Disease is spreading across Asia

10 years after being drawn up, the sixth Millennium Development Goal seems out of reach. HIV/AIDS, Tuberculosis and Malaria are claiming more lives each year. HIV infections have more than quadrupled since 1990.

Goal 6b was to create universal access to treatment for HIV/AIDS for all who need it. "It has been quietly shelved," says Annabel Kanabus, the director of the international AIDS fund, Avert. "Universal access hasn't been achieved, we are absolutely miles from it. In developing and middle income countries, I think there is barely any country that has reached it."

Sub-Saharan Africa remains hardest hit, with over 22 million HIV/AIDS patients of over 33 million world wide. The Global Fund to Fight AIDS, Tuberculosis and Malaria was set up in 2002 and has helped distribute antiretroviral medicine to those who need it; it has treated six million people with TB successfully, as well as distributed over 100 million mosquito nets and malaria medicine to over 100 million people.

But this contribution is not enough; it is mainly the world's poor who are hit hardest by these pandemics and trapped in the downward spiral of poverty. Though money plays a role in the development and distribution of medicine, technology is also limited, says Stefan Kaufmann, the director of the Max Planck Institute for infectious diseases in Berlin.

"There are diseases for which it was relatively easy to develop a vaccine and for those we do have vaccines today. Obviously it is the difficult diseases for which we have yet to create vaccines."

Kaufmann names HIV/AIDS, tuberculosis and malaria, saying these are "much more complex and the mechanisms that cause them are much more tricky so we can't take the traditional route in developing vaccinations for them."

TB not as easy to treat as before

The world has had a TB vaccination for almost 100 years. Despite this the contagious lung disease is on the rise, especially in Southeast Asia. Its rapid spread is linked to the rapid spread of HIV in the region. "If you've got HIV, you end up with a compromised immune system. And therefore this means that diseases which you might have anyway and which normally your body would keep under control, don't get kept under control."

Kanabus points out that there are many people who have TB, but "it is kind of a latent form which doesn't cause so many problems. You have it, you get over it, but it makes you a carrier of TB. Now what happens if you go and get HIV is it activates the TB and then you get active TB and that's what makes TB an opportunistic infection."

Each year around two million people are killed by TB, even though the cost to cure the disease is relatively low. In developing countries, a six to eight month antibiotic treatment for TB costs as little as 10 US dollars per person. However, if medication is administered irregularly or stopped prematurely, the TB bacteria can mutate and become treatment resistant. This is now a big problem, especially in Asia, because this form of TB is much more difficult to diagnose and more expensive to treat.

50 percent of the world population at risk of malaria

Malaria is another epidemic that is in theory easy to prevent, but according to the World Health Organization, more than half of the world's population is in danger of getting malaria. Although over 100 million nets have been distributed, some of the mosquitoes that carry the parasite have become resistant to the insecticides used on them.

Even if the situation sometimes seems hopeless, Kanabus is sure something can be done about these diseases. "I think that compared with the cost of the Iraq war, a lot of these kind of disease-specific things are quite doable. They are talking about cutting back - these are sums which could save vast numbers of people's lives. I think we've got to try and work on all these fronts. And with each of them, we've got to try and go forward in a cost-effective and collaborative way. We do live in economically challenging times and therefore we've got to spend the money as well as we possibly can."

Public awareness, she says, must also be raised around the world for the Millennium Development Goals to be successfully reached.

Author: Sarah Berning
Editor: Anne Thomas