Great strides made in universal access to HIV/AIDS treatments.

With 3 million people living with HIV/AIDS in developing countries now receiving antiretroviral therapy, a new universal goal has been devised to provide treatment to every person who needs it, according to a new report.

In May, the World Health Organization, Joint United Nations Program on HIV/AIDS and UNICEF released the progress report, "Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector." The report found that by the end of 2007, only 31 percent of people in need of antiretroviral therapy were receiving it. However, according to the report, considerable progress has been made in the effort to prevent mother-to-child HIV transmission, with 18 percent of pregnant women globally being tested for HIV/AIDS, up from 10 percent in 2005.

"The success displayed in this report should not be undermined," said Terri Creagh, PhD, director of research at the Well Project, a nonprofit organization that has a mission to address the HIV/AIDS pandemic through a focus on women. "(HIV/AIDS) is still a significant problem."

Although universal access to HIV/AIDS treatment for all affected people can seem an almost impossible mission, most countries are ready to commit to the objective, said Creagh. Still, she said, sometimes a strong desire is not enough.

"Having policies does not mean that things will get done," said Creagh, noting that many developing countries do not have adequate health care infrastructures to distribute drugs to communities struggling with HIV/AIDS.

Moreover, the drugs that do get to hard-to-reach rural populations in places such as Africa will do little if patients are not monitored. According to the progress report, in 2007 nearly 33 percent of pregnant women living with HIV received anti-retrovirals, up from 10 percent in 2004, with the most significant increase in sub-Saharan Africa. Such treatment prevents the woman from transmitting HIV to the fetus. But after many pregnant women give birth, anti-retrovirals may not be continually administered to them. In fact, the report found that only 12 percent of HIV-positive pregnant women globally who received antenatal care were evaluated to determine if they were qualified to receive anti-retrovirals after their children were born. If such women do not continue to receive regular treatments, the children who were originally protected by anti-retrovirals risk losing their mothers and becoming orphans.

If all HIV-positive pregnant women worldwide received treatment, HIV/ AIDS could be prevented in nearly 100 percent of children, as almost all children that live with HIV/AIDS were infected by their mothers, Creagh told The Nation's Health.

"Women are the key to changing the epidemic," Creagh said.

Women can play a major role in preventing new HIV/AIDS cases, as they make up more than half of the total HIV/AIDS population receiving antiretroviral therapy, according to the report. But, men also need to be the focus of preventive education and outreach, Creagh said.

Unfortunately, treating men can be more difficult, she said, because of a culture of denial and subsequently low testing rates. Even though using a condom is one of the most effective ways to prevent HIV transmission, many men refuse to adopt the preventive measure due to a "macho" attitude, she said.

"It is hard to change a cultural paradigm," Creagh noted.

Precautionary measures are the best--and cheapest--methods to prevent HIV/AIDS, according to Creagh. However, the current treatment--antiretroviral therapy--is effective only for those that are able to obtain it in time and are routinely monitored.

But if someone does not know if she or he is infected, the impact of expanding treatment access is stunted. There are millions of people who are unaware of their HIV status: In 17 countries studied, 11 of which were located in sub-Saharan Africa, only about 10 percent of men and women each had been tested for HIV/AIDS, the report stated.

The report's authors noted that despite treatment progress, "weak health care systems, a critical shortage of human resources and a lack of sustainable, long-term funding" will prove to be obstacles in achieving absolute universal access.

For more information or a copy of the HIV/AIDS progress report, visit www.who.int.