How to Distribute AIDS Drugs

[Guest guest]

Dear Forum members,

Indian AIDS policy makers could learn a lession or two

from the following article. But it seems they are refusing to

learn- on how to enhance access to AIDS treatment in India.

What a shame! [Moderator]

_________________________

How to Distribute AIDS Drugs

By CAROL BELLAMY

In the last few weeks, a ray of hope has appeared in the global fight

against AIDS. Pharmaceutical manufacturers have finally begun slashing

prices for anti-retroviral drugs for sub-Saharan Africa and other

AIDS-ravaged regions where a bottle of aspirin is beyond the means of

most victims.

As making vital drugs available begins to look possible, attention is

turning to the question of how to deliver them to the infected people

who need them. This is no simple proposition, but it is feasible.

Twenty-five years ago, the United Nations Children's Fund and its

partners created a model that could be used in the AIDS fight when we

found a way to immunize millions of desperately vulnerable children

against preventable diseases in the developing world. Now Unicef is

prepared to step forward as the lead United Nations agency in the

procurement of anti-retroviral drugs on behalf of individual

countries.

Unicef's global supply center in Copenhagen already works with many

pharmaceutical companies in the purchase of vaccines and essential

drugs. And together with Unaids, which coordinates United Nations work

on AIDS, we have started to identify and publish sources and prices of

the drugs needed to fight H.I.V., the virus that causes AIDS.

Treating H.I.V. infection is of course far more costly and complex

than vaccinating children. But the immunization campaign that began in

the early 1980's succeeded because we were able to develop effective

strategies for funding, procurement and distribution of vaccines and

these same approaches can help the world fight AIDS.

A quarter-century ago, the notion of immunizing millions of children

was regarded as folly. Apart from the cost, the infrastructure in most

developing countries was considered too fragile to support a sustained

campaign. Local governments and wealthy nations were thought to lack

commitment. And the coordination of efforts by governments, the

private sector, the United Nations and other entities that would be

involved was seen as too complex. This perception was wrong. Today

global immunization is arguably the most successful public health

initiative ever, saving around three million children's lives each

year.

Of the estimated 25 million Africans who are H.I.V.-positive, the

World Health Organization says five million need treatment urgently.

Moreover, the pandemic disproportionately affects the most vulnerable

part of the population, the young. Adolescents are the group with the

highest infection rate. Around 600,000 infants are expected to be

infected with H.I.V. through mother-to-child transmission this year.

And the number of children orphaned by AIDS, currently more than 13

million, will continue to rise. Even if the cost of treatment for

H.I.V. can be reduced to $350 a patient annually, the lowest of the

current estimates, most countries won't be able to afford the drugs.

Donors must step in with subsidies. The Global Fund for Children's

Vaccines, launched in 1999 to purchase vaccines for low-income

countries, provides an excellent example of how this might work.

An international fund could be established and financed by

governments, private givers and the United Nations. It would then

purchase the drugs from pharmaceutical companies on behalf of the

countries that need them.

The next step would be distribution. For immunization, Unicef and the

W.H.O. helped establish a vaccine delivery system in each country in

need of help. Through our extensive field network, we could assist now

in the development of AIDS drug distribution strategies tailored to

each country's strengths and weaknesses. We could also bolster

grass-roots and community activists, especially those living with

H.I.V., who can educate people on testing and treatment and help run

health services. Such local activism is the hallmark of successful

immunization programs.

Of course, other factors must come into play to make treatment work,

such as considerably more support for basic health services, effective

monitoring and, most crucially, political commitment from the affected

countries. But the task, while daunting, is not out of reach. We're

crossing the first hurdle reducing prices. Unicef's immunization

programs offer models for funding, procurement and distribution. Now

it's time for action.

Carol Bellamy is executive director of the United Nations Children's

Fund.

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Source:

http://www.nytimes.com/2001/03/26/opinion/26BELL.html?ex=986621358 & ei=

1 & en=1 24620b44fb1ee03

[Guest guest]

Dear Forum members,

Reference your posting of Carol Bellamy's ridiculous article and your

moderator's anguished note, I think some sort of reality check is called

for and perhaps you would be good enough to share the response given by

someone in Vietnam.

Sujaya Misra

E-mail: <smisra@...>

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Jaminette has respect for any head of a UN agency, but finds this op ed

piece to be the second most absurd thing that Ms Bellamy or her

speechwriter has said in the past two months.

Providing care for people living with HIV, including the provision of

antiretroviral drugs, is MUCH, MUCH more complex than immunisation of

healthy children. Immunisation programmes have taught us almost nothing

about how to implement HIV prevention and care programmes. Remember Le

Dien Hong?

Maybe UNICEF can buy drugs cheaply. Good on them. But the funding,

procurement, and distribution of antiretroviral drugs is the simplest

and the least important first step in developing efffective care

programmes.

Get real, Carol.

Jaminette

E-mail: jamie@...