As World AIDS Day approaches on December 1, activists complain that the international community is falling short of providing treatment for HIV in developing countries. VOA's David McAlary reports that the main global AIDS program financing agency hopes donors will boost their contributions during next year's round of pledging.

The United Nations AIDS Program says 40 million people are living with HIV. The World Health Organization had a goal of getting three million of them in developing nations on drug treatment by the end of 2005, but this so-called "three by five" deadline passed without being met.

"One year later, the world is still one million people short of the three by five goal,"  said Christopher Collins, who is a member of the International Treatment Preparedness Coalition, a group of 800 HIV treatment activists from more than 125 countries. The coalition has issued a report saying that, despite important areas of progress, the AIDS treatment delivery effort is at risk of stagnating.

"In every country we analyzed, the number receiving AIDS drugs is dwarfed by the number in urgent need," he continued.  "There remain huge funding gaps and the crisis in human resources is not receiving sufficient attention. Many national governments have failed to make delivery of AIDS treatment to their citizens a priority. No clear global targets have been set for scale-up of AIDS services."

Collins says more people are getting treatment every year, but the pace is too slow to meet the United Nations AIDS Program goal of about 10 million people on HIV drugs by 2010. He says at the current pace, only half that many will receive treatment by then.

The World Health Organization says the international community has decided not to set another interim treatment target like three by five. The chief of its HIV/AIDS Department, Dr. Kevin DeCock, says that, instead, countries must take greater responsibility by setting their own national treatment goals. DeCock says a new WHO five-year strategic plan outlines how the agency will help nations in five key technical areas.

"Those five priorities are the following: The scaling up of HIV testing and counseling; reinforcing prevention; continuing treatment scale-up; strengthening health systems; and investing in surveillance, monitoring, and evaluation that can guide the health sector response to the epidemic," he says.

But meeting those goals will take money, which is in short supply.  Contributions to the main financier of AIDS programs worldwide - the Global Fund to Fight AIDS, Tuberculosis and Malaria  - are $1 billion short, according to Anurita Bains, the Special Assistant to the United Nations Envoy on HIV/AIDS in Africa.

"We have a serious problem with resources in order to fund universal access to treatment. If we are talking about scaling up to universal access to treatment, we need a sustainable long-term commitment to resources," Bains says.

Bains says the funding shortfall undermines the goal of universal access to HIV treatment and prevention services established in 2005 by the world's eight major powers, the G8.

The head of the Global Fund, Richard Feacham, issued a statement saying the organization shares the impatience of the International Treatment Preparedness Coalition. He says programs financed by the fund have more than doubled the number of people getting AIDS treatment, but far too many people still need them. Feacham says a priority is to secure additional resources at the next round of Global Fund pledging to begin next March.

The coordinator for the U.S. government's global AIDS programs, Mark Dybul, says the United States is doing its part with President Bush's commitment of $15 billion over five years, but he adds that others should do more.

"So we're providing more than half of what everyone else in the world us providing," Dybul says. "So we hope the rest of the world steps up and does so, maybe around World AIDS Day, to have a commitment that matches the commitment of the American people to stand with the people of the world on HIV/AIDS."

The charitable medical group Doctors Without Borders says that, whatever the amount raised, expanding AIDS treatment in poor countries will fail unless there are generic alternatives to the costly newer medicines. It says the latest drug regimens the World Health Organization recommends to overcome resistance to older drugs can be six times more expensive than today's most commonly used generic combination.