BMJ  2004;329:1281-1283 (27 November), doi:10.1136/bmj.329.7477.1281

Education and debate

Barriers to better care for people with AIDS in developing countries

Andrew S Furber, clinical lecturer in public health1, Ian J Hodgson, lecturer2, Alice Desclaux, professor of medical anthropology3, David S Mukasa, HIV and AIDS trainer and counsellor4

1 Public Health GIS Unit, School for Health and Related Research, University of Sheffield, Sheffield S1 4DA, 2 School of Health Studies, University of Bradford, Bradford, 3 Centre de Recherche Cultures, Santé, Sociétés, Université d'Aix-Marseille, Maison Méditerranéenne des Sciences de l'Homme, 13094 Aix en Provence Cedex 2, France, 4 Uganda Red Cross Society, PO Box 494, Kampala, Uganda

Correspondence to: A S Furber A.Furber@sheffield.ac.uk

WHO's "3 by 5" initiative to increase access to antiretroviral drugs to people with AIDS in developing countries is highly ambitious. Some of the biggest obstacles relate to delivering care

The first 150 words of the full text of this article appear below.

Introduction

Access to good quality antiretroviral treatment has transformed the prognosis for people with AIDS in the developed world. Although it is feasible and desirable to deliver antiretroviral drugs in resource poor settings,1 w1 w2 few of the 95% of people with HIV and AIDS who live in developing countries receive them. The World Health Organization has launched a programme to deliver antiretroviral drugs to three million people with AIDS in the developing world by 2005, the "3 by 5" initiative.2 w3 We identify some of the challenges faced by the initiative, focusing on delivery of care.

Continuum of care

Ideally, care for people with AIDS should start with voluntary counselling and HIV testing. However, only 10% of people who need testing in low and middle income countries have access to services, and therefore most are unaware of their serological status.w5 Care should include psychological, social, and economic support as well as broad based medical care incorporating . . . [Full text of this article]

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Stigma and discrimination

Systems of delivery

Community involvement

Access to treatment

Conclusions


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