Fight against AIDS: 25 years after the beginning of the epidemic, prevention is very difficult

Twenty-five years after the onset of the epidemic, prevention of transmission of HIV / AIDS remains terribly difficult, said the association Sidaction during a press conference in Paris
Prevent and treat both!
Promoting prevention tools such as male or female condom was marked success in many countries, but under the combined pressure of the U.S. government and churches, many governments now favor the promotion of abstinence, and although no scientific evidence to justify such a choice comes.

In Eastern Europe, South Asia and South East, access to injection equipment for drug users is almost impossible, and some countries are an open war against them, making it very complicated intervention to reduce risk of transmission.

Since the confirmation of the benefit of HAART in slowing the progression of the disease and help to live better and longer, the issue of access to treatment in developing countries has been raised dramatically. This is a two-speed world that is designed with patients for whom there is hope in developed countries, while others are condemned in developing countries.

However, it is clear that progress, from 2001 essentially has been made. Conjunction with a major financial mobilization (through the Global Fund to fight against AIDS, tuberculosis and malaria) and a deliberate policy on the part of many development actors, WHO was able to launch a goal 3 million people on treatment by the end of 2005.

But even that goal was only half of the immediate needs, it has been achieved only 50% and again, all patients in developing countries are not equal. In sub-Saharan Africa, only 10% of patients who need access to treatment, against more than 50% in the Caribbean ...

Future challenges
Future challenges are many. Sustainability of financing systems access to prevention, care and treatment is not assured, and already, in some countries, it seems that there will be less money available that past year.

Meanwhile, the health facilities in the most affected countries are unable to absorb the exponential increase in care needs of patients, so that they are reluctant to go there. Alternatives to public health systems are not encouraged and are even opposed in some countries.

Weak human resources makes terribly complicated the implementation of access to health care programs, despite the WHO recommendations to delegate more nurses and medical technicians part of medical care. For example, less than a hundred doctors can prescribe antiretroviral correctly in Burkina Faso, where 300,000 HIV-positive people need to follow.

Access to generic drugs, which has led to a considerable reduction in the cost of antiretroviral drugs, is severely challenged by the combined pressures of the WTO and some producers treatments countries like the U.S. and Switzerland.

It probably will not be possible to have access to newer drugs as it was possible to benefit from generic treatments first generation through Indian manufacturers ... Finally, the political will to effectively fight against AIDS is not always present you, despite the beautiful successive statements. Some prefer to deal with AIDS rather than the AIDS virus. Fiscal mobilization is not at the rendezvous.

Mission and actions sidaction
The mission of the international programs is to contribute to the development of programs to fight against AIDS in developing countries.

The priority intervention is access to care, it being understood that the flaps prevention, care, support and treatment form a continuum, says Sidaction.

This action is primarily in sub-Saharan Africa and to a lesser extent in Eastern Europe, Asia and Latin America.

Specifically, the action of Sidaction through financial and technical support of projects (92 in 2005) implemented mainly by local associations (53 in 2005) in 23 countries, and monitoring.

We can describe the support of Sidaction as follows:

- Financial support for access to care and treatment programs,

- Technical assistance on the ground, particularly in the areas of management, structuring and professionalization, access to medicines and pharmacy management, the pediatric care ...

- Financial and technical support in the field of training,

- Studies and lobbying on issues of access to health care and community health.

In 2005, more than 2 million have been directly incurred to finance actions in the field, making Sidaction the first actor to developing countries from the French associations fighting against AIDS.