PARIS, France (AFP) – The World Health Organisation (WHO) admitted Wednesday it was unlikely to meet its goal of getting anti-HIV drugs to three million poor people by the end of 2005 and called for another US$18 billion to fight AIDS over the next three years.

In a June 2005 report, issued six months before its self-imposed deadline, the UN agency said around a million people in developing and transitional countries were now getting antiretroviral therapy (ART).

That compares with 400,000 in December 2003 when the

“Three by Five” initiative was launched to global fanfare.

But the WHO had hoped that 1.6 million people would have access to these life-saving drugs by June 2005.

ART is a combination of drugs that prevent replication of HIV, a virus that destroys the body’s immune system and leaves it exposed to infection.

But they are not a cure; the patient must follow a strict daily regimen of drugs that can have bad side-effects; and the cheapest available drugs may not tackle specific viral strains.

“Current data and trends indicate that providing ART to three million people by the end of 2005 will be unlikely,” said the report dubbed Progress on Global Access to HIV Antiretroviral Therapy: An Update on ‘3 by 5’ produced jointly by WHO and UNAIDS.

However, there is reason to be hopeful that growth rates will continue to increase in the remainder of 2005 and beyond.

“An estimated US$27 billion is available or has been pledged for HIV/AIDS globally from all sources for the period 2005-2007… (but) at least an additional US$18 billion above what is currently pledged is needed.”

‘All sources’ means spending by patients, governments as well as donors, and on care and prevention as well as on drugs.

Of the 39.4 million people in the world living with AIDS or the human immunodeficiency virus (HIV), the vast majority live in poor countries where, until the price of drugs began to plunge several years ago, ART was dismayingly out of reach.

It was in that context that WHO Director-general Lee Jong-Wook promoted the Three by Five initiative, seeking to rally everyone behind a common flag.

Critics said the goal was worthy but too ambitious given the lack of medical infrastructure on the ground, especially in Africa.

Some were reminded of the 1981 UN declaration of ‘Health for All by the Year 2000’ which fell notoriously wide of the mark.

“This is the first time that complex therapy for a chronic condition has been introduced at anything approaching this scale in the developing world,” Lee said on Wednesday.

“The challenges in providing sustainable care in resource-poor settings are enormous, as we expected them to be. But every day demonstrates that this type of care can and must be provided.”

In the report, co-authored with the specialised agency UNAIDS, the WHO pointed to progress as well some entrenched obstacles.

In sub-Saharan Africa, around 500,000 people are now receiving ART – more than triple the number of a year ago and nearly double the tally of six months earlier, an “especially encouraging” sign that the distribution motor is getting into higher gear.

In Asia, the second most-affected region, the number of people on ART has tripled since June 2004 to around 155,000 today.

More than 50 per cent of the Asian increase occurred in the first six months of 2005.

In addition, there were no signs that the precious drugs were being distributed unfairly – for example, favouring men more than women in male-dominated societies, the report said.

The report also highlighted the following problems among the 49 “focus” countries identified as needing especial help:

. inexperience in drug procurement policy and and supply bottlenecks;

. a dearth of health workers to help administer ART to patients with HIV and provide them with counselling; and

. children are still too often excluded from medical care and need new drugs formulated to their needs.

“Fifty percent of HIV-infected children will die before their second birthday in the absence of treatment,” the report warns.

The WHO-UNAIDS report estimates that 6.5 million people in the low- and middle-income countries identified in the initiative are in need of ART.