From Africa Recovery, Vol.11#3 (February 1998), page 17

AIDS drugs plan starts in Uganda and Côte d'Ivoire

By Peter Mwaura

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has launched a plan to enable poor people with HIV/AIDS in developing countries to receive treatment with potent new drugs that are prolonging lives in the industrialized countries. The drugs control HIV infection and treat and prevent AIDS related illnesses.

The pilot phase of the initiative begins this year in Uganda, Côte d'Ivoire, Vietnam and Chile, with a plan to adapt the countries' health infrastructures to ensure effective distribution and use of the drugs. Participating pharmaceutical companies will subsidize purchases of the drugs, but the level of subsidies will vary from country to country, depending on the economic and epidemiological context.

The UNAIDS drug access initiative seeks to address some of the obstacles faced by people living with HIV/AIDS, such as insufficient health services, the increasing complexity of HIV care and the high cost of treatment. According to UNAIDS Executive Director Peter Piot, "Our ultimate goal is to provide developing countries with proven strategies to improve care and increase access to the newest and most effective drugs. However, in order to evaluate and perfect the approaches we are trying, we must begin with small-scale pilot programmes, involving tough decisions to determine the limits of participation. But the alternative is to do nothing."

In each pilot country, two new entities will be created and their activities monitored by UNAIDS. A national HIV/AIDS drugs advisory board will be set up under the Minister of Health composed of representatives of communities affected by HIV/AIDS as well as medical and public health officials. The board will devise a coordinated national policy for the provision of HIV-related drugs and set criteria for the participation of health centres in the initiative and for the selection of patients. It will also draw up treatment guidelines for the use of physicians.

The second entity will be a non-profit company, which will act as a clearing house for placing orders and bringing drugs into the country. It will also be a recipient and channel for drug subsidies. The company, which will be funded by the pharmaceutical companies that use it, will also address logistical and other related issues.

Pharmaceutical companies will make available a range of HIV-related drugs, including antiretrovirals to combat the underlying HIV infection, antimicrobials to prevent and treat opportunistic infections common among people with HIV/AIDS, and antibiotics to treat sexually transmitted diseases (STDs). In addition, diagnostic companies will provide virological services and tests for patient monitoring. Decisions about which drugs are provided will vary from country to country, and will be taken by the advisory board after assessments of the country's specific needs.

While the pharmaceutical companies will provide HIV/AIDS-related drugs at subsidized prices, local health ministries will both create new sources of funding and build on existing programmes. UNAIDS will provide $1 mn for oversight of the health advisory boards and non-profit companies, evaluation of the pilot phase, and the dissemination of recommendations for applying the initiative in other comparable situations.

UNAIDS hopes this programme will provide information to determine whether HIV/AIDS-related drugs can be obtained and distributed effectively in developing countries. "Armed with this information, countries will then be able to mobilize the necessary resources to treat infected individuals, and to help control the global epidemic," says Dr. Joseph Saba, coordinator of the Initiative.

The UNAIDS plan has been supported by French President Jacques Chirac who at an AIDS conference in Abidjan last December appealed to rich nations to create an AIDS therapy support fund to help Africa. Mr. Chirac denounced the AIDS therapy gap that has left the continent struggling with two-thirds of the world's victims but little or none of the new drugs available in rich countries.

However, some experts say the plan will divert national resources to one disease at the expense of other diseases such as malaria. Others say the large sums of money involved could be better spent on the hunt for a vaccine. "Only 6 percent of people with AIDS worldwide get drugs, making a vaccine the only option for the other 94 percent," says Mr. Gordon Nary, director of the International Association of Physicians in AIDS Care.

[Back to index] [To Volume11#3 -- full graphics]

Material from this article may be freely reproduced, with attribution to "Africa Recovery, United Nations".
We would appreciate a copy of the reproduction.

Africa Recovery
Room S-931
United Nations
New York, NY 10017 USA

Tel: (212) 963-6857
Fax: (212) 963-4556
Email: africa_recovery@un.org

Website: www.africarecovery.org
Contact us by email: africa_recovery@un.org