ACW Interview: Mr Craig McClure
At the recently concluded 3rd IAS conference on HIV pathogenesis and treatment, AIDS-Care-Watch caught up with Mr Craig McClure, executive director of the International AIDS Society, to talk about access to HIV/AIDS care and treatment services around the world.
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ACW: The vast majority of people living with HIV/AIDS do not have access to antiretroviral (ARV) drugs. Can you comment on current progress in scaling up of ARV provision globally?
CM: Enormous progress has been achieved in the past two years. Over one million people living in developing countries who need antiretroviral therapy (ART) are now receiving it. Although it appears that the [World Health Organization] target of having 3 million on treatment by the end of 2005 is unlikely to be reached, setting the target has driven over 40 developing countries to prepare detailed plans for implementing ART programmes. Today, health workers are being trained and funding is beginning to flow into countries through Global Fund for AIDS, Tuberculosis and Malaria (GFATM), the US President’s Emergency Fund (PEPFAR), bilateral and in country resources, plus non-governmental organisations (NGOs) are starting to educate local communities to prepare for treatment.
The prices of medication have dropped and the drug procurement and distribution are improving. All this is a monumental task and no one should underestimate the progress that has been made. Still, there are approximately 5 million people in the developing countries who need ART now, but do not have access. The pace of expansion must continue to grow, and even increase, despite the enormous challenges.
The consequences of every delay are the loss of life, destruction of families and great damage to entire communities.
ACW: Comprehensive HIV/AIDS care ranges from HIV counselling and testing services through to palliative care for those close to the end of life. Aside from ARVs, which other care and treatment options do you think are likely to add years or quality to someone’s life?
CM: Cotrimoxazole and other prophylaxis for opportunistic infections are critical, in addition to antiretroviral treatment. And other basic medications, like anti-diarrhoeals and pain killers are required. And for many, many people with HIV/AIDS living in poverty, food and clean water are needed. I believe that efforts to expand ART access are now incorporating to a large degree the need for these other options, but people also need to remain focused. ARV drugs, taken regularly and safely, are the only tools that can keep people alive and healthy with HIV for the long term.
ACW: One of the main differences between rich and poor regions in relation to HIV/AIDS is a more rapid progression towards AIDS-related illness in developing countries. What do you think might be the reasons for this difference? Can you recommend any measures that may alleviate this more rapid progression?
CM: Poor nutrition, poor basic health care, lack of access to clean water, other co-infections, the many vulnerabilities caused by poverty.
ACW: People living with HIV have a much higher lifetime risk of developing a range of common, potentially fatal, and yet treatable diseases, such as tuberculosis (TB) and meningitis. Is adequate or appropriate attention being given at the national or international level to preventing and treating these conditions?
CM: There is an issue of pitfalls of developing vertical stand-alone ART programmes, but most countries, donors and international organizations are working to integrate ART into tuberculosis and antenatal clinics, and other points of contact that people have with the health system. In general though, health systems are weak in developing countries, and the unprecedented momentum to expand ART services for PLWA should provide benefits for health systems overall.
ACW: Many – if not almost all – HIV-related interventions are concerned with doing things or providing material for people. In what ways do you think affected people can be empowered to take more control of their own health? What impact do you think this would have on their day-to-day lives?
CM: I am concerned about overly simplistic notions that people can “empower” themselves. People need services and people need to be trained to deliver those services. People living with HIV/AIDS and those most affected need to be partners in the development of those services. Plus, people with HIV/AIDS and those most affected can be a driving fire to make that happen, by advocating with governments, then workplaces and the city leaders.
***
For more information about the AIDS-Care-Watch campaign, please visit: www.aidscarewatch.org.
This interview was conducted by an HDN Key Correspondent. To contact the Key Correspondent team, please email: correspondents@hdnet.org
******
ACW: The vast majority of people living with HIV/AIDS do not have access to antiretroviral (ARV) drugs. Can you comment on current progress in scaling up of ARV provision globally?
CM: Enormous progress has been achieved in the past two years. Over one million people living in developing countries who need antiretroviral therapy (ART) are now receiving it. Although it appears that the [World Health Organization] target of having 3 million on treatment by the end of 2005 is unlikely to be reached, setting the target has driven over 40 developing countries to prepare detailed plans for implementing ART programmes. Today, health workers are being trained and funding is beginning to flow into countries through Global Fund for AIDS, Tuberculosis and Malaria (GFATM), the US President’s Emergency Fund (PEPFAR), bilateral and in country resources, plus non-governmental organisations (NGOs) are starting to educate local communities to prepare for treatment.
The prices of medication have dropped and the drug procurement and distribution are improving. All this is a monumental task and no one should underestimate the progress that has been made. Still, there are approximately 5 million people in the developing countries who need ART now, but do not have access. The pace of expansion must continue to grow, and even increase, despite the enormous challenges.
The consequences of every delay are the loss of life, destruction of families and great damage to entire communities.
ACW: Comprehensive HIV/AIDS care ranges from HIV counselling and testing services through to palliative care for those close to the end of life. Aside from ARVs, which other care and treatment options do you think are likely to add years or quality to someone’s life?
CM: Cotrimoxazole and other prophylaxis for opportunistic infections are critical, in addition to antiretroviral treatment. And other basic medications, like anti-diarrhoeals and pain killers are required. And for many, many people with HIV/AIDS living in poverty, food and clean water are needed. I believe that efforts to expand ART access are now incorporating to a large degree the need for these other options, but people also need to remain focused. ARV drugs, taken regularly and safely, are the only tools that can keep people alive and healthy with HIV for the long term.
ACW: One of the main differences between rich and poor regions in relation to HIV/AIDS is a more rapid progression towards AIDS-related illness in developing countries. What do you think might be the reasons for this difference? Can you recommend any measures that may alleviate this more rapid progression?
CM: Poor nutrition, poor basic health care, lack of access to clean water, other co-infections, the many vulnerabilities caused by poverty.
ACW: People living with HIV have a much higher lifetime risk of developing a range of common, potentially fatal, and yet treatable diseases, such as tuberculosis (TB) and meningitis. Is adequate or appropriate attention being given at the national or international level to preventing and treating these conditions?
CM: There is an issue of pitfalls of developing vertical stand-alone ART programmes, but most countries, donors and international organizations are working to integrate ART into tuberculosis and antenatal clinics, and other points of contact that people have with the health system. In general though, health systems are weak in developing countries, and the unprecedented momentum to expand ART services for PLWA should provide benefits for health systems overall.
ACW: Many – if not almost all – HIV-related interventions are concerned with doing things or providing material for people. In what ways do you think affected people can be empowered to take more control of their own health? What impact do you think this would have on their day-to-day lives?
CM: I am concerned about overly simplistic notions that people can “empower” themselves. People need services and people need to be trained to deliver those services. People living with HIV/AIDS and those most affected need to be partners in the development of those services. Plus, people with HIV/AIDS and those most affected can be a driving fire to make that happen, by advocating with governments, then workplaces and the city leaders.
***
For more information about the AIDS-Care-Watch campaign, please visit: www.aidscarewatch.org.
This interview was conducted by an HDN Key Correspondent. To contact the Key Correspondent team, please email: correspondents@hdnet.org
posted by AIDS-Care-Watch at 2:31 pm
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