Towards universal access: WHOs role in HIV prevention treatment and care [editorial]

June 2006 marks the 25th anniversary of a report of five cases of Pneumocystis carinii (now jirovecii) pneumonia in men who have sex with men heralding the acquired immunodeficiency syndrome (AIDS). Over 65 million infections with the causative agent human immunodeficiency virus (HIV) have now caused at least 25 million deaths. Following recognition at the XI International Conference on AIDS in 1996 that combination antiretroviral therapy (ART) dramatically improves survival various initiatives have helped to bring treatment to people with HIV/AIDS in developing countries. Although the target of treating 3 m people by the end of 2005 (WHOs "3 by 5" initiative) was not reached about 1.3 m people now receive ART in low- and middle-income countries. Major lessons from the initiative include the utility of country-owned targets in mobilizing efforts and promoting accountability the need for extensive partnerships to scale up activities the importance of identifying and resolving health systems constraints the challenges of ensuring equity and the synergy between treatment initiatives and a simultaneous scaling-up of HIV prevention. (excerpt)