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Barriers to better care for people with AIDS in developing countries

WHO's 3 by 5 initiative to increase access to antiretroviral drugs to people with AIDS in developing countries is highly ambitious. Some of the biggest obstacles relate to delivering care. Andrew S Furber and colleagues explain

By: Andrew S Furber, Ian J Hodgson, Alice Desclaux, David S Mukasa

Access to good quality antiretroviral treatment has transformed the prognosis for people with AIDS in the developed world. Although it is feasible and desirable to deliver antiretroviral drugs in resource poor settings,1w1w2 few of the 95% of people with HIV and AIDS who live in developing countries receive them. The World Health Organization has launched a programme to deliver antiretroviral drugs to three million people with AIDS in the developing world by 2005, the “3 by 5” initiative.2w3 We identify some of the challenges faced by the initiative, focusing on delivery of care.

Ideally, care for people with AIDS should start with voluntary counselling and HIV testing. However, only 10% of people who need testing in low and middle income countries have access to services, and therefore most are unaware of their serological status.w5 Care should include psychological, social, and economic support as well as broad based medical care incorporating

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