[Ip-health] Health GAP Reaction to WHO HIV Treatment Progress Report

[Mike Palmedo]

http://www.commondreams.org/news2005/0126-13.htm

FOR IMMEDIATE RELEASE
JANUARY 26, 2005
11:24 AM

CONTACT: Health Gap Global Access Project
Sharonann Lynch: 646 645 5225
Asia Russell: 267 475 2645

Health GAP Reaction to WHO HIV Treatment Progress Report: Goal of
Treatment Access for All Threatened by Rich Country Inaction on Debt,
Funding


WASHINGTON -- January 26 -- At a joint press conference today at the
opening of the World Economic Forum in Davos, WHO reported progress in
the goal of reaching 3 million HIV positive people with combination
anti-HIV treatment by the end of 2005, called "3 by 5". WHO was joined
by UNAIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and
the U.S. bilateral AIDS program (PEPFAR, the President's Emergency Plan
for AIDS Relief).

Approximately 5.8 million HIV positive people in developing countries
are in immediate clinical need of treatment, of whom WHO reported 12.4%
currently have access. A dramatic increase in the rate of treatment
scale up is necessary in order to reach the WHO target but surmountable
political barriers are standing in the way, according to activists.

REALITY CHECK:

"It is not time to pop the champagne as long as continued support and
action from world leaders is uncertain and 8,200 people continue to die
each day," said Sharonann Lynch of Health GAP. "Neither the WHO or the
GFATM know whether they will receive adequate funding this year for
desperately needed programs just as the any of 5.3 million people in
need of treatment do not know whether they will be among the 50% the
"3x5" campaign hopes will have access to life- saving treatment."

"Reaching the 3 million people by 2005 is possible but depends on the
choices and priorities of international leaders," continued Lynch. "In
2005 donor countries must support debt cancellation for poor countries,
major AIDS funding increases, increased numbers of health care workers
in poor countries, and support for generic competition, in particular
low cost medicines for for second-line and pediatric treatment. This
will bring the world closer to "3 by 5," and to the most important
goal--universal HIV treatment access to free treatment."

UNAIDS estimates that $10.2 billion is needed in 2005 for AIDS treatment
care and prevention. Of that, WHO estimates a $2 billion gap in funding
to reach 3 by 5. Although donors have promised major funding increases,
these have not been forthcoming. For example the Bush Administration
will likely include a request for $3.2 billion in AIDS funding for the
2006 budget. Although this amount is an increase over the 2005 request,
the U.S. fair share of funding for AIDS, tuberculosis and malaria is
double that amount. Funding gaps faced by the Global Fund, which needs
$2.3 billion in 2005 alone to continue to issue grants and renew funding
for existing programs, must be filled in order to keep pace with global
treatment need.

"AIDS is called the largest threat to global stability, but
international leaders are still treating this pandemic like a passing
fad," said Asia Russell of Health GAP.

The spotlight will shift from Davos to London next week where the Group
of 7 (G-7) Finance Ministers meet to discuss debt cancellation for poor
countries. The G-7 countries have been unable to agree about dropping
poor countries' debts, a move that would free up money for fighting
AIDS. "While the G-7 wasted time quibbling about developing country
debt, massive debt burdens continue to hijack scarce resources and
cripple treatment scale up efforts," said Asia Russell of Health GAP.
"The Finance Ministers should leave their meeting with a clear plan to
cancel 100% of impoverished country debt, financed by the IMF and World
Bank." Limited debt relief has enabled Mozambique to invest its national
AIDS plan. Mozambique has an estimated 8,000 people on treatment out of
199,00 in clinical need. 100% debt cancellation would free up resources
in order to meet its goal of increasing to 50% coverage up from the
current 4% coverage.

While the donor countries admit the massive shortage of health care
workers in developing countries is another major barrier to treatment
scale-up, they have no action plan to address it. "G7 countries must end
their poaching of doctors and nurses from the hardest hit countries, and
instead invest in health care worker training," said Eustacia Smith of
Health GAP.

ON PEPFAR:

"PEPFAR proves old habits die hard and gets new life in the U.S. AIDS
program. As long as there is a exclusive approval process for ARV's
benefiting big pharma, the "Buy American" restrictions remain in place
for drugs to treatment opportunistic infections, and PEPFAR pushes brand
name regimens over generic alternatives and national guidelines, Big
Pharma will be well cared for," said Sharonann Lynch.

Tanzania's scale up plans are stalled until negotiations are finished
with U.S. officials for the country to qualify for PEPFAR funding while
still maintaining its national treatment plan and guidelines, including
the use of generic antiretrovirals from India for first-line treatment.
The mission hospitals in Tanzania, supported through PEPFAR grants, are
raising private funds to purchase more affordable local drugs for
opportunistic infections because the "buy American" rules on such drugs
will drain its financing from PEPFAR. And in Kenya, USAID field officers
have tried to arrange for the UK's Department for International
Development (DfID) to pay for drugs to treat opportunistic infections,
allowing PEPFAR recipients to purchase affordable locally produced drugs
rather than the more expensive U.S. brands, thereby bypassing the
burdensome "buy American" restrictions that apply to all
non-antiretroviral medicines.

ON FDA APPROVAL OF ASPEN BLISTER PACK:

Aspen Pharmacare announced yesterday the approval by the US FDA of a co-
blistered combination of generic antiretrovirals (a blister pack
containing co- formulating AZT and 3TC, co-packaged with a separate dose
of nevirapine).

"This approval is too little, too late--and too unilateral," said Brook
Baker of Health GAP, "The WHO already had an internationally supported
Pre- Qualification Project for listing AIDS medicines of proven quality,
including generic products." Since the launch of PEPFAR the Bush
Administration has refused to permit PEPFAR grantees to procure more
affordable generic medicines- -forcing them to waste limited resources
on more costly brand name products, reaching fewer people with live
saving medicines.

"Had affordable generic drugs been used by PEPFAR in the first place,
more people may have been alive today," said Amanda Lugg of Health GAP.

According to several generic companies, some applications to the US
approval process have been delayed because brand name drug companies are
refusing to provide "reference rights" to the generic companies that
would confirm the equivalence between European and US versions of
originator products. As a result they are forced to redo their
bioequivalence studies, wasting time and money. Aspen would have avoided
this problem because of its existing cozy relationship with originator
companies.