WHO sticks head in sand over high cost of newer AIDS drug
Medecins Sans Frontieres (MSF) - International - www.msf.org
2006-08-16
Most patients whose lives had been saved by first-line treatment will be abandoned the moment they need second-line drugs unless governments pull their heads out of the sand and start tackling this issue, says Ibrahim Umoru, a peer educator working for MSF in Lagos, Nigeria, who had to switch treatment in 2006 after having developed resistance to first-line.
Toronto
- After nearly six years of providing antiretroviral
treatment in developing countries, the international medical humanitarian
organization Mdecins Sans Frontires (MSF) expressed dismay at the political
complacency surrounding the need to ensure that newer AIDS medicines are
accessible for people living with HIV/AIDS in developing countries.
Data released by MSF at the
XVI International AIDS Conference in
Toronto
clearly show how the high price of newer medicines is driving the cost of
treatment up and threatening the sustainability of treatment programmes:
in the MSF-supported
programme in Khayelitsha, South Africa, 10% of patients at three years and 16%
at four years need to switch to second-line however, second-line treatment is
five times more expensive than first-line.
in Nigeria, 8%
of patients on treatment for 18 months need second-line, which costs over seven
more than first line (US 200 vs US 1,473) tenofovir is not available as an
alternative to first therapy in case of toxicity.
In
Guatemala
, a second-line regimen costs US6,500 - 28 times more than the first-line.
The World Health
Organization's latest antiretroviral treatment guidelines for resource-poor
settings released at the Toronto Conference recommend newer generation ARVs for
both first- and second-line therapy. Because of patent issues, many of these
drugs are not available from generic manufacturers. As a result, originator
companies are able to charge prohibitively high prices and are often slow to
make the drugs available in developing countries.
"We applaud the fact
that WHO has expanded the drug formulary to include newer drugs into their
guidelines. However, no mechanism exists to make those drugs available at a
country level." said Dr Alexandra Calmy of MSF's Campaign for Access to
Essential Medicines. "It is the responsibility of WHO to encourage
governments to use the flexibilities in the WTO TRIPS Agreement, including
issuing compulsory licenses to access generic drugs.
"Other actors,
including the Global Fund and UNAIDS must also get serious about the fact that
we're facing a potentially major crisis unless they act now to bring down the
cost of treatment."
Generic competition has been
a major engine driving down the price of first line drugs from over US10,000
per patient per year to under US140. Today, 50% of people in the developing
world on ARVs rely on generic medicines from
India
. However, now that countries like
India
have to grant patents on medicines, sources of generic medicines are at risk of
drying up.
Ensuring affordability of
newer medicines is the only way to ensure long-term quality care for people with
HIV/AIDS in the developing world.
"I would not be alive
today if I could not access second-line medicines," says Ibrahim Umoru, a
peer educator working for MSF in
Lagos
,
Nigeria
, who had to switch treatment in 2006 after having developed resistance to
first-line.
"I am in the very lucky
minority. Most patients whose lives had been saved by first-line treatment will
be abandoned the moment they need second-line drugs unless governments pull
their heads out of the sand and start tackling this issue."
MSF provides antiretroviral
treatment to more than 60,000 patients in 32 countries.
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