Scaling Up AIDS Treatment What Is the Potential Impact and What Are the Risks 英文参考文献.docVIP

Open access, freely available online Perspectives Scaling Up AIDS Treatment: What Is the Potential Impact and What Are the Risks? Peter Lamptey*, David Wilson T here has been a recent and dramatic rise in global funding for HIV/AIDS, from US$2.1 emphasis and funding are shifted from prevention to treatment [2]. Countries in which this pattern has been seen are evidence of the pitfalls of failing to adapt prevention efforts once life- extending treatment becomes widely available. Of course, prevention and treatment are not mutually exclusive. Successful prevention efforts mean fewer patients will need the costly drug treatment programs, helping extend the sustainability of ART. In turn, the success of ART in prolonging healthy living helps prevention efforts by reducing the stigma associated with self-education and responsible behaviors. Box 1. Initiatives to Fund ART ? The WHO“3 by 5” Initiative: This initiative aims to place 3 million people in low- and middle-income countries on ART by the end of 2005. billion in 2001 to US$6.1 billion in 2004 [1], thanks to several new funding mechanisms (Box 1). These funds, coupled with reduced drug costs, make it feasible to roll out antiretroviral therapy (ART) even in resource-poor settings. Nevertheless, the total number of people living with HIV rose in 2004 to reach its highest level ever: an estimated 39.4 million people are living with the virus, including 4.9 million who acquired it in 2004 [1]. Therefore, the debate over the appropriate ? The US President’s Emergency Plan for HIV/AIDS Relief: This initiative aims to treat 2 million HIV-infected people with ART, to prevent 7 million new infections, and to care for 10 million HIV- infected individuals and AIDS orphans in ?ve years (2004–2009). ? The Global Fund to Fight AIDS, Tuberculosis, and Malaria: In the ?ve years following its inception (2002–2007), the Global Fund aims to provide 1.6 million people with ART and 52 million people with VCT, and to support mo