‘Lack of Will’ Responsible for Limited Access to Treatment in Developing Nations, Op-Ed Says

"The barrier to the use of AIDS drugs for all HIV patients is not some physical or educational impossibility; it is lack of will," Howard Hiatt, a professor at Harvard Medical School and senior physician at Brigham and Women's Hospital in Boston, writes in a New York Times op-ed. Hiatt notes that "no more than 25,000" of the 28 million Africans with HIV have access to AIDS medications. Some officials in both Western and affected nations say that developing countries lack the necessary health infrastructure to administer drugs and that the populations are "too poorly educated" to follow treatment regimens properly, but such notions are a "misconception," Hiatt states. He says that Partners in Health, a not-for-profit program begun in Haiti in 1983 by Harvard physician Paul Farmer and Anglican priest Rev. Fritz Lafontant, runs a clinic that should be used as a model for treatment programs in disadvantaged settings. The Haitian clinic, which operates on donations, treats about 1,400 HIV patients. One hundred of the sickest patients receive antiretroviral medications under the supervision of local health workers trained at the clinic. The program in Haiti and a sister program in Lima, Peru, which treats tuberculosis patients, have been largely successful with most clients "function[ing] normally." The Partners in Health program is "a small effort against a huge worldwide problem," Hiatt states, adding that the program could treat more people with drug donations from major pharmaceutical companies. He concludes that the program has "shown that if we do not treat the millions of Africans who are dying of AIDS, it is because we have chosen not to, not because we can't" (Hiatt, New York Times, 12/6).