[Ip-health] SUNS: WHO needs to get serious about high cost of new AIDS drugs

[Thiru Balasubramaniam]

Health: WHO needs to get serious about high cost of new AIDS drugs

Geneva, 30 Nov (Kanaga Raja) -- Five months after the World Health
Organization (WHO) released updated AIDS treatment guidelines that
recommend
the use of newer and improved drugs in developing countries, the
organization has
failed to outline a strategy to help countries access these drugs, the
international
medical humanitarian agency Medecins Sans Frontieres (MSF) said
Wednesday.

AIDS treatment in the developing world will not be sustainable unless
international institutions get serious about the high cost of newer
medicines, MSF
warned.

MSF's warning has come just as World AIDS Day is being observed around
the
world on 1 December.

According to the 'AIDS Epidemic Update 2006', a joint UNAIDS/WHO
report, a
total of 39.5 million people were living with HIV in 2006 (2.6 million
more than
in 2004), and that the number of new infections rose to 4.3 million in
2006
(400,000 more than in 2004).

The UNAIDS/WHO report said that Sub-Saharan Africa remains the most
affected
region in the world - two-thirds of all people living with HIV (24.7
million in
2005) live in this region.

MSF said that new WHO-recommended drug regimens for patients starting
treatment can be up to six times more expensive than today's most
commonly used
combinations.

In addition, due to drug resistance or side effects, people on
anti-retroviral
treatment eventually need to switch to newer drugs. In the case of
resistance,
people need to receive entirely new drug combinations, or face becoming
sick
again and dying. This ''second-line'' therapy can be up to 50 times
more expensive.

''Our experience over the last year has told us two things. First,
treatment costs are
going to rise massively in the coming years unless something is done
about high
drug prices. Second, we cannot rely on pharmaceutical companies to
solve this
problem. We need drastic changes in strategy,'' said Dr. Tido von
Schoen-Angerer,
Director of MSF's Campaign for Access to Essential Medicines.

''It's clear as day that at current prices, the cost of accessing newer
drugs will
bankrupt treatment programmes, but governments, industry, and
multilateral
agencies are doing far too little to address the issue,'' he added.

MSF said that currently it provides anti-retroviral therapy to over
80,000 patients
in 65 projects in more than 30 countries. Data from MSF's programme in
South
Africa, which is one of the organisation's longest-running treatment
programmes,
shows that 17.4% of people who have been on treatment for five years
have had to
switch to second-line therapy.

In Malawi, where MSF has 11,000 people on AIDS treatment, it is
estimated that
roughly 1,600 people will need to switch to newer drug combinations in
three
years, which will take up 70% of the entire treatment budget.

''AIDS treatment became a reality in the developing world because of the
availability of affordable generic drugs,'' said Dr. von
Schoen-Angerer. ''Treatment
programmes will fail unless a continual supply of generic versions of
newer
medicines is also guaranteed.''

Generic competition since 2000 helped bring down prices of certain
first-line
AIDS drugs by 99%, from $10,000 to roughly $130 per patient per year.

Yet prices for newer drugs will remain high primarily due to increased
patent
barriers in key generic-producing countries like India. On top of cost,
newer
medicines often are not marketed in developing countries, said MSF.

''Many newer drugs are not even available where we work, because
companies do
not make a priority of registering them,'' said Dr. Moses Massaquoi of
MSF in
Malawi. ''It's simply unacceptable that we have to wait many years to
use
medicines that are commonly used in wealthy countries, if we get them
at all.''

Tenofovir, one of the most commonly prescribed AIDS drugs in wealthy
countries
and one of the drugs recommended by WHO, was approved for use in the US
in
2001, but Gilead, the manufacturer, has only registered it in roughly
15 of 97
developing countries that qualify for the company's reduced pricing.

According to MSF, Abbott launched an improved version of one of its
anti-retrovirals - heat stable lopinavir/ritonavir - over a year ago in
the US, but the
drug is still not registered in a single developing country, even
though the new
formulation is much better adapted to tropical settings.

For most developing countries outside of Africa, such as Thailand and
Guatemala,
the company has announced a price of $2,200 per year, which is far more
than the
average annual income in those countries.

MSF said that a high-level meeting of WHO, UNAIDS and the World Bank
which
concluded on Wednesday in Washington DC failed to address the fact that
pharmaceutical patents continue to drive the price of treatment up.

''Donor money should not be squandered to pay for overpriced drugs. The
priority
is to make drug prices come down as much as possible,'' said Dr. von
Schoen-Angerer.

''International organizations, donors and industry must overhaul their
strategies to
ensure that universal access to AIDS treatment for life becomes a
reality - this
means confronting companies and their patents,'' he stressed.

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Thiru Balasubramaniam
Geneva Representative
CPTech
voice +41.22.791.6727
fax +41.22.723.2988
mobile +41 76 508 0997
thiru@cptech.org