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Back To Vidyya Effort To Speed Access To HIV/AIDS Medications In Developing Countries Underway

Dialogue Between Pharmaceutical Companies And The Joint United Nations Program On HIV/AIDS Is Successful

The Joint United Nations Program on HIV/AIDS (UNAIDS) announced on 12 May 2000 that a new dialogue has begun between five pharmaceutical companies and United Nations organizations to explore ways to accelerate and improve the provision of HIV/AIDS-related care and treatment in developing countries.

The pharmaceutical companies involved - Boehringer Ingelheim, Bristol-Myers Squibb, Glaxo Wellcome, Merck & Co., and F. Hoffmann-La Roche - have indicated their willingness to work with other stakeholders to find ways to broaden access to care and treatment, while ensuring rational, affordable, safe and effective use of drugs for HIV/AIDS related illnesses. The companies are offering, individually, to improve significantly access to, and availability of, a range of medicines. Other pharmaceutical companies have also expressed interest in cooperating in this endeavour.

The companies have responded to calls from UN Secretary General Kofi Annan inviting the private sector to engage in partnerships for expanding the global response to HIV/AIDS and to support the International Partnership against HIV/AIDS in Africa, a collective international initiative to curtail the spread of HIV and reduce its impact in African countries.

In recent months, these calls have been reiterated by the heads of United Nations organizations, in particular by Gro Harlem Brundtland, Director-General, World Health Organization (WHO), James Wolfensohn, President, World Bank and Peter Piot, Executive Director, UNAIDS, whose advocacy efforts have been fundamental in drawing leading companies into cooperative action to help meet the challenges of the epidemic. The heads of the other two organizations involved in the discussions, Carol Bellamy, Executive Director, United Nations Children's Fund (UNICEF) and Nafis Sadik, Executive Director, United Nations Population Fund (UNFPA), have also actively promoted effective alliances with the business community.

Participants in this cooperative endeavour have adopted a set of principles that reflect a common vision of how the HIV/AIDS epidemic can more effectively be tackled in developing countries: unequivocal and ongoing political commitment by national governments; strengthened national capacity; engagement of all sectors of national society and the global community; efficient, reliable and secure distribution systems; significant additional funding from national and international sources; and continued investment in research and development by the pharmaceutical industry.

Constructive discussions have begun between the five companies and the United Nations organizations to explore practical and specific ways of working together more closely to make HIV/AIDS care and treatment available and affordable to significantly greater numbers of people in need in developing countries. The intention is to improve the prevention, treatment and care of HIV-related illnesses, and the prevention of mother-to-child transmission of HIV. Activities to promote the development of an HIV vaccine are being conducted in parallel. This endeavour is expected to expand to include other partners from all sectors.

A number of recent pilot initiatives aimed at improving access to HIV-related care have resulted in useful experience being gained in mobilizing multisectoral action to strengthen health infrastructures in developing countries. This new endeavour will aim to build on this experience.

Welcoming the initiation of the discussions, Peter Piot said: "This is a promising step in a long-term process, and an opportunity for committed governments, donors, NGOs, people living with HIV/AIDS, and private industry to enter into discussion to scale up access to care in ways that respond to the specific needs and requests of individual countries. Lowering the price of medicines, however, is only one critical factor in what must become a much broader and more urgent effort to help people living with HIV and AIDS lead healthier and more productive lives. We need significant new funding that is on a level with the enormous human, social and economic challenges now being posed by the epidemic."

An accelerated response that more adequately addresses the rights of all people to HIV/AIDS-related services within the broader context of national development agendas is considered to be an urgent priority by the United Nations.

These discussions are taking place at a time when there has been increasing international mobilization to slow the spread of HIV and alleviate the devastating impact that the AIDS epidemic is having in many countries, in particular in sub-Saharan Africa. HIV/AIDS causes more death than any other infectious disease worldwide and, in the worst affected countries, one in four adults is now infected.

Some 50 million poor people in developing nations are infected with H.I.V.. By some estimates, sub-Saharan Africa has 80 percent of the world population of people infected by H.I.V., though few of those people have ever had an AIDS test.

In many poor countries, distributing the drugs, teaching people to take them and monitoring levels of virus, T-cells and drug residues in the blood amount to a mammoth task.

"To be realistic, this is not going to fix the problem, but I'm cautiously optimistic," said Dr. Piot, of Unaids.

While the agencies involved in today's accord emphasized the hope of lower prices, the drug companies focused on joint principles for tackling the epidemic. These include stronger government efforts, better drug-distribution systems and more financing from donors, all matters outside the corporate world. Who would pay to create such standards remains unclear.

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Editor: Susan K. Boyer, RN
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