Effort to get AIDS drugs to poor countries

The Global Fund, World Bank and United Nations Children’s Fund (UNICEF) and Clinton Foundation last week announced agreements that will make it possible for developing countries to purchase high-quality AIDS medicines and diagnostics at the lowest available prices. In many cases, prices negotiated by the Clinton Foundation with five manufacturers of antiretroviral drugs and five manufacturers of HIV/AIDS diagnostic tests, are 50 percent less than are currently available. In a media release, UNICEF said the agreements paved the way for countries supported by the Global Fund, World Bank and UNICEF to gain access to drug and diagnostics at the prices negotiated.

“Countries will be required to provide guarantees of payment, to conduct long-term tenders and to ensure the security of drug distribution.” The Global Fund, World Bank and UNICEF will support their funding recipients in complying with these terms, consistent with their policies and existing practices. The drugs in the agreements include individual formulations and two and three fixed dose combinations which have been pre-qualified by the WHO to assure quality and efficacy. This is a standard prerequisite for procurement under the Global Fund, World Bank and UNICEF policies. UNICEF said the medicines are critical components of the four regimens recommended by WHO as the “first line” treatment for AIDS in its three by five initiative. It said in developing countries outside Brazil, such life sustaining therapy is available to fewer than 200,000 people living with the virus, although six million require treatment.

The pharmaceutical manufacturers included in the agreement include Aspen Pharmacare Holdings in South Africa; Cipla, Hetero Drugs Ltd, Ranbaxy Laboratories and Matrix Laboratories in India. UNICEF said the most common first line formulation under these agreements is as low as US$140 per month one-third to one-half of the lowest price otherwise available in most settings. The diagnostic tests included in these agreements are offered by five leading medical technology companies and include CD4 tests from Beckman Coulter Inc, Becton Dickinson and Company and viral load tests from Bayer Diagnostics, bioM?rieux and Roche Diagnostics. The prices available for these tests under the agreement include machines, training, reagents and maintenance and are up to 80 percent cheaper.

Commenting on the agreements, former US president Bill Clinton said: “I am grateful for this collective effort, which will soon help many hundreds of thousands of people and eventually millions, live longer, healthier lives. With these agreements we are one step closer to making sure future generations can live without the scourge of AIDS.” Richard Feachman, executive director of the Global Fund, said access to HIV treatment for all who need it is a moral imperative and now the target of growing financial commitments. He said the agreements built on “sound science, agreed policy and market economics to maximise the reach of these commitments.” UNICEF’s executive director, Carol Bellamy, said the partnership of the organisations works “to break down some of the barriers — such as price, supply and demand — that are impeding access to lifesaving AIDS medicines and diagnostics in developing countries.” The Global Fund and World Bank are among the world’s largest sources of funding commitments to AIDS treatment. The Fund focuses more than 60 percent of the US$2.1 billion committed for two years to 122 countries to fight AIDS. The World Bank has committed US$41.6 billion to fight AIDS through the multi-country HIV/AIDS programmes and other AIDS operations, including grants for the poorest countries.