AIDS Plan Falls Short Of Target

But U.N. officials said that some progress had been made. Perhaps the biggest strides have been in streamlining the drug regimens and reducing their prices, once the symbols of how unreachable antiretroviral treatment was for infected people in the developing world.

Five years ago, a year's supply cost $10,000, and a patient had to take more than a dozen pills a day. Today, the drug therapy often costs less than $200 a year and comes in fixed-dose combination pills, single tablets containing three different drugs that are taken once or twice a day.

But unless more health care workers are trained to administer the drugs, improved access to the medicines may actually pose a threat to patients, an AIDS expert said.

"That's a serious concern when you're dealing with drugs that are very toxic," said Kevin Frost, director of Treat Asia, a program of the American Foundation for AIDS Research. "If patients are self-medicating without proper supervision, it can very quickly lead to drug resistance and side effects, which if they are not managed, can be deadly."

U.N. officials said programs in many countries are on the verge of enrolling large numbers of patients in the next few months. In numerous countries, the basic infrastructure for treatment, health care clinics and workers, is in place but not being used effectively.

Jim Yong Kim, the director of AIDS programs for WHO, said: "It's just a matter of getting down to it, of going forward and getting people trained."

Since WHO announced what it calls the "three by five" program target in December -- 3 million people by 2005 -- only 40,000 people have been placed on AIDS drugs, officials said.

The figure of 440,000 on the life-extending drugs is an estimate derived from the reporting done by the countries themselves. It does not reflect the people who drop out of treatment.

Brown reported from Washington.