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The USAID | DELIVER project improves patient access to essential medicines in Zambia. Success story.
Arlington, Virginia, JSI, DELIVER, 2011 Feb.  p.Success story on a logistics system pilot project in Zambia that set out to cost-effectively improve the availability of lifesaving drugs and other essential products at health facilities.
Economists tell scientists AIDS drug projects can be scaled up. Calls for more money dominate the agenda but economists say more can be done with current funds.
Lancet. 2003 Jul 19; 362(9379):215.Economists said at the international AIDS conference on HIV pathogenesis and treatment in Paris on July 14 that nations with a high HIV/AIDS burden should spend more of their resources on antiretrovirals, a move which directly contradicts current medical opinion. The medical community has said that handing out antiretrovirals would be a waste of resources; could worsen drug resistance; and instead it urged preventative measures. Three pilot studies presented at the meeting from the Ivory Coast, Senegal, and Uganda—funded by UNAIDS—found that with a little help to set up medical infrastructure, drugs can be delivered, even to remote areas, without increasing drug resistance. (excerpt)
AIDS ALERT. 1998 Jan; 13(1):3.Although 1.6 million people in Uganda are infected with HIV, the country has only 6 health care centers equipped to deliver antiretroviral treatment. Uganda, Chile, Vietnam, and Cote d'Ivoire will participate in a pilot program which will help provide the health infrastructure and affordable drugs to ensure that combination therapies are used and used appropriately. Thus far, Glaxo Wellcome, Hoffmann-La Roche, and Virco NV have agreed to participate in the project. The 4 countries have agreed to create a national HIV/AIDS drug advisory board and a nonprofit company to serve as a clearinghouse for ordered drugs. The board will establish a coordinated national drug policy for the use of HIV drug therapy, including criteria for choosing the most appropriate drugs and who will receive them. The program should initially enable up to 3000 Ugandans to receive therapy, still far from meeting the total need for such therapy. The pharmaceutical companies will sell the drugs at subsidized prices, while local health ministries will create new sources of funding and UNAIDS will provide a $1 million grant. The pilot programs will be evaluated with regard to the improvements realized in overall health care delivery, the number of people treated, their impact upon the demand for emergency care, and rates of morbidity and mortality.
Lancet. 1997 Dec 13; 350(9093):1759.Antiretroviral drugs, used to prevent HIV infections from progressing to AIDS, will be used in a pilot project in Uganda, the Ivory Coast, Chile, and Viet Nam, beginning in January 1998. The project was announced at the AIDS in Africa conference (December 7-12, 1997) in Abidjan. Approximately 3000 patients from each country will be given 2- and 3-drug combinations. The countries selected for the project had to guarantee consistency of drug supplies. Patients most in need of therapy will be recommended by physicians in 4 or 5 centers in each country. Although it is being played down by UNAIDS, this method of selection has created some controversy. UNAIDS stresses the need for a cross-section of the population and for realistic drug prices. Prices must be low enough for people in developing countries to afford them and high enough to maintain the interest of drug companies. Nonprofit organizations in the countries are negotiating prices with drug companies (Glaxo Wellcome, Virco, and Roche). Compliance is also a concern; without it, resistant HIV-1 strains could emerge. The director of the Harvard University School of Public Health believes that treatment seen as a family issue would ensure compliance. The European Commission (EC) AIDS advisor states that the EC believes the money would be better spent on community prevention.