In 2000, the world’s countries agreed upon 8 MDGs to be achieved by 2015: eradicate poverty and extreme hunger, achieve universal primary education, promote gender equality, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainable and develop a global partnership for development. These are ambitious goals aimed at drastically improving quality of life for people worldwide and they require substantial global cooperation to share expertise and funding amongst countries.
Specific targets were set for each goal, one of which is to achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. This goal, getting people who need it on antiretroviral (ARV) treatment is brilliant: like most of the MDGs, it has a ripple effect that means improvements in more than one area. ARV treatment means fewer people suffering from illness and unable to work, mothers and fathers for children, professionals who live long enough to train others, more people to tend fields and feed their families, fewer new infections, more activists to advocate for political accountability and action on pressing issues throughout the Global South.
Antiretrovirals (ARVs) are used to treat HIV, but there is no cure. They are severely expensive drugs, costing between $10,000 and $15,000, primarily as a result of pharmaceutical patents; although there is nearly universal adherence to ARVs in the Global North where individuals and/or governments are able to afford the drugs. These countries also have extensive health care networks, with medical professionals relatively readily available to diagnose and treat patients – all factors absent in many developing countries that are further complicated by limited budgets.
Clearly, when these goals were set, those involved knew they were ambitious. But “ambitious” should not be conflated with “impossible”: there are examples of countries that have overcome the barriers that people so often accept instead of challenge: absent health infrastructures and personnel, illiterate patients not used to regimented prescriptions, growing numbers of HIV+ people needing drugs, expensive medications protected by international intellectual property rights organizations that are impossible to afford in the world’s poorest countries. Brazil is one place that has reduced the cost of drugs to an average of $3,000. This is not a new development – this program has been in place since the late 1990s.
Less than one third of those needing treatment are receiving ARVs according to The Millennium Development Goals report from the United Nations. While more people are being able to access drugs through innovative programs provided by governments and civil society organizations like Médécins sans Frontières (MSF) alike, new infections are outpacing gains in treatment.
Worse is that with 9 months to go, this is not being talked about in the media, in parliaments, in the UN Assembly. Meanwhile, 9.7 million people needing HIV treatment will die, leaving countries struggling to staff their departments and provide programming, children without parents, and in some cases, a number of newly infected people.
This goal is ambitious, but it is also achievable: Brazil is widely acknowledged as the model for achieving ARV adherence. Since 2the late 1990s, the country has provided ARV treatment to all those for whom it is medically necessary. It was the result of political commitment – in Brazil itself, and from international partners such as the World Bank that financed the initiative, and willingness to challenge the power pharmaceutical companies wield.
With 9 months to go, the UN, governments, civil society organizations, corporations and individuals should be doing all they can to say to people living with HIV worldwide that they will not be left to die in a world that has the treatment they need.
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