed more than 60% of HIV-positive people did not know their HIV status. As a result, many patients start treatment too late. Around 18% of patients initiating treatment were lost to follow-up during the first year, a large proportion of them dying due to late initiation of treatment.

"The report findings indicate challenges but also clear opportunities for optimizing investments and increasing efficiency. By starting treatment earlier and improving adherence within the first year, we can save many more lives," said Dr Gottfried Hirnschall, WHO's Director for HIV/AIDS. "We also need to not only further increase access to key HIV/AIDS interventions but also to pay attention to ensure higher quality of these life-saving services," he said