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JAMA. 2001 Sep 26; 286(12):1444.The 20th anniversary of the first diagnosis of HIV infection has come and gone. So has the razzmatazz surrounding the UN General Assembly's Special Session on AIDS in June. Headlines made when UN Secretary-General Kofi Annan appealed for the world to act on the global emergency AIDS represents have been superseded by other events. It's back to business as usual. Or is it? It must not be. The AIDS crisis is as real now as a few months ago, and it will continue to grow unless the world is constantly reminded of it and plans to stem the epidemic are turned into action. The recent focus on AIDS among the poorest countries of the world--in particular in Africa--may have given an impression that those who live in countries with stable or declining infection rates no longer need to worry. Recent infection figures in the United States showing disturbing increases in some population groups prove this is not so. And the effects of globalization mean that there no longer is such a thing as a localized health problem. The HIV/AIDS epidemic is a global emergency and it calls for global commitment and action. UN Secretary-General Annan recently asserted that "AIDS can no longer do its deadly work in the dark. The world has started to wake up." Frighteningly, it has taken 22 million deaths and 13 million orphaned children to act as a global alarm clock. Today, there are 36 million people living with HIV/AIDS. (author's)
Bulletin of the World Health Organization. 2006 May; 84(5):338.The context for this theme collection is the publication of the report of the Commission on Intellectual Property Rights, Innovation and Public Health. The report of the Commission -- instigated by WHO's World Health Assembly in 2003 -- was an attempt to gather all the stakeholders involved to analyse the relationship between intellectual property rights, innovation and public health, with a particular focus on the question of funding and incentive mechanisms for the creation of new medicines, vaccines and diagnostic tests, to tackle diseases disproportionately affecting developing countries. In reality, generating a common analysis in the face of the divergent perspectives of stakeholders, and indeed of the Commission, presented a challenge. As in many fields -- not least in public health -- the evidence base is insufficient and contested. Even when the evidence is reasonably clear, its significance, or the appropriate conclusions to be drawn from it, may be interpreted very differently according to the viewpoint of the observer. (excerpt)
SCIENCE. 1991 Mar 15; 251:1312-3.AIDS scientists met in February 1991 to discuss international trials of AIDS vaccines because of the urgency in conducting such trials since the US Food and Drug Administration approved 6 vaccines for trails. Major problems discussed were how to insure access to potential AIDS vaccines to developing countries, where to conduct future tests of vaccine efficacy, and which of the leading institutions should coordinate such an effort. The most difficult issue centered around who assumes the risks and who benefits. Many researchers considered conducting AIDS vaccine trials in developing countries since they have a large population varied in age and gender at high risk of HIV infection. Assuming an HIV vaccine is effective, additional questions must be addressed: How can a developing country afford a vaccine at free market prices? If that country does get the vaccine should not other developing countries also get it? Who will pay for it and distribute it? WHO has already contacted ministries of health about AIDS trials. Other organizations, e.g., the US Centers for Disease Control and the US National Institutes of Health, also already involved in international AIDS vaccine research do not want to be kept out of the Phase III trials. Some recommended that WHO be the international umbrella, others suggested that no organization control all the research. Nevertheless the vaccine will be produced in a rich country, and if left to the free market, it will be too expensive. 1 suggestions is a 2-tiered pricing plan in which rich countries pay higher prices thereby subsidizing the price in poor countries. Another is a patent exchange where the vaccine developers donate the vaccine patent to an international organization and they in turn can get an extension on an existing patent. Another alternative includes removing AIDS vaccines from the private sector altogether.