PARIS, Jan 26 (AFP) - Access to life-saving AIDS therapy is spreading quickly in many poor countries, the World Health Organisation (WHO) reported Wednesday, but admitted it was far off its goal of getting the vital drugs to three million needy people by year's end.
In the latest update on its "Three by Five" initiative, the WHO said that at the end of 2004, around 700,000 people in developing countries and transitional economies were receiving antiretroviral drugs.
That tally marked a big gain from six months earlier, when only 440,000 people had access to the treatment, the UN agency said.
It added that those who are receiving the drugs are enjoying "dramatic" benefits in health.
Despite this progress, fewer than one in four are getting the drugs out of the three million badly-infected poor people the WHO hopes to reach by December 31 2005.
And that three million is little more than half of the 5.8 million poor people who are in urgent need of treatment, it admitted.
"The figures speak for themselves," the WHO said bluntly.
"Global progress towards the 'Three by Five' target can only be made if major progress is made in the countries with the greatest unmet need for treatment."
The agency estimated the costs this year of meeting "Three by Five" in 49 countries at between 3.1-3.8 billion dollars (2.4-2.9 billion euros), on the basis of a drug cost of 304 dollars (233 euros) per person.
So far, only 1.55 billion dollars (1.19 billion euros) have been pledged or committed from national resources, international agencies and private and government donors, it said.
"This would leave a shortfall of more than two billion dollars (1.53 billion euros)," the WHO said, adding though that the gap would narrow if the cost of buying and administering the drugs could be brought down further.
The WHO update made these points:
- Of the 700,000 now getting the drugs, 220,000 of them are in Latin America, led by Brazil, which has a well-regarded AIDS programme and is a big producer of cheap generic drugs.
- In sub-Saharan Africa, the number getting the treatment has doubled in six months, to 310,000. Botswana, Kenya, South Africa, Uganda and Zambia have made the best progress. But another 3.7 million infected Africans face a death sentence without early access to the drugs.
- In Asia, Thailand is leading the way. Every district now has antiretroviral therapy facilities, and each day more than more than 3,000 people are started on treatment.
- HIV-infected people who get the drugs are getting "dramatic" benefits. After one year of therapy, the survival rate is more than 90 percent, falling back to 80 percent after two years. These rates are the same as in rich countries.
- Fears that antireviral drugs are inappropropriate for poor-country settings are wrong, according to the evidence. "Adherence to regimens is as high as 90 percent," the report says.
Antiretroviral drugs are complex medications which can cause toxic side-effects. Several pills have to be taken several times a day -- and for life, as there is no cure for HIV.
The present generation of drugs became available in the mid-1990s, and immediately became credited with handing a lifeline to those whose immune systems had been badly damaged by the AIDS virus.
But high prices placed the drugs out of reach of poor countries until 2003, when voluntary cuts by pharmaceutical companies and competition from generics started to drive down the cost.
The WHO nailed its colours to the "Three by Five" target on September 22 2003 in an announcement at the United Nations, made shortly after Lee Jong-wook took over as secretary-general.
Poor countries are bearing the brunt of the global epidemic, especially in Africa, which is home to nearly two-thirds of the 39.4 million people with AIDS or the human immunodeficiency virus (HIV) which causes it.
At the time, the number of sub-Saharan Africans with access to antiretrovirals numbered just 75,000.
The WHO's headline-making goal was praised universally for its good intentions. But many analysts wrote it off as a media-friendly pipedream, destined to be thwarted by the chronic lack of medical infrastructure in badly-hit countries.

01/26/2005 11:00 GMT - AFP