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Lancet Infectious Diseases. 2008 Jan; 8(1):14.A report from the International Treatment Preparedness Coalition (ITPC) warns that meeting the "near universal access target" to AIDS drugs access by the 2010 deadline will require an enormous effort by governments, global agencies, and drug companies. According to the report, which looked at AIDS treatment access in 14 countries, "scale-up is working but high prices, patent and registration barriers, and ongoing stock-outs are core issues impeding AIDS drug delivery". "The issues highlighted in this report are real and widespread", said Nathan Ford of Médecins Sans Frontières (MSF; Johannesburg, South Africa). The HIV programmes run by MSF across the developing world are struggling against user fees, high drug costs, lack of human resources, and poor health infrastructure, he told TLID. The ITPC, a group of 1000 treatment activists from more than 125 countries, highlights that the high cost of antiretroviral drugs is a particular barrier in Argentina, China, and Belize. (excerpt)
Washington, D.C., World Bank, Knowledge and Learning Center, 2005 Nov.  p. (Findings Infobriefs No. 118; Good Practice Infobrief)The Mali Multi-sectoral AIDS Project (MAP) began implementation in late 2004 and is in the preliminary phases of the project cycle. This project has been commended by the World Bank's Board for its innovation and the involvement of the private sector to address HIV/AIDS. Mali is one of the poorest countries in the world due to factors such as its limited resource base, land-locked status and poor infrastructure. According to the 2001 Demographic and Health Survey (DHS) published by the Ministry of Health, Mali's HIV/AIDS prevalence rate is estimated at 1.7% in 2001. The project objective is to support the Government of Malis efforts to control the spread of the HIV/AIDS epidemic and provide sustainable access to treatment and care to those infected with or affected by HIV/AIDS. While Mali currently has a low HIV prevalence rate by Sub-Saharan African standards, it runs a high risk of experiencing an increase in prevalence rates. (excerpt)
Choices. 2001 Dec; 4.We are facing the most devastating global epidemic in modern history. Over 60 million people have been infected. In the worst affected countries one in four adults are now living with HIV/AIDS, a disproportionate number of younger women and girls. More than 80 percent are in their twenties. The result is a devastating hollowing out of communities, leaving only the very young and the very old and thrusting millions of families deeper into poverty. Meeting this challenge means progress on three fronts: first, preventing new infections and reversing the spread of the epidemic; second, expanding equitable access to new HIV treatments; third, alleviating the disastrous impact of AIDS on human development. Effectively responding to HIV/AIDS requires a wide range of initiatives under strong national political leadership, including sex education in schools, public awareness campaigns, programmes in the workplace, mobilization of religious and community leaders, action to mitigate the impact on poverty and essential social services, support for orphans and tough policy decisions in ministries of finance to ensure optimal allocation of resources to cope with the crisis. (excerpt)
Access to treatment in the private-sector workplace: the provision of antiretroviral therapy by three companies in South Africa.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2005 Jul. 47 p. (UNAIDS Best Practice Collection; UNAIDS/05.11E)The availability of antiretroviral therapy from 1996 onwards has made a huge impact on the lives of those people living with HIV who can afford the drugs. But most of the beneficiaries of the new drugs live in the world's high-income countries. For many of them, AIDS has become a manageable chronic condition rather than a death sentence. Affluent countries have seen a 70% decline in AIDS-related deaths since the introduction of antiretroviral therapy. In countries in which antiretroviral drugs are provided on a large scale (in Brazil, for example), the impact is remarkable. The number of hospital patients with AIDS is greatly reduced, people living with AIDS return to their families and jobs, and AIDS-related morbidity and mortality fall dramatically. However, for the huge majority of people living with HIV in low- and middle-income countries, it is a different story. Neither they nor their countries' health-care services can afford to annually pay the huge amounts of money that the drugs cost, even taking into account recent reductions in drug prices. Cost has not been the only barrier to wide-scale provision of antiretroviral therapy in low- and middle-income countries. Health experts have expressed concerns about providing drugs to large numbers of people in settings where health-care services do not even offer adequate basic care, let alone the support and monitoring needed for antiretroviral therapy. The slow progress in antiretroviral provision has meant that although five to six million people need antiretroviral therapy in low- and middle-income countries, only about 700 000 had access to it by the end of 2004. In sub-Saharan Africa, more than four million people need treatment, but only 310 000 had access by the end of 2004. (excerpt)
Bulletin of the World Health Organization. 2006 May; 84(5):337-424.Developing countries are failing to make full use of flexibilities built into the World Trade Organization's (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to overcome patent barriers and, in turn, allow them to acquire the medicines they need for high priority diseases, in particular, HIV/AIDS. First-line antiretroviral (ARV) drugs for HIV/AIDS have become more affordable and available in recent years, but for patients facing drug resistance and side-effects, second-line ARV drugs and other newer formulations are likely to remain prohibitively expensive and inaccessible in many countries. The problem is that many of these countries are not using all the tools at their disposal to overcome these barriers. Medicines protected by patents tend to be expensive, as pharmaceutical companies try to recoup their research and development (R&D) costs. When there is generic competition prices can be driven down dramatically. The TRIPS Agreement came into effect on 1 January 1995 setting out minimum standards for the protection of intellectual property, including patents on pharmaceuticals. Under that agreement, since 2005 new drugs may be subject to at least 20 years of patent protection in all, apart from in the least-developed countries and a few non-WTO Members, such as Somalia. Successful AIDS programmes, such as those in Brazil and Thailand, have only been possible because key pharmaceuticals were not patent protected and could be produced locally at much lower cost. For example, when the Brazilian Government began producing generic AIDS drugs in 2000, prices dropped. AIDS triple-combination therapy, which costs US$ 10 000 per patient per year in industrialized countries, can now be obtained from Indian generic drugs company, Cipla, for less than US$ 200 per year. This puts ARV treatment within reach of many more people. (excerpt)
Africa Recovery. 2003 Dec;  p..On 28 November the British Broadcasting Corporation (BBC) posted an online audio interview with UN Secretary-General Kofi Annan about the struggle against HIV/AIDS. The transcript of this important broadcast appears below in its entirety. It has been edited slightly for clarity. The Secretary-General was speaking to Ms. Carrie Gracie on "The Interview" programme for BBC World Service radio. It is reproduced with the permission of the BBC. BBC: Over the past two weeks the BBC World Service has been running an AIDS season and we've heard many aspects of the illness. But today we want to get a sense of your personal contribution and whether you think that you're winning the battle. So I want to start by asking you about the enemy. When did you first realize what a serious enemy you were up against with AIDS? Annan: I think it was when I discussed the issue with the World Health Organization [WHO] and UNAIDS [the Joint UN Programme on HIV/AIDS] and looked at the figures and the statistics and the devastation it was causing in many African countries, and at the attitude of the leaders. We needed leadership. We needed leadership at all levels. But it was most important to get the presidents and the prime ministers speaking up and that was not happening. I thought we should do whatever we can to raise awareness and to get them involved. (excerpt)
Investing in a comprehensive health sector response to HIV / AIDS. Scaling up treatment and accelerating prevention. WHO HIV / AIDS plan, January 2004 - December 2005.
Geneva, Switzerland, WHO, 2004. 72 p.This document discusses the context for the work being undertaken in WHO’s HIV/AIDS programme. It analyses the epidemiological situation and includes the most recent estimates of antiretroviral coverage, the global strategic framework and current challenges to translating this into results at the country level (Section 1 – Background). Section 2 describes the comparative advantages offered by WHO, the functional areas of activity within the HIV/AIDS area of work for 2004–2005 and the specific focus of the programme on scaling up antiretroviral therapy and accelerating HIV prevention. Section 3 describes how WHO is structured and how resources and capacity are being reoriented to support country-level action. Section 4 illustrates how WHO works within the United Nations system and with other partners. Section 5 outlines the resources required in 2004–2005 for WHO to accomplish its stated contribution to HIV/AIDS. Section 6 describes the mechanisms for technical and managerial oversight of the HIV/AIDS programme. The WHO HIV/AIDS Plan is not a detailed work plan. Rather, it provides an overall framework to guide the departments responsible for HIV/AIDS in preparing such work plans at the country, regional and headquarters levels of WHO. These work plans are now being developed and will define the specific tasks and activities required to bring the WHO HIV/AIDS Plan to fruition, together with timelines and resource requirements. Joint planning sessions between headquarters, regional and country offices integrate the work of the three levels to ensure that all priority needs are addressed and that gaps in resources are identified. (excerpt)