Abuja, 6 December 2005 -- In order to achieve scaling-up universal access to HIV prevention, care and treatment, the World Health Organization (WHO) has recommended that countries adopt a policy of free access at the point of service delivery to HIV care and treatment, including antiretroviral therapy. The recommendation, according to the UN Agency is based on the best available evidence and experience in countries. It is also warranted as an element of the exceptional response needed to turn back the AIDS epidemic.

These were made known during a media briefing organized by WHO at the 14th International Conference on AIDS and Sexually Transmitted Infections in Abuja, Nigeria. A WHO Discussion Paper presented at the briefing said, “even with sliding fee scales, cost recovery at the point of service delivery is likely to depress uptake of antiretroviral treatment and decrease adherence by those already receiving it”.

In July this year, leaders of the G8 countries endorsed efforts to move towards universal access to HIV treatment and care by 2010. UN Member States, in September, also endorsed the initiative. WHO notes that user charges at the point of service delivery ‘institutionalize exclusion’ and undermine efforts towards universal access to health services. It adds however that “abolishing them requires prompt, sustained attention to long-term health system financing strategies, at both national and international levels”.

Botswana is one of the countries in the African Region that offers free health services in the public sector, including HIV treatment. The Botswana Minister of Health, Mrs. Sheila Tlou, who was at the briefing, confirmed that free treatment has increased access and adherence in her country, which has met its 3 by 5 target. On the issue of sustainability, which has been raised in several quarters as one of the factors that could militate against free treatment, Minister Tlou said national governments need to put resources into HIV/AIDS programmes and depend less on foreign donors. The Botswana government, she said, provides 90% of the funds needed for HIV/AIDS.

In his contribution, Professor Michel Kazatchkine, French Ambassador for HIV/AIDS and Member, Scientific and Technical Advisory Committee (STAC) on HIV/AIDS to WHO agreed that user fees are an impediment to access, adherence and treatment. Noting however that there would be a major challenge of funding should fees be abolished, Prof. Kazatchkine advised that innovative, sustainable sources of funding need to be found for HIV/AIDS. One such way being adopted by France, according to him, is taxing of airline tickets, which he said would raise about two hundred and fifty million Euros annually for HIV/AIDS. Governments, he added, also need to increase their national budgets for HIV/AIDS, as donor aid is not sustainable. 
For more information, please contact:

Austine Oghide, 
HIP, WHO Nigeria 
Tel: 234 (0) 8034022390