What obstacles to achieving the universal access goal are identified in the report?
A. Obstacles to rapid and effective scale-up identified in the report include weak health systems, including a critical shortage of human resources; the lack of reliable, sustainable, long-term financing for prevention and treatment scale-up; and weak information systems. The report calls for increased resources, sustained political commitment, improved stakeholder coordination and additional research to address these challenges. Programmatic obstacles also include: poor knowledge of HIV status; late initiation of ART and low rates of patient retention in treatment programs; inadequate outreach to at-risk populations and those individuals living in rural areas; the high cost of second-line regimens; lack of capacity for infant diagnosis; and weak linkages with other services including tuberculosis control and maternal and infant health programmes.
