November 29, 2010

Stagnant Funding and New Barriers to Affordable AIDS Drugs

HIV/AIDS treatment in developing countries is being dealt a double blow that will mean treatment recommendations cannot be implemented and the promise of new scientific research will remain unfulfilled.


Geneva, November 29, 2010 – HIV/AIDS treatment in developing countries is being dealt a double blow that will mean treatment recommendations cannot be implemented and the promise of new scientific research will remain unfulfilled, said the international medical humanitarian organization Médecins Sans Frontières/Doctors Without Borders (MSF).  

“The price of the newer medicines we need is set to go through the roof, just as donors have decided to retreat from their commitment to expand AIDS treatment,” said Dr. Gilles van Cutsem, MSF’s medical coordinator for South Africa and Lesotho. “As doctors trying to treat people with HIV/AIDS, we feel like our hands are being tied behind our back.”

The World Health Organization’s (WHO) latest recommendations for AIDS include treating people with better tolerated drugs, and earlier. The revised strategy calls for treating people before they become ill from opportunistic infections such as tuberculosis. Data just published from MSF’s project in Lesotho shows the value of this new strategy: providing people with treatment earlier led to a 68 percent reduction in deaths, a 27 percent reduction in new diseases, a 63 percent reduction in hospitalization, and a 39 percent reduction in people defaulting from care.

This “treat early” strategy has a benefit to individuals, but also to society, as it makes people with HIV less infectious and hence less likely to transmit the virus. Research in Africa has shown that treating AIDS can reduce heterosexual transmission of the virus by 92 percent.

“The evidence of what we need to do in order to turn the tide of the epidemic is mounting,” said Dr. van Cutsem. “But just as we’re seeing the promise of the latest treatment recommendations, the money that donors are allocating to HIV/AIDS is stagnating. Even South Africa, a middle-income country with the largest antiretroviral treatment program in the world, will struggle to implement the full WHO recommendations if its proposal to the Global Fund is not approved.”    

The Global Fund recently received only US$11.7 billion in pledges, compared to the $20 billion it said it needed. The US-funded PEPFAR program, which supports at least half of all people on HIV/AIDS treatment in developing countries, is flat-lining funding for the third year in a row.    

At the same time, rich countries are working to give unfair advantages to companies that make patented products, limiting access to generic medicines and raising prices. The vast majority—80 percent—of the AIDS medicines MSF uses to treat 160,000 people comes from generic producers in India, the so-called ‘pharmacy of the developing world,’ as does more than 80 percent of donor-funded AIDS medicines on a global scale. India’s position as key producer of affordable medicines has already been compromised by World Trade Organization rules that obligate the country to grant patents on medicines.  

Yet India has a patents law that imposes strict limits on what can and cannot be patented, in the interest of public health. Multinational pharmaceutical companies have tried and failed to have this law overturned, and now the EU is taking up their fight. As a part of free trade agreement negotiations with India, the EU is pushing for policies such as ‘data exclusivity,’ which would act to restrict even further generic producers’ ability to put more affordable generic medicines on the market. If these types of restrictions are put in place, access to affordable generic versions of newer medicines needed to tackle HIV/AIDS will be severely compromised.

MSF has been providing antiretroviral therapy since 2000 and today treats more than 160,000 people living with HIV/AIDS. Five million people are on treatment in developing countries today.  This represents important progress, but ten million people are still waiting in line and will die within the next several years if left untreated.