Sub-Optimal Treatment Threatening Survival of HIV/AIDS Patients

Stagnation in HIV/AIDS funding and the high cost of new medicines
are putting the lives of thousands of poor patients at risk, the
international medical humanitarian organization Doctors Without
Borders/Medecins Sans Frontieres (MSF) warned today at the 2009
International AIDS Society Conference in South Africa. Patients needing
new drug regimens will return to AIDS "death row." While the lack of
access to antiretroviral treatment for seven million people remains
unaddressed, inadequate financing now further threatens treatment
scale-up.

In one of the longest running public sector AIDS treatment programs
in Africa, a partnership between MSF and the Department of Health in
Khayelitsha, South Africa, 16 percent of patients experienced treatment
failure on their first-line regimen within five years. A quarter of
those patients who were switched to a second-line regimen failed on
this alternative treatment line within two years. With no third-line
regimen available in South Africa--as is the case in many other
developing countries--these patients are now at risk of dying.

View the new report HIV/AIDS treatment in developing countries - The battle for long-term survival has just begun.

"What we are seeing in Khayelitsha is what we will soon see
throughout Africa if there is not a focused push for urgent change,"
said Dr Eric Goemaere, medical co-ordinator for MSF in South Africa.
"We need to provide the most robust first-line treatment possible, to
detect treatment failure through monitoring HIV levels in the body
before patients show symptoms, and to provide access to affordable
second and third-line treatment combinations. None of this is happening
now, which means that thousands of patients are back on AIDS death row."

Unlike older first-line drugs, most second- and third-line drugs are
patented and priced out of reach for patients in developing countries.
In some of these countries, switching from a first- to second-line
regimen increases treatment costs as much as 17-fold.

To stop spiraling costs, countries will have to routinely use
measures such as compulsory licenses, which allow the generic
manufacture of drugs under patent to ensure affordable treatments. MSF
is recommending that drug companies put their AIDS drug patents in the
"patent pool" that the international drug financing agency UNITAID is
creating to allow poor countries to access critically needed drugs at
affordable prices. The patent pool will provide generic producers or
researchers with drug licenses in exchange for a fee paid to the
originator company.

"It is a question of choice for national and donor governments,"
said Dr. Tido von Schoen-Angerer, director of MSF's Access to Essential
Medicines Campaign. "Will they give poor people just a few extra years
of life, or the same chance for long-term survival as people with
HIV/AIDS in rich countries?"

At present, over three million people living with HIV/AIDS in the
developing world receive antiretroviral therapy. An estimated seven
million people who are in need of treatment are still waiting for
access. MSF operates HIV/AIDS programs in approximately 30 countries
and provides antiretroviral treatment to more than 140,000 HIV-positive
adult and child patients.