WHO's AIDS Target - An Inevitable Failure

The World Health Organization (WHO) initiative to treat 3 million HIV-infected people in low- and middle-income countries by the end of 2005 (popularly known as the 3 by 5 initiative) has failed. Unrealistic assessments of how many people could be treated in the time frame explain the failure. But there has been additional fallout from the fiasco. Relations are frayed between WHO officials and South Africas health minister, who is trying to step up her nations AIDS treatment program responsibly. Additionally, because drugs were qualified for use before they had been properly tested and then later withdrawn, the 3 by 5 initiative added to uncertainty about how to proceed in many treatment programs around the world.

Viewpoint: HIV/AIDS and the health workforce crisis: What are the next steps?

In scaling up antiretroviral treatment (ART), financing is fast becoming less of a constraint than the human resources to ensure the implementation of the programmes. In the countries hardest affected by the acquired immunodeficiency syndrome (AIDS) pandemic, AIDS increases workloads, professional frustration and burn-out. It affects health workers also directly, contributing to rising sick leave and attrition rates. This burden is shouldered by a health workforce weakened already by chronic deficiencies in training, distribution and retention. In these countries, health workforce issues can no longer be analysed from the traditional perspective of human resource development, but should start from the position that entire societies are in a process of social involution of a scale unprecedented in human history. Strategies that proved to be effective and correct in past conditions need be reviewed, particularly in the domains of human resource management and policy-making, education and international aid. True paradigm shifts are thus required, without which the fundamental changes required to effectively strengthen the health workforce are unlikely to be initiated.

Is treatment of tuberculosis in Malawi prolonging the lives of people with HIV/AIDS?

Over the last 15 years, tuberculosis (TB) case numbers have increased 300-400% in Malawi, in conjunction with a rise in HIV infection. This is primarily because HIV increases the risk of disease reactivation in people with latent tuberculosis infection, and also because it increases susceptibility to new TB infections.

Technology reminds sick to take pills

CAPE TOWN A local doctor has developed a pill bottle that uses cellphone technology to remind patients to take their medicines and warns them if they are about to take an extra dose by mistake.