Kaiser Daily HIV/AIDS Report Summarizes Opinion Pieces in Response to WHO ‘Three-by-Five’ Plan

The World Health Organization on Dec. 1 as part of its World AIDS Day activities announced details of its "three-by-five" plan, which aims to treat three million HIV-positive people with antiretroviral drugs by 2005. WHO's plan, which lays out a timetable and roadmap for treating three million people with antiretroviral drugs in the next two years but does not provide or subsidize the drugs, calls for training 100,000 health care workers, refocusing 10,000 clinics in poor countries to treat HIV/AIDS and using some common antiretroviral drug combinations (Kaiser Daily HIV/AIDS Report, 12/1). An opinion piece and two editorials that were published over the weekend discuss the WHO plan. The Kaiser Daily HIV/AIDS Report summarizes them below:

• David Brown, Washington Post: WHO's plan to use "minimally trained ... community treatment supporters" to do much of the health care work in its three-by-five initiative is "radical" because such a model has "never been tried on the scale that the WHO initiative envisions," Brown, a medical and science reporter for the Washington Post, writes in an perspective piece. While it is "good news" that some research has shown that community workers "do a better job than those appointed by governmental bodies or those who volunteer," Brown writes that HIV/AIDS treatment presents a unique challenge to community medicine because treatment is not a one-time occurrence but requires daily doses of drugs. The plan "is going to try to loosen professional medicine's grasp on the world's most important infectious disease, and hand it over to the people," a process that the world is "watching with keen anticipation," Brown concludes (Brown, Washington Post, 12/7).
  
  
• Long Island Newsday: The WHO plan is a "profound, risky and absolutely imperative" plan that is long overdue, according to a Newsday editorial. There are several "dangers" in the plan, including concerns that the initiative could result in "a bit of erosion" in some of WHO's traditional focus areas -- like its initiatives against polio -- and that medical workers might begin to let prevention efforts "slide as treatment takes an ever-larger role," the editorial says. However, providing treatment for three million people by 2005 would be "major progress," and "[i]n a world that for too long has wrung its hands at AIDS, some trade-off" between the new program and older WHO initiatives is "acceptable," the editorial says. However, WHO must work to ensure that "its push for treatment and its push for prevention are complementary," the editorial concludes (Long Island Newsday, 12/7).
  
  
• Washington Post: The WHO plan represents "a critical and belated response to a disease that is ravaging sub-Saharan Africa," a Post editorial states. Although the WHO plan "has produced a kind of roadmap for making care available" to the underserved areas of the world, a "significant [funding] gap" in how the organization will provide the needed treatments remains, according to the Post. The editorial concludes, "The world's resources commitment [to fighting HIV/AIDS] must be generous, broad-based and ... ongoing," adding that "a map is only useful if people are willing to follow it" (Washington Post, 12/6).