| Chapter 2: | Treating HIV/AIDS |
|
|
fore, the millennium began with the international community’s mobilization efforts to provide and increase HAART access in these regions (UNAIDS, 2006a; WHO, 2006b). For example, the U.S.-based PEPFAR, which was formulated in 2003, had a goal to provide treatment to about 2 million individuals affected by HIV/AIDS worldwide within 5 years (USDS, 2004). PEPFAR’s initial plan was to spend approximately $15 billion primarily in low-income nations chosen based on U.S. political views to fight HIV/AIDS, tuberculosis, and malaria; this expenditure was increased to about $48 billion in 2008 by President Obama to fund the same plan for an additional 5 years (UNAIDS, 2010a). From 2003 to 2010, the number of individuals receiving antiretroviral drugs through PEPFAR specifically in sub-Saharan Africa increased from 50,000 to about 3.2 million (USDS, 2011). Similar to the efforts of the United States, WHO also introduced a “3 by 5” initiative in 2003 with an objective to “provide access to HAART to 3 million people in developing countries by 2005” (UNAIDS, 2006a; WHO, 2006a). The United Nations member states scaled up these initiatives with a goal for everyone affected by the virus to access HAART by 2010 (WHO, 2006b). Despite the fact that the United Nations fell short of its 2010 goal, with only about 42% of those in need receiving HAART by the end of 2008, the international community continues to assist low-income nations in accessing anti-HIV drugs. Among those living up to this mission, the Global Fund was the largest multilateral organization contributor in 2009. The United States through PEPFAR was the largest single donor nation in the fight against HIV/AIDS during the same year, followed by the United Kingdom through the Department for International Development (DFID) (UNAIDS, 2010b). Some of the other nations helping poor nations access anti-HIV drugs include France, Sweden, Canada, Germany, Ireland, the Netherlands, Italy, Australia, Japan, Norway, and Denmark. There is no doubt that the effort to scale up HAART in low-income nations is beneficial. However, with it comes public health concerns, such as those springing from adherence failure (the potential for the development of drug-resistant HIV), and hence treatment failure and increase in the infection rate, all of which undermine the international