Drug companies, UNAIDS make drugs available
Many need treatment but few will be chosen
In Uganda, 1.6 million people are infected with HIV and yet the country has only six health care centers equipped to deliver antiretroviral treatment. That overwhelming scenario is one a UNAIDS initiative hopes to change with the help of multinational drug companies working together with the nation’s health officials.
Uganda is one of four countries (Chile, Vietnam, and Cote d’Ivoire are the other three), chosen for a pilot program that will help provide the health infrastructure and affordable drugs to ensure that combination therapies are used and used appropriately. So far, Glaxo Wellcome, Hoffmann-La Roche, and Virco NV have agreed to participate in the project, which will test the strategy in countries that are diverse and have political stability.
"The AIDS epidemic defies standard thinking," said UNAIDS Director Peter Piot, MD. "Its potential for immense and lasting destruction make the strengthening and updating of health care delivery systems in hardest-hit countries an even more urgent priority."
As a requirement to participate, the countries have agreed to form two new entities a national HIV/AIDS drug advisory board and a nonprofit company that will act as a clearinghouse for the drugs ordered by the countries. The board will devise a coordinated national drug policy for the use of HIV drug treatment, including criteria for choosing the most appropriate drugs and evaluating who needs them. The nonprofit company will act as a distributor for the drugs and be responsible for the business and logistical issues of the initiative.
How much the drugs will be subsidized is a difficult issue, as is the criteria for deciding who will receive the drugs, said Joseph Saba, MD, clinical research specialist for UNAIDS. "Even at reduced costs, there is still the need to pay for the drugs and that is not an easy solution," he said, adding that the program initially should enable up to 3,000 Ugandans to receive therapy.
While that number is small compared to the need, the program is a viable alternative to doing nothing, Piot said.
Financing will come from the pharmaceutical companies, which will sell the drugs at subsidized prices, from local health ministries, which will create new sources of funding, and from a $1 million grant from UNAIDS. Cote d’Ivoire, for example, is expected to establish a special solidarity fund from corporate contributions, new tariffs, and nonprofit insurance company contributions. In Uganda, money from a $70 million World Bank program for preventing sexually transmitted diseases may be used to purchase the drugs, which will include many antiretrovirals, antimicrobials, and antibiotics used for standard HIV treatment.
"These countries are looking outside the box, working seriously on systems of nonprofit insurance and corporate contributions," Saba said.
The pilot programs will be evaluated in terms of improvements in overall health care delivery, the number of people treated, their impact on the demand for emergency care, and the rate of illness and death. The evaluations will be used to modify the program and provide guidance for other countries when the program expands, possibly in two years, Saba added.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content