Nearly $6 billion is needed to reach the World Health Organization's goal of providing three million people with antiretroviral drugs by 2005, according to estimates published in a special July 3 edition of the Lancetdevoted to HIV/AIDS, Reuters reports (Reaney, Reuters, 7/1). The 3 by 5 Initiative also calls for training 100,000 health care workers, refocusing 10,000 clinics in developing countries to treat HIV/AIDS and using common antiretroviral drug combinations to treat HIV-positive people. However, the plan does not provide the drugs or subsidize their cost (Kaiser Daily HIV/AIDS Report, 5/11). Juan Pablo Gutierrez of the Division of Health Economics and Policy at Mexico's National Institute of Public Health and colleagues examined the 34 countries that account for 90% of people living with HIV/AIDS in developing countries who need antiretroviral treatment (Gutierrez et al., Lancet, 7/3). The researchers calculated the cost of antiretroviral drugs, support programs, monitoring treatment and administrative costs. The researchers then estimated the number of HIV-positive people who need treatment and support in each country and the cost per patient by country to calculate the total cost, study co-author Dr. Benjamin Johns of WHO said, Reuters reports. Researchers defined people who needed treatment as those "expected to die" within two years if they did not receive drug therapy (Reuters, 7/1). The researchers also considered two other variables -- the cost of the drugs and the speed at which the scale-up of drug distribution occurs. The drug prices considered include $140 per patient per year -- the price negotiated by the William J. Clinton Foundation for first-line treatment in certain countries -- and $304 per patient per year -- a regimen that includes the cost of alternative drugs if patients develop a resistance to the first-line drugs. Of the nearly 500,000 HIV-positive people on antiretroviral treatment in developing countries, more than 100,000 are in Africa, compared with only 25,000 people who were on treatment in Africa two years ago, UNAIDS Executive Director Peter Piot said, according to Agence France-Presse. UNAIDS estimates that by 2005, the world will have to spend $10.7 billion in developing countries to combat HIV/AIDS and $14.9 billion by 2007 (Agence France-Presse, 7/1).

The July 3 issue of the Lancet is a special feature focusing on HIV/AIDS in advance of the XV International AIDS Conference that will be held in Bangkok, Thailand, July 11-16. The issue includes commentary on the epidemic and articles on treatment, research, and the connection between health and human rights. The complete issue can be viewed online (Lancet, 6/3).