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WHO and ARV access
------------------
 
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 medi-
cation.
 
The plan comes from a collaboration among tuberculosis experts, fore-
most among them the new WHO director general, Jong-wook Lee. That 
program, called the TB Drug Facility, purchases drugs in bulk on be-
half of countries and then oversees the distribution.
 
Global health specialists have applauded the program because it cre-
ated 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 advis-
ers.
 
Lee has embraced a goal of treating 3 million people with antiretro-
viral 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, in-
cluding 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 re-
duce 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 di-
rector 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 re-
gionally, until a new WHO program proves successful. But he said, "If 
you can bring on other producers, and create competition among gener-
ics, 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." 
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