PHA-Exchange> Free HIV Drugs Have Boosted AIDS Survival

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Source: CDC HIV/STD/TB Prevention
News Update / Wednesday, July 30, 2003

"Free HIV Drugs in Brazil Have Boosted AIDS Survival"
Reuters (07.25.03)::Matías A. Loewy; Jimena Castro Bravo

Survival among adult AIDS patients in Brazil has dramatically improved since
universal free access to triple antiretroviral treatment began in 1996.
"Median survival was five months for cases diagnosed in the 1980s, 18 months
for those diagnosed in 1995, and 58 months for those diagnosed in 1996," the
year the policy was launched, reported Dr. Jose Ricardo Pio Marins, of the
University of Campinas in Sorocaba, Brazil, and colleagues. The study,
"Dramatic Improvement in Survival Among Adult Brazilian AIDS Patients," was
published in the journal AIDS (2003;17(11):1675-1682).

"It is the first time a study has demonstrated that universal free access to
triple antiretroviral treatment in a developing county can produce benefits
on the same scale as in richer countries," said Marins.

The study involved 3,930 randomly selected adult AIDS patients diagnosed in
1995 and 1996, who were from seven states representing all regions of
Brazil. The patients were tracked for an average of five years. After
accounting for other factors, the authors found antiretroviral treatment was
the main predictor of survival.

However, Marins noted that there is still much to be done before HIV/AIDS is
under control in Brazil. "Only 40 percent of the 600,000 HIV-positive
patients in Brazil are aware of their infection. The rest just fear the
social and physical consequences of this disease and prefer not to undergo
the test," he added.

The study results come at a time when the Brazilian Ministry of Health is
considering breaking the patents of three AIDS drugs: Merck's efavirenz
(Sustiva), Roche's nelfinavir (Viracept), and Abbott's lopinavir/ritonavir
(Kaletra). These drugs currently account for almost two-thirds of the
government's HIV drug budget.

Negotiations between the Brazilian government and the drug companies are
slated to begin August 1 and could last until the end of the month. "If we
don't reach a deal, we will use the licenses in a compulsory way," Health
Minister Humberto Costa said at a press conference.

"The world community must realize that we need to have a low-cost drug
policy for developing countries if we want to defeat AIDS," observed Marins.