[Ip-health] New WHO AIDS treatment progress report

Fri Apr 20 05:43:01 2007

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[ Picked text/plain from multipart/alternative ]
Michelle Childs points out that while there is only one reference to
IP, the new WHO AIDS report does include the following important
passage:

On Apr 18, 2007, at 2:31 PM, Benjamin Krohmal wrote:

> In the 92 page report, there is only one reference to patent or IP:
> "[India's] generic drug manufacturing industry also faces the
> challenge of compliance
> with international laws on intellectual property rights, including
> that of supplying the domestic antiretroviral  drug
> market with generic versions of products that are patented or for
> which patents are pending."
>
>
> report:
> http://www.who.int/entity/hiv/mediacentre/
> univeral_access_progress_report_en.pdf
> statement:
> http://www.who.int/mediacentre/news/releases/2007/pr16/en/index.html
>
>
> Significant growth in access to HIV treatment in 2006
>
> More efforts needed for universal access to services
>
> 17 APRIL 2007 | LONDON -- Access to antiretroviral therapy for
> advanced HIV infection in low- and middle-income countries continued
> to grow throughout 2006, with more than 2 million people living with
> HIV/AIDS receiving treatment in December 2006, a 54% increase over
> the 1.3 million people on treatment one year earlier in these
> countries. These encouraging findings were released today in a new
> report, =93Towards universal access: scaling up priority HIV/AIDS
> interventions in the health sector,=94 published by WHO, the Joint
> United Nations Programme on HIV/AIDS (UNAIDS) and UNICEF.
>
> At the same time, the report details a number of key areas in which
> efforts to scale up services are insufficient if the global goal of
> moving towards =93universal access to comprehensive prevention
> programmes, treatment, care and support=94 for HIV by 2010 is to be
> achieved. For example, just 11% of HIV-positive pregnant women in
> need of antiretrovirals (ARVs) to prevent mother-to-child
> transmission of HIV (PMTCT) in low- and middle-income countries are
> receiving them. Global coverage of HIV testing and counselling
> remains unsatisfactorily low, as does coverage of prevention and
> treatment interventions for injecting drug users. And while countries
> committed themselves to setting targets for universal access by the
> end of 2006, only 90 had provided data on these by that date.
>
> =93The combined efforts of donors, affected nations, UN agencies and
> public health authorities are providing substantial, ongoing progress
> in access to HIV services,=94 said Dr Margaret Chan, Director-General,
> WHO. =93Yet, in many ways we are still at the beginning of this
> commitment. We need ambitious national programmes, much greater
> global mobilization, and increased accountability if we are going to
> succeed."
>
> Progress in access to HIV treatment
>
> The report shows that countries in every region of the world are
> making substantial progress in increasing access to HIV treatment.
> More than 1.3 million people in sub-Saharan Africa were receiving
> treatment in December 2006, representing coverage of approximately
> 28% of those in need compared to just 2% in 2003. Coverage in other
> regions varied, from 6% in North Africa and the Middle East, to 15%
> in Eastern Europe and Central Asia and 72% in Latin America and the
> Caribbean. Overall, while encouraging trends continue, just 28% of
> the estimated 7.1 million people in need of treatment in all low- and
> middle-income countries were receiving it in December 2006.
>
> Funding provided by the United States President=92s Emergency Plan for
> AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and
> Malaria was supporting 1 265 000 individuals receiving treatment by
> the end of 2006. The prices of most first-line ARVs decreased by
> between 37% and 53% in low- and middle-income countries from 2003 to
> 2006, and by between 10% and 20% from 2005 to 2006.
>
> =93The significant progress outlined in this report in scaling up
> access to treatment is a positive step forward for many countries in
> achieving their ambitious goals of universal access to HIV
> prevention, treatment, care and support,=94 said Dr Peter Piot,
> Executive Director of UNAIDS. =93However new data in the report also
> shows that there is still a long way to go, particularly in the
> widespread provision of treatment to prevent mother to child
> transmission of HIV, which remains one of the simplest and cheapest
> proven prevention methods available,=94 he added.
>
> The number of children receiving treatment increased by 50% in the
> past year, but from a very low base. In December 2006, only about 115
> 500 (15%) children of the 780 000 estimated to be in need of HIV
> treatment had access to it. According to HIV/AIDS Director in WHO, Dr
> Kevin De Cock, "urgent priorities are improving access to HIV
> treatment for children, especially in sub-Saharan Africa, as well as
> for injecting drug users everywhere". =93Access to HIV testing and
> counselling, a critical entry point for both prevention and treatment
> services, also needs to be broadened significantly if we are to come
> near to reaching the targets for universal access by 2010," he added.
>
> =93Children continue to be the missing face of the AIDS pandemic,=94 said
> UNICEF Executive Director Ann M. Veneman, =93with too many children
> still missing out on life-saving treatment and access to other
> essential services.=94 In 2005, UNICEF, UNAIDS and other partners
> launched the Unite for Children, Unite against AIDS campaign. It
> targets four key areas:
>
>     * prevention of mother to child transmission;
>     * treatment of paediatric AIDS;
>     * education programmes for prevention; and
>     * support for orphans and vulnerable children.
>
> Challenges and recommendations
>
> Among the report=92s recommendations for improving the global AIDS
> response are the following:
>
> Increase efforts to accelerate the prevention, diagnosis and
> treatment of HIV disease in children.
>
> In addition to the need to increase treatment access, progress
> remains unsatisfactory in the prevention and diagnosis of HIV disease
> in children. The technical challenges of expanding services for
> children have been considerable. New approaches to overcoming these,
> such as the development of appropriate diagnostics and fixed-dose
> paediatric drug formulations, need to be more widely explored and
> accelerated.
>
> Introduce a range of strategies to increase knowledge of HIV status.
>
> Surveys in 12 high-burden countries in sub-Saharan Africa showed that
> a median of just 12% of men and 10% of women in the general
> population had been tested for HIV and received the results. While
> client-initiated voluntary counselling and testing (VCT) is helping
> people know their status, provider-initiated HIV testing and
> counselling (PITC) in health-care settings is emerging as a key
> additional strategy to expand access to HIV prevention, treatment and
> care services. The conditions under which testing and counselling are
> provided must also be improved in order to diminish obstacles to
> uptake, such as fear of stigma and negative reactions to disclosure.
>
> Accelerate scale-up of services to prevent mother-to-child
> transmission of HIV (PMTCT).
>
> More than 100 low- and middle-income countries have established PMTCT
> programmes, yet only seven were reaching 40% or more of HIV-infected
> pregnant women in 2005. In sub-Saharan Africa, where 85% of HIV-
> infected pregnant women live, coverage in countries ranges from less
> than 1% to 54%. Current efforts to prevent mother-to-child
> transmission of HIV are far below what is required to meet the UN
> target of reducing the proportion of children infected with HIV by
> 50% in 2010.
>
> Improve access to services for most-at-risk populations, including
> injecting drug users and men who have sex with men (MSM).
>
> Injecting drug use is a major mode of HIV transmission in several
> regions and is emerging as a concern in Africa. Adequate prevention,
> treatment, and care services need to be provided to this population
> if a significant impact is to be made on HIV transmission. Resurgent
> transmission of HIV and other sexually transmitted infections in MSM
> in industrialized countries needs to be countered, and prevention
> needs of MSM in low- and middle-income countries addressed.
>
> Invest in prevention for people living with HIV/AIDS.
>
> Persons living with HIV can be the strongest advocates for HIV
> prevention. Better follow-up is required of individuals diagnosed
> with HIV in voluntary counselling and testing centres. The health
> sector should provide a wider range of services and interventions to
> help people with HIV/AIDS to maximize their health, prevent and treat
> opportunistic and sexually transmitted infections, reduce the harms
> associated with injecting drug use, and avoid passing HIV on to
> others.
>
> Improve access for people living with HIV/AIDS to quality TB
> prevention, diagnostic and treatment services.
>
> Most cases of TB are preventable or curable. Nevertheless, almost 1
> million people living with HIV will develop TB disease each year,
> leading to nearly a quarter of a million avoidable TB deaths. Chronic
> underinvestment and inadequate political commitment to TB control in
> many countries of high HIV prevalence have resulted in high TB
> incidence among people with HIV/AIDS and have contributed to the
> development of TB drug resistance. The emergence of extensively drug-
> resistant tuberculosis (XDR-TB) must now be urgently addressed
> through increased coordination and availability of prevention,
> diagnostic, and treatment services, and through comprehensive
> infection control strategies.
>
> Recognize male circumcision as an important additional HIV prevention
> intervention.
>
> Recent clinical trial data demonstrate a significant reduction in the
> risk of heterosexually acquired HIV infection among circumcised men.
> Male circumcision could have a major public health impact in
> countries where HIV prevalence is high, transmission is predominantly
> through heterosexual contact, and rates of male circumcision are low.
> Such countries should urgently consider scaling up access to safe
> male circumcision services. Key issues in implementation include the
> quality and safety of services, cultural considerations, and
> adherence to human rights principles in the provision of male
> circumcision, including informed consent, confidentiality, and
> absence of coercion.
>
> Address concerns about longer-term financial sustainability.
>
> Financial concerns, especially with reference to what will be
> available from major multilateral and bilateral sources in the long
> term, continue to limit the scope and rate of scale-up in many
> countries and threaten long-term sustainability. While encouraging
> reductions have occurred in the price of first-line regimens in most
> low- and some middle-income countries, the demand for expensive
> second-line regimens will continue to increase. Unless prices for
> second-line regimens fall significantly, budgetary constraints may
> put treatment programmes at risk.
>
>
>
>
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Benjamin Krohmal
Coordinator - Project on Medical Innovation
Knowledge Ecology International
Tel: +1-202-332-2670 ex. 17
Fax: +1-202-332-2673
ben.krohmal@keionline.org