[Ip-health] ITPC: Drug Access Priorities to Achieve 2010 AIDS Treatment Target

[robert weissman]

New Analysis from 14 Countries Identifies Drug Access Priorities to Achieve=
 2010 AIDS Treatment Target

Dr. Jim Kim joins teleconference to release report with ITPC. Kim says foun=
dations laid by AIDS response are "the best chance we've ever had to build =
comprehensive health systems in the poorest settings."

NEW YORK AND CAPE TOWN, South Africa, Nov.27 /PRNewswire-USNewswire/ -- The=
 International Treatment Preparedness Coalition (ITPC), a group of 1,000 tr=
eatment activists from more than 125 countries, today issued its fifth repo=
rt on scale up of AIDS services: Missing the Target #5: Improving AIDS Drug=
 Access and Advancing Health Care for All. The report is available at www.a=
idstreatmentaccess.org.

The comprehensive report investigates AIDS drug access in 14 countries and =
finds that scale up is working but high prices, patent and registration bar=
riers, and ongoing stock-outs are core issues impeding better and faster AI=
DS drug delivery.

"The foundations to make the 2010 target are in place in many countries. If=
 governments, global agencies, and drug companies focus on tactically impro=
ving AIDS drug access by continually lowering costs, ending patent and regu=
latory problems, and fixing drug availability logistics, while simultaneous=
ly strengthening health systems, there is real possibility for making the '=
near universal access' target by 2010," said Gregg Gonsalves, a coordinator=
 of the project.

Missing the Target teams in nine countries -- Cambodia, Cameroon, China, Do=
minican Republic, India, Kenya, Russia, Zambia, and Zimbabwe -- also looked=
 at broader issues in AIDS service delivery in their countries. "AIDS treat=
ment scale up cannot succeed without stronger health systems, adequate nutr=
ition, and concerted action against stigma and marginalization," said Matil=
da Moyo of the Zimbabwe research team.

"Mobilization around AIDS has opened up fantastic new possibilities in heal=
th service delivery by infusing new resources, intensifying the engagement =
of people living with HIV/AIDS, and focusing on specific, measurable outcom=
es," said Dr. Jim Yong Kim, Director of the Francois-Xavier Bagnoud Center =
for Health and Human Rights (FXB) at Harvard University. "We must learn fro=
m and build on these foundations because they represent the best chance we'=
ve ever had to build comprehensive health systems in the poorest settings."

"It is irresponsible to get bogged down in debates on simplistic dichotomie=
s like prevention versus treatment or disease-specific funding versus stron=
g health systems. We can, and we must, do all of this, better, for more peo=
ple, and in an increasingly coherent way," added Chris Collins, a coordinat=
or of the project.

"The UNAIDS epidemiologic estimates released last week show that we're gett=
ing closer to reaching the goal of treatment for all," said Shona Schonning=
 of the Russia research team. "The UNAIDS report shows that prevention and =
treatment programming have had impact. Now its time to scale up these progr=
ams and continue to make progress on what remains a devastating epidemic."

In the report, civil society advocates in 14 countries identify specific pr=
oblems and recommend solutions to improve AIDS drug access:

-- In Argentina, high cost and restrictions on some drugs impede access to =
some second line and other medicines.

-- In Belize, human resources shortfalls, price increases and inadequate qu=
ality assurance hamper drug delivery.

-- In Cambodia, expanded access to drug resistance and viral load testing i=
s needed, as is increased attention to drug quality.

-- In China, access to second-line therapy is extremely limited, new WHO tr=
eatment guidelines on improved first-line treatment have not been widely im=
plemented and patents on key medicines are preventing cost-cutting generic =
competition.

-- In the Dominican Republic, new intellectual property laws and patent enf=
orcement by Merck are leading to higher prices and limited access to some k=
ey drugs.

-- In India, drug stock-outs are reported across the country, particularly =
where IDUs require treatment regimens that are not hepatotoxic.

-- In Malawi, a chronic shortage of health care workers is a major impedime=
nt to drug access; while ARV stock-outs are rare, other important drugs are=
 often unavailable.

-- In Morocco, new intellectual property laws threaten the provision of AID=
S treatment.

-- In Nigeria, despite a rapid scale up of ARV treatment and a free treatme=
nt policy, treatment sites are not easily accessible in many parts of the c=
ountry, and CD4 and other tests are still being offered at a fee in several=
 locations.

-- In the Philippines, treatment is not yet accessible to all, there is a h=
ealthcare worker shortage and diagnostic testing access is limited.

-- In Russia, ARV stock-outs are a severe and ongoing problem.

-- In Uganda, stock-outs are commonplace, and limited support and care serv=
ices undermine drug access.

-- In Zambia, there is concern that AIDS drug access depends on the work of=
 NGOs and the government is not sufficiently engaged.

-- In Zimbabwe, stock-outs are frequent and the increasingly unfriendly gen=
eral policy environment remains a cause for concern.

Action Recommendations for Global Agencies and National Governments

-- The World Health Organization: Take the lead to educate countries about =
changes to standard first- and second-line treatment regimens and lead glob=
al efforts to simultaneously expand AIDS services while strengthening broad=
er care systems.

-- United Nations technical agencies: Clearly and publicly communicate chan=
ges in WHO ARV drug guidelines and provide technical support and guidance t=
o countries to help implement the changes.

-- The Global Fund: Proactively support grantees in identifying and correct=
ing procurement bottlenecks and strengthening national procurement systems =
for ARVs and other medicines and ensure grantees are procuring medicines at=
 preferential prices.

-- Bilateral programs (PEPFAR, etc.): Work with national treatment programs=
, community organizations, PLWHA and other partners to support national eff=
orts to switch to optimized first-line treatment.

-- UNITAID (the international drug purchase facility): Work aggressively to=
 support initiatives to increase competition and further reduce the price o=
f new standardized treatment regimens.

-- Drug companies: Act with enlightened self-interest to expand access to p=
roducts by registering them much more expeditiously and stop intimidating c=
ountries that use flexibilities in trade law.

-- National governments: Build local and regional drug regulatory capacity,=
 make fuller use of the WHO drug prequalification process, and use flexibil=
ities in international trade rules to secure the lowest possible drug price=
s.

About the International Treatment Preparedness Coalition

The International Treatment Preparedness Coalition (ITPC) was born out of t=
he International Treatment Preparedness Summit that took place in Cape Town=
, South Africa in March 2003. That meeting brought together for the first t=
ime community-based HIV treatment activists and educators from over 60 coun=
tries. Since the Summit, ITPC has grown to include more than 1,000 activist=
s from over 125 countries and has emerged as a leading civil society coalit=
ion on treatment preparedness and access issues.


Source: International Treatment Preparedness Coalition


CONTACT:  Chris Collins: +1-845-701-0158, ChrisCSF@aol.com, or Kay
Marshall, +1-347-249-6375, kaymarshall@mac.com, both for AIDS Vaccine Advoc=
acy
Coalition

Web Site:  http://www.aidstreatmentaccess.org/