25 million people have died of AIDS worldwide in the two decades of the epidemic.1, 2 With 40 million people currently infected, and 8,000 new dead each day, the AIDS epidemic is poised to surpass the Black Death as the worst plague to ever afflict humankind. There are 13 million AIDS orphans in Africa and it is estimated that the number will grow to 40 million by the end of this decade without massive intervention.1 Your help is desperately needed.

TREATMENT WORKS IN RESOURCE-POOR SETTINGS

In the US, Europe and other wealthy countries, antiretroviral drugs have significantly improved the lives of HIV-infected individuals and have dropped AIDS mortality by over half within a few years.3 In the developing world, however, less than 1/10 of 1% of those living with AIDS has access to antiretroviral drugs.4 Once blamed on price, treatment costs have now been lowered from $15,000 per year to as little as $295 per year as a result of generic drug manufacturing and world pressure upon the major pharmaceutical companies.4 Consequently, organizations like Medicins Sans Frontieres (MSF) are using generic and reduced-price drugs to treat patients in Nigeria and South Africa.4

People in developing countries can be treated effectively for HIV with antiretroviral medications. Research has shown that community-based treatment of AIDS with antiretroviral therapy in resource poor settings saves lives.5, 6 Not only does treatment reduce morbidity and mortality, but it limits the spread of HIV among the population. Research has shown that antiretroviral treatment limits mother-to-child transmission of HIV, and expanding treatment to other infected individuals could have an immediate and substantial impact on the AIDS epidemic in sub-Saharan Africa.7

Despite complex issues of poverty and lack of health infrastructure, progress has been made. Brazil and Thailand are manufacturing more affordable generic versions of the life-saving medications. Successful treatment programs are underway in clinics in Mozambique, Botswana, Uganda and Malaysia. Most stunningly, between 1996 and 1999, through the use of antiretroviral medications, Brazil halved the number of AIDS deaths and cut the incidence of opportunistic infections by 60-80%!8

YOUR SUPPORT IS NEEDED

As the demand for treatment increases, research, education, and training are needed to ensure that antiretroviral drugs are used safely and effectively. Studies are needed to learn how to monitor toxicity and resistance in resource-poor settings, particularly in these areas where a much larger genetic variety of HIV-1 strains circulate.9 Research and clinical capacities in these settings need to be developed and maintained.10 11 The desperate lack of antiretoviral treatment for millions of individuals needs to be heard. Your expertise and political support can make a difference and save lives.

WHAT CAN YOU DO?

• Use the respect accorded to you by virtue of your profession to support global antiretroviral treatment.
• Support or engage in drug treatment trials and operations research in resource-poor settings.
• Join or build institutional ties that develop research and clinical expertise in Africa and Asia.
• Urge drug companies to lower their prices for antiretroviral drugs.
• Write your Congressperson and President Bush to give additional monies for the Global Fund for AIDS.
• Join MSF's Campaign for Access to Essential Medicines at www.accessmed.msf.org.
• Stay informed at www.globaltreatmentaccess.org.
• Become a member of the Northwest Coalition for AIDS Treatment in Africa (NCATA) by contacting Sharon Garrett at ghungus@u.washington.edu or Megan McLemore at meegwie@hotmail.com.