Millions denied access to anti-retrovirals

Da: “” del 3 febbraio 2003

The vast majority of people living with AIDS will continue to be denied access to life-saving anti-retroviral therapy (ART) unless considerable additional resources are provided to the Global Fund for the fight against HIV/AIDS, said Dr. Massimo Barra, the new representative of non-governmental organisations from developed countries on the Global Fund board.

Speaking to the press in Geneva today, Barra said the proposals which the Global Fund has been able to support to date will only provide ART to 491,906 people in need over the next five years, leaving the needs of over five million people uncovered.

“This is completely unacceptable and we must do all in our power to impress on the international community how shameful it is that so many people will die when affordable drugs are available on the market,” said Barra, who took part in discussions on the issue at the Global Fund board meeting that has just concluded in Geneva.

The Global Fund, which has received pledges of US$2.2 billion to date, is disbursing funding in two rounds over the next five years. Recommended proposals would bring the number of beneficiaries of Fund-supported ART to only 491,906 over the next five years. Dr. Barra was selected to the Board last week. He is a veteran of the Italian AIDS response and the founder and director of “Villa Maraini”, an Italian Red Cross Foundation which has provided direct assistance to more than 25,000 injecting drug users. Sharing needles is a major mode of HIV transmission in many developed countries.

He believes that “the most important thing that the Global Fund can do is to make available access to treatment. Otherwise we condemn millions of people to death. This is a scandal which the Red Cross cannot accept. Therapy is an important part of prevention, it is not possible that it is only accessible to 5% or 10% of the population. “We have seen the dramatic reduction of the price of drugs. Nobody could imagine that what previously cost $12,000 per year could be brought down to $300.

It could cost even less if there was the political commitment and public pressure to change the situation. The Red Cross must help this process in a humanitarian way in defence of the most vulnerable people,” he says. Dr. Barra has been active in the Italian Red Cross since he was eight years old and says be became a doctor because he was a Red Cross activist. He grew up in the Prate district of Rome, near the Vatican. As a boy he would spend most of his Sundays at a Red Cross first aid station.

As a teenager he worked on mobile blood collection and while doing his rounds met such celebrity donors as Sophia Loren and Gina Lollobrigida. He later took on an international role in the Red Cross Red Crescent. He headed the Youth Commission for eight years from 1974 to 1982 and has maintained his interest in youth participation in his HIV/AIDS work. “I am heading the European Red Cross Network on AIDS (ERNA) and we insist that the 32 Red Cross and Red Crescent Societies which participate always include their head of youth at our meetings. Youth is vital to the Red Cross and vital to the fight against HIV/AIDS and TB.

” He says a key challenge for ERNA now is to provide more support to TB programmes particularly in Russia, Kazakhstan and Armenia. “TB programmes are closing down because there is no money. Things are going backwards. One of our agendas is to really push those countries which don’t seem to be making much headway with the Global Fund,” he explains.

“It is not enough just to give drugs. It has to be done in a humanitarian way, to marginalised people, alcoholics, prisoners and they have to be supported and given follow-up to ensure they benefit from the treatment. The Red Cross is very good at doing that.” Dr. Barra is a great believer in getting close to the most vulnerable. He has visited over 70 countries in his work for the Italian Red Cross and the Federation.

He has been a staunch advocate of reaching out to intravenous drug users on the streets of Rome, extending them a helping hand, medical assistance and a sympathetic ear through the Italian Red Cross Foundation, Villa Maraini. “It is not enough to offer therapy and wait for those who need it to ask for help. You must go to them where they stay in the streets, in the police stations, in the courts. You must go and meet them and if you do as we have done with 25,000 people in Rome you can say you know everyone.

We know every drug user in Rome. That way you reduce violence and crime as well. I am against zero tolerance. Intolerance brings intolerance. We must reach out to people,” he says. “Harm reduction works. Addicts generally don’t share needles anymore in Italy. It is vital that this experience is taken up in Central Asia and Russia as well. It’s not just a humanitarian issue, it’s an opportunity for society as a whole.

If you reduce the possibility for one drug user to become HIV-positive, this is good for all the population. “I wonder in Russia why they don’t use methadone. This is not logical. There are thousands of studies which show that this is the most useful thing to help drug users. Harm reduction is the most cost-effective way of addressing these problems. Needle exchange is more effective than vaccination.”