PHA-Exchange> WHO and ARV access

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WHO looks to ease access to AIDS drugs           30 July 2003

The Boston Globe

By John Donnelly

The World Health Organization announced yesterday that it will create a new
model to buy antiretroviral AIDS drugs in hopes of dramatically speeding
distribution and reducing the cost of the life-saving medication.

The plan comes from a collaboration among tuberculosis experts, foremost
among them the new WHO director general, Jong-wook Lee. That program, called
the TB Drug Facility, purchases drugs in bulk on behalf of countries and
then oversees the distribution.

Global health specialists have applauded the program because it created a
larger market for TB drugs and spurred competition. That in turn drove down
the cost of TB drugs, 30 percent for front-line, or commonly used,
medication and 95 percent for secondary drugs.

The program, which has reached nearly 2 million TB patients the past two
years, also has provided an additional benefit: The WHO works with local
partners to ensure that the drugs are being distributed properly, providing
a safeguard against improper use, which can lead to drug resistance.

At a cost of less than $20 million, the program has delivered drugs to 33
countries and decreased the price of the main TB drugs to as low as $11 for
a six-month daily regimen of medicine.

''The main issue is getting drugs to patients, and we've got to make it more
rapidly available,'' said Ian Smith, one of Lee's top advisers.

Lee has embraced a goal of treating 3 million people with antiretroviral
medicines by the year 2005. Now, about 300,000 people in the developing
world receive those drugs.

The WHO has pledged to draw up a plan by Dec. 1 to meet its goal. The plan,
which the WHO hopes will begin in three to four months, also will cover
anti-malarial medication. Others in the health field, including those
working in family planning, are also examining the model and may adopt it,
WHO officials said.
''The primary goal in this is to dramatically increase access,'' Smith said.
''We also want to reduce the price, but that is a byproduct of the program
and not the primary aim.''

The price of generic antiretroviral drugs tumbled sharply last year to
roughly $1 a day for people with AIDS in the developing world. The cost in
the United States is about $10,000 a year. AIDS activists hope the price
falls even further, and some believe the TB model holds great promise.

''The principles of the program were very successful and we think could be
applied'' for AIDS drugs, said Paul S. Zeitz, executive director of the
Global AIDS Alliance, an advocacy organization. ''It could be fantastic.''
Zeitz cautioned that developing countries still should explore options under
consideration for pooling resources regionally, until a new WHO program
proves successful.
But he said, ''If you can bring on other producers, and create competition
among generics, you'll have Thai producers, Brazilian producers, Chinese
generic producers, all competing with the Indian producers, and as you
create more and more demand for the drugs, we believe it will continue to
drive the price down.''