Innovation and new technologies needed to accelerate HIV response
Dr Margaret Chan
Director-General of the World Health Organization
Excellencies, distinguished delegates, colleagues in public health, ladies and gentlemen,
Over the past 30 years, the HIV response has spearheaded innovation in areas ranging from basic science, to medicines and diagnostics, to the meaningful engagement of people affected by HIV.
The world marvelled in 1996 when antiretroviral therapy, or ART, was first shown to be effective. Yet few dreamed that these expensive medicines could be made available in poor countries.
Now, close to 7 million people in low- and middle-income countries are taking daily ART and living healthy, productive lives. Efforts to deliver ART in poor countries have been characterized by innovation across the board.
Countries are using task-shifting and task-sharing to make progress despite the chronic shortages of health workers. They are involving local communities in counselling and testing and provision of support services. More and more, they are integrating HIV services with other health services in innovative ways.
Innovative financing and market interventions have brought the price of drug regimens down from over $10,000 per year per patient to less than $200 for a 2010 WHO-recommended first-line regimen.
Let me acknowledge the tireless work of civil society organizations, partners such as the Clinton Health Access Initiative, PEPFAR, the Global Fund, and UNITAID, and the innovative approaches communities have used to advocate for global access to essential medicines.
Implementing countries have creatively used the flexibilities available through TRIPS and other trade agreements to make treatment more affordable.
However, doing more of the same is not enough. We need innovation urgently. We are still running behind this devastating epidemic.
Nine million people still do not have access to treatment. Within 10 years, most of the 34 million people living with HIV will require ART. For every person who begins ART, another two become infected.
We know, beyond doubt, that early treatment has a powerful effect on preventing sexual transmission of HIV within sero-discordant couples.
We must maximize the preventive benefits of treatment through early diagnosis and treatment. WHO commits to providing clear guidance on this evidence and working with partners to support countries to overcome the implementation challenges.
Creatively combining treatment with the other innovative preventive interventions is essential. Examples include male circumcision, male and female condoms, PMTCT, targeted programmes for high-risk groups, and education for behaviour change. A micro-biocide to help women protect themselves is likely just around the corner.
Ladies and gentlemen,
WHO is concerned about access to what we have. We are equally concerned about innovation for new products and ensuring access to those future technologies. Innovation is important, but innovations must be affordable.
We need to continue to invest in the basic science and clinical research that will lead to better drugs and diagnostics and eventually to a vaccine and a cure.
New partnerships and mechanisms are working to stimulate technical innovation and reward creativity.
I commend UNITAID for taking the initiative to establish the Medicines Patent Pool. The WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property recognized early on the potential of such voluntary mechanisms.
Recently the G8 encouraged patent-holders to participate in the Medicines Patent Pool. I admire the companies that are in negotiations with the Patent Pool, and the US NIH for having been the first to license to the Pool.
WHO, with key partners, is coordinating action at the global level and supporting countries to radically simplify HIV treatment. In May, the World Health Assembly adopted a new HIV/AIDS strategy. The strategy provides a roadmap on how innovation in the HIV and broader public health response can contribute to the achievement of universal access and the MDGs. After 30 years, we have within our grasp the tools to reverse the epidemic.
Let us accelerate the two-pronged innovation that has been the hallmark of the HIV response: innovation to deliver existing interventions and innovation for new tools to do more.