Only 60% of Aids patients in Africa still take the drugs they need to stay alive two years after starting treatment, researchers reported on Monday. Of the patients found no longer to be taking the drugs after two years, 40% died and the rest missed scheduled appointments, failed to pick up medication or may have transferred to other clinics. A small percentage stopped their treatment but continued to get other medical care at clinics where they started Aids drugs.

"I don't want people losing heart from this, even though 60% isn't fabulous," said Sydney Rosen, an assistant professor at Boston University's School of Public Health, who led the study. The study was published in the Public Library of Science Medicine journal.

The 60% for Africa is "a fairly gloomy conclusion", said Dr Charlie Gilks, director of treatment at the WHO's Aids department, who was unconnected to the paper. "But considering the huge challenges we started with, a 60% retention rate is not such a bad benchmark."

When the Aids pandemic hit Africa, many experts worried that the continent's weak health systems would crumble under the stress. WHO's "3 by 5 programme" aimed to put three million people on anti-retrovirals to fight Aids by 2005. By the initiative's end, only 1.3 million were receiving them. Another 4.8 million patients still need the drugs, out of some 25 million people in Africa living with Aids.

Rosen and colleagues examined 32 publications reporting on 74 192 patients in 13 African countries between 2000 and 2007. Their report included many studies done in sub-Saharan Africa, particularly South Africa, which has the world's highest number of Aids patients.

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