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GHF2010 – PS34 – HIV/AIDS Programmes: Access, Care & Funding

Session Outline

Parallel session PS34, Monday, April 19 2010, 16:00-17:30, Room 4
Chair(s): Alexandra Calmy, Scientific Chief Resident, Department of Internal Medicine, Division of Infectious Diseases, HIV/AIDS Unit, Geneva University Hospitals, Switzerland, Gorik Ooms, Researcher, Department of Public Health, Institute of Tropical Medicine Antwerp, Belgium
Effects of Global Health Initiatives Funding for HIV on South African Health Systems
Thubelihle Mathole, School of Public Health, University of Western Cape, South Africa
Backtracking on International Funding for HIV/AIDS Treatment: Consequences in Several African Countries
Mit Philips, Analysis and Advocacy Unit, Médecins sans frontières, Belgium
UNITAID's Medicines Patent Pool Initiative
Ellen 't Hoen, Senior IT Advisor, UNITAID, Switzerland

Session Documents

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Session Report

Submitted by: Anne Descours (ICVolunteers)

Photo by V. Krebs,

Funding of anti-retroviral (ARV) treatments for HIV in developing countries is decreasing. New initiatives are needed to continue the significant efforts that have been made in the last years to fight against HIV and AIDS. The UNITAID Medicines Patent Pool Initiative proposes an innovative collaborative management structure for patents to improve the availability of new and more efficient ARV drugs.

Mit Philips represents the non-governmental organisation Médecins Sans Frontières (MSF) which has been active in the field of HIV for several years. After a period of significant funding for the prevention, treatment and care of AIDS, Mr Philips reports that MSF is observing a general flattening of financial support in this area. The main funding agencies have tended to shift their interest from anti-HIV treatments to other health issues or health systems support, putting these in competition with AIDS. Fighting AIDS has already cost the funding agencies a great deal, because of the price of treatments, and international public opinion is now more disposed to support prevention rather than treatment. The financial crisis has also reduced total funds available.

All donors expect the Global Fund to Fight AIDS, Tuberculosis and Malaria to step in to make up the shortfall, but there is no certainty that it will. The consequences for patients are dramatic. Patients are initiating their treatment at a more advanced stage of the disease, there are treatment interruptions due to supply difficulties, people do not trust the programmes as much as before and there is a loss of the benefit of high anti-retroviral coverage. As a result, there is a negative impact on HIV transmission, on mortality rates and the prevalence of tuberculosis has increased. Whereas the World Health Organization recommends earlier treatment, in the field there is a clear backlash against funding patient treatment.

ARV started very late in the developing world, but tremendous progress has been made in the last decade thanks to significant funding and to generic manufacturers in India lowering considerably the price of ARV treatment. However, in 2005, a new patent policy started in India that increased production costs and reduced competition.

Ellen t’Hoen, from UNITAID, told the meeting that UNITAID’s Medicines Patent Pool Initiative is an innovative project that aims to promote wider availability of new and more efficient anti-retroviral therapies in low and medium income countries.

The Initiative proposes a fair deal to leading pharmaceutical companies and generic manufacturers from southern countries. On a voluntary basis, the top pharmaceutical companies will put their ARV drug patents in a patent pool that will be available for generic manufacturers against licenses. Royalties based on product sales will be paid by the latter to big companies. The main manufacturers active in HIV medicine production have expressed strong interest, but the modalities have still to be discussed. The Patent Pool is expected to be launched in 2010 and will be public health driven and focused on developing countries. The main goals are to lower the cost of therapy, to broaden the set of first line fixed-dose triple therapy and to make second and third line therapies more widely available. It will also be useful to develop products for markets that do not exist in developed countries such as formulations for paediatric use or heat-stable compounds. This is the first initiative of this kind which is clearly oriented to the market. The key pharmaceutical companies will only accept if the royalties are high enough which means that there must be enough end-buyers. The ability of southern countries to buy new and efficient treatments will thus still rely on funding, but also on the will of patent holders and generic manufacturers to collaborate.

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