A campaign to get drugs to the needy accelerates

TORONTO -- The former director of the global campaign against AIDS yesterday predicted that 3 million patients in the developing world will be taking potent drug cocktails by the end of next year.

Dr. Jim Kim, a Harvard professor who led the World Health Organization's HIV/AIDS department until December, said in an interview that efforts to treat patients have hastened in recent months, stoking optimism about reaching the 3 million goal in 2007.

That will still be two years later than the original treatment objective established by the WHO as part of a widely heralded initiative known as ``3 by 5." It aimed to provide AIDS drugs to 3 million patients in the developing world by 2005.

Disease specialists estimate that about 6.8 million patients in low- and moderate-income nations are so ill that they should be getting AIDS drugs, with most living in sub-Saharan Africa.

Currently, about 1 million patients in that region are taking the pills, a tenfold increase since late 2003.

``This does represent a very significant achievement over the last 2 1/2 years," said Dr. Kevin De Cock, Kim's successor at the WHO, ``although obviously there's a great deal more to be done."

But doctors from Africa cautioned that there's no guarantee that the ranks of patients on medication will continue to expand. That's because there's no guarantee the billions of dollars spent to purchase drugs will keep flowing -- even to the people now benefiting from it.

The money comes overwhelmingly from three entities: the US government, the World Bank, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

And each of them attaches time limits to its financial support. For example, President Bush's $15 billion AIDS drug initiative has a five-year lifespan and will need the approval of Congress next year to be extended, De Cock said.

Dr. Agnes Binagwaho, leader of Rwanda's national AIDS control effort, decried the requirement that drug-funding campaigns undergo a review process.

``Let me tell you, it's not ethical at all," she said. ``This should not be a case of negotiation -- this should be automatic."

Stephen Smith can be reached at stsmith@globe.com.