HIV drugs have not only “transformed a fatal disease into a chronic one,” but “[t]hey have also made HIV a big business,” this Economist editorial states. The editorial examines the market for HIV drugs, writing, “The market is as unusual as it is large, both buoyed by government support and worryingly dependent on it. The past decade has brought fancier medicine in rich countries and copious aid for poor ones. But the war is far from won.” The editorial writes, “In total, public and private investment has yielded more than two dozen HIV drugs,” adding, “Sales of antiretroviral drugs in America and the five biggest European markets reached $13.3 billion in 2011, according to Datamonitor, a research outfit.”
Treatment and Prevention Strategies
UNAIDS Executive Director Calls On African Leaders To Reduce 'Triple Dependency' On External Sources Of HIV Drugs, Commodities, Technologies
“Delivering a speech at [Wednesday's] opening session of the 16th Conference of the West African Economic and Monetary Union (UEMOA), UNAIDS Executive Director Michel Sidibe congratulated leaders across the region for their personal commitment to the HIV response, specifically with regard to upholding human rights and protecting human capital,” UNAIDS reports in an article on its website. “Addressing eight Heads of State and other high-level participants in Lome, Togo, he called on African leaders to reduce their ‘triple dependency’ on external sources for HIV drugs, commodities, and technologies,” the agency writes, adding, “To ensure the health and security of their populations, African leaders should focus greater attention and resources on the local production of medicines, said the UNAIDS executive director” (6/6).
Noting that the “[r]oll-out of antiretroviral treatment for HIV in sub-Saharan Africa has been accompanied by rising rates of drug resistance,” Raph Hamers, a global health research fellow at the Academic Medical Centre of the University of Amsterdam, and colleagues “call for improved patient management and the integration of population-based drug resistance surveillance into national treatment programs” in this BMJ analysis. “In sub-Saharan Africa, the region with the highest HIV/AIDS burden, high-level political commitment and substantial international funding have led to an unparalleled scale-up of access to treatment over the past eight years,” they write, adding, “However, little attention has been paid to the potential emergence and spread of drug-resistant HIV and its public health implications.”
“The potential for antiretroviral medicine to reduce transmission of HIV and tuberculosis has been demonstrated, but the challenges of using treatment to prevent infection will need to be tackled country by country, and with focus on people for whom it will have the biggest impact, the latest bulletin on HIV treatment from the World Health Organization says,” the Center for Global Health Policy’s “Science Speaks” blog reports. “WHO’s June 2012 Antiretroviral Treatment as Prevention (TasP) of HIV and TB Programmatic Update is the latest of a series of documents the organization says will lead to a completed set of guidelines on treatment and prevention in July 2013,” the blog reports, noting, “The organization also plans to release new recommendations in time for the July International AIDS Conference, addressing the preventative use of antiretroviral medicine by people who are uninfected but potentially exposed to HIV, including those involved in commercial sex work, in ongoing relationships with infected partners, and men who have sex with men” (6/18).
Less Expensive ARV Combination Just As Effective For Women In Developing Countries As Costlier ARVs, Study Shows
A new study by researchers at Brigham and Women’s Hospital in Boston shows that the less-expensive antiretroviral nevirapine, when used in combination with other antiretroviral drugs (ARVs), is as effective as a more expensive combination among women in developing countries, VOA News reports. While the nevirapine-containing combination was not as effective as some ARV combinations available in the U.S., “about 83 percent of women were able to suppress their virus and stay alive and well after starting the nevirapine-based regimen,” according to lead author Shahin Lockman, an associate professor at Harvard Medical School, who looked at the combinations among 500 African women with late-stage HIV infection, according to the news service.
“More than 100 million condoms will be distributed annually to sex workers, men who have sex with men, and other groups vulnerable to HIV as part of a new five-year program to be run by the Ethiopian government and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR),” PlusNews reports. “Dubbed MULU, the Amharic word for comprehensive, the $70 million program — implemented by the NGOs Population Services International and World Learning — will also target day laborers in the booming construction industry, migrant workers and their partners,” the news service notes.
USA Today features a Q&A on Truvada, an antiretroviral drug that a Food and Drug Administration (FDA) panel in May recommended be approved for pre-exposure prophylaxis (PrEP) to prevent HIV among healthy people at risk of contracting the virus. The newspaper includes comments from different experts on the drug, saying implementation and cost are two major hurdles to its use for PrEP. Carlos del Rio, chair of the Emory Department of Global Health at the Rollins School of Public Health, co-director of the Emory Center for AIDS Research, and a board member at HIVMA (the HIV Medicine Association), said that if the drug is approved for use as a prevention tool, “I don’t think, honestly, in the short term, this is going to have much impact in the U.S., much less globally. … It’s a tool, but at the current price of up to $14,000 a year per individual, it’s simply not possible to think this will have an immediate impact in the epidemic globally,” according to the newspaper. The FDA is expected to make a decision later this summer, USA Today notes (Manning, 6/25).
U.S. Global AIDS Coordinator Ambassador Eric Goosby “discussed lessons learned from the U.S. response to the global HIV/AIDS epidemic over the past decade at an event hosted by the Brookings Institute Monday morning,” the Center for Global Health Policy’s “Science Speaks” blog reports. “While calling recent scientific advances in HIV prevention ‘game changers’ that have offered hope of an AIDS-free generation, [Goosby said] that the successful fight against the epidemic relies on recognizing AIDS-specific efforts so far as a foundation for further health gains, on country ownership, and on continuing to build ‘the shared responsibility’ of a multi-donor response,” the blog adds.
In this Forbes opinion piece, John Lechleiter, president and chief executive officer of Eli Lilly and Company, examines the business of counterfeit medicines, writing, “With global sales last year estimated as high as $200 billion, counterfeit medicine is big business, and it’s growing.” “In a recent Forbes column, Henry I. Miller cited an estimate by Roger Bate of the American Enterprise Institute that more than 100,000 people die every year from counterfeit drugs,” he continues, adding, “That’s why fighting counterfeits is essential to safeguarding health. We need action — national and international — to better secure the pharmaceutical supply chain.”
The U.S. Government Accountability Office (GAO) recently released two reports on issues related to global health. In “Ensuring Drug Quality in Global Health Programs,” the agency writes, “Concerns have been raised about the potential for substandard drugs to enter the supply chains of global health programs,” and notes that it concluded, “U.S.-funded global health programs have put regulatory and policy requirements in place to help prevent procurement of substandard drugs” (8/1). In another report looking at the WHO, titled “Reform Agenda Developed, but U.S. Actions to Monitor Progress Could be Enhanced,” GAO found, “The United States has provided input into WHO’s reform agenda, particularly in the areas of transparency and accountability, but the Department of State’s (State) tool for assessing progress in the area of management reform could be enhanced” (7/23).