The following text, by Dr Gro Harlem Brundtland,
Director-General of the World Health Organization, appeared today as
an "Op-Ed" in the International Herald Tribune.
"AFFORDABLE AIDS DRUGS ARE WITHIN REACH"
To suffer from a disease with no
treatment or cure is tragic. To know that a treatment exists, but is
too expensive, brings the ultimate despair.
Outrage about the plight of those with HIV in
developing countries has recently reached the pages of Western
newspapers. This is good. The fact that less than a tenth of the 36
million people infected by HIV can afford the drugs used to treat the
disease is outrageous.
But it isn’t a lost battle. In fact, we have
begun dismantling the obstacles that are preventing essential drugs
from reaching the millions who need them.
We are seeing an unprecedented effort, driven by
committed people from governments, non-government organizations,
UNAIDS, WHO, other UN organizations, and the private sector.
Popular outrage, political will, market forces and
the best science are enabling the pursuit of a fundamental principle
of public health: the supply of essential medicines on the basis of
need rather than on the ability to pay. In this case, the forces of
globalization are being used to narrow the gap between the wealthy and
A year ago, the medicines needed to slow the
progression of AIDS were far beyond what most Africans, Latin
Americans, and Asians, or their governments, can afford. At a cost of
$10.000 to $15.000 per person year the drugs are out of reach, and
there has been little stimulus for developing country governments to
organize their health care systems to treat those living with HIV.
Today, antiretroviral combination drug therapies
have become available to some African countries for around $1000
dollars per patient per year – a tenth of what they used to be.
Offers last week by a pharmaceutical company producing generic drugs
mean that these combination therapies could be made available in
Africa for a price of $600 or less per person per year.
True, such prices are still beyond what almost any
African health system and most patients are able to spend. But it must
not stop here. We must ensure that not only HIV/AIDS drugs but all
essential medicines and vaccines are accessible to all. It will take
time, but we must make sure that no moment is wasted.
Yes, it is a difficult process. Along the road,
there will be disputes about how trade agreements are to be
interpreted. There will be challenges to national drug policies which
threaten to change the established order of things. There will be
arguments about patent rights and they can only be solved by testing
their limits through a legal process. The stakes are very high indeed.
We want differential pricing to work in practice.
This means appreciating companies’ concerns that lower prices in the
poorest countries should not be used as a lever to influence
negotiations in those which can easily afford to pay more. We need
mechanisms to prevent illicit re-export of lower priced drugs into
richer economies. We need an environment where the right regulations
are fairly enforced so that competition can work effectively. This is
starting to happen: just watch how prices of generic drugs (that are
not protected by patents) are falling as rapidly as their brand-name
We must ensure that getting the patent holder a
reasonable return does not block best-price efficiencies. An effective
regime for international trade is one which allows countries to
implement workable systems that secure health needs while respecting
It would be naive, however, to think that cutting
the prices of medicines is enough. Medicine costs of $600 per person
per year are still beyond what almost any African health system and
most patients can afford. The prospect of cheaper medicines stimulates
demand for care, and this will actually increase the need for
No matter how low prices go, it is inevitable that
additional funding will be needed to meet the costs of care for the
poorest. Developing country governments can commit their own
resources, like Brazil and other countries have already shown. But
most of this money must come through increased development assistance
as well as debt relief. This has to be new money. We can’t take from
the little that is already being spent on other common deadly diseases
such as those which kill four million children each year.
Experience has shown that combination therapy can
be effectively administered in Africa without the elaborate laboratory
monitoring which is routine in industrialized countries. But there is
concern that lack of monitoring will cause resistance of the HIV
viruses to AIDS medication that quickly will render the available
medicines useless. We can deal with this. We can find a safe minimum
standard that ensures safe use of quality drugs while being affordable
in poor countries.
Through all this, we must ensure that the new hope
of wider access to care complements and strengthens efforts to prevent
HIV from spreading. Keeping people free from HIV must always remain
our main goal.
For further information, journalists can contact
Gregory Hartl, WHO Spokesperson, Geneva. Telephone (+41 22) 791 4458.
Fax (+41 22) 791 4858. Email: email@example.com
All WHO Press Releases, Fact Sheets and Features as well as other
information on this subject can be obtained on Internet on the WHO
home page http://www.who.int/