An international group of public health experts is calling for a new AIDS corps modeled on the U.S. Peace Corps to fight the HIV epidemic in developing countries. The proposal is one of several initiatives the experts recommend to greatly expand health care for HIV patients in countries with inadequate medical services.
With billions of dollars flowing from the United States and other donors and with price cuts for AIDS drugs, a U.S. National Academy of Sciences panel says the time is right to vastly increase HIV treatment and prevention programs in developing nations.
New United Nations figures show that bilateral and multilateral assistance to HIV programs jumped 60 percent between 2000 and 2002. Much more is to come with most of the U.S. commitment of $15 billion yet to be distributed and other funds being targeted by the World Health Organization and the Global Fund to fight AIDS, Tuberculosis, and Malaria.
But U.S. AIDS relief coordinator Randall Tobias says countries with scarce health resources are having difficulty absorbing the money and increasing treatment to match the contributions.
"In talking with people in Africa who are involved in these programs, they are much, much more focused on the issues of infrastructure and the people and the capacity constraints than they are on the drugs because right now, they are able to get drugs, but there is so little treatment going on because the capacity doesn't exist," he said.
This is apparently part of the reason why United Nations data show that only 400,000 people have access to AIDS treatment in developing countries, a minuscule number compared to the world's 40 million infected, six million of whom the U.N. says need treatment now.
But the U.S. National Academy of Sciences panel of American and African public health specialists says the gap can be dramatically reduced if governments and international organizations help developing societies improve their ability to deliver AIDS treatments.
"The first and most important recommendation of our committee is to act now," said James Curran of Emory University in Atlanta, the chairman of the group. "Don't wait for all the answers, but act now. Don't wait until all the challenges have been met, but act now."
For the panel, acting now involves tackling AIDS not only with established public health practices but also trying new things and learning by doing.
To strengthen the weak public health infrastructure in developing countries, Mr. Curran's team recommends partnerships and knowledge sharing between experienced medical, academic, and business institutions in industrial countries and those in developing nations. They also call for a cadre of technical specialists to help these countries fight AIDS, akin to the U.S. Peace Corps.
"We assign hundreds of thousands of soldiers overseas, we assign Peace Corps people overseas, we assign State Department people overseas, we mobilize thousands of people and hire them to guard our airports," he said. "Why not tap into something to deal with a global threat like AIDS?"
The U.S. panel says other necessary ingredients for successful AIDS programs are a continuous funding commitment by donors and steps by leaders in AIDS-stricken nations to fight the stigma of the disease and encourage people to get tested for it.