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).
Treatment and Prevention Strategies
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).
Gilead Sciences Signs Deals With 3 Indian Pharmaceutical Companies To Promote Low-Cost HIV Drugs In Developing Countries
Gilead Sciences Inc. announced Thursday that it plans to partner with Mylan Inc., Ranbaxy Laboratories Ltd. and Strides Arcolab Ltd. “to promote access to high-quality, low-cost generic versions of Gilead’s HIV medicine emtricitabine in developing countries,” the Wall Street Journal reports (Stevenson, 8/2). Gilead signed deals with the three Indian companies “to drive sales and reduce manufacturing costs of low-cost generic versions of its HIV drug emtricitabine in developing countries,” Reuters reports, noting that under the deals, Gilead “will provide technology and funding to help reduce manufacturing costs of the drug, the companies said” (Kuber, 8/2).
In this post in the PLoS “Speaking of Medicine” blog, Judit Rius Sanjuan, a lawyer from Barcelona, Spain, and the U.S. manager of the Access Campaign at Medecins Sans Frontieres (MSF), says the Trans-Pacific Partnership (TPP), a regional trade agreement that currently involves 11 countries but could expand to include other countries in the Asia-Pacific region, “threatens to set a dangerous precedent with damaging implications for developing countries where MSF works, and beyond.” “Negotiations are being conducted in secret, but leaked drafts of the agreement outline U.S. aggressive intellectual property (IP) demands that that could severely restrict access to affordable, life-saving medicines for millions of people,” she writes, concluding, “At this pivotal moment in the fight against AIDS, when the scientific, medical and policy tools needed to reverse the epidemic are finally at hand, … the U.S. government’s demands in the TPP will threaten so much of what has been achieved so far, and will make the vision of an AIDS-free generation impossible, or at least much more expensive” (8/7).
U.S. Secretary of State Hillary Clinton on Tuesday visited officials in South Africa and discussed the response to HIV/AIDS, the Associated Press/Huffington Post reports. Speaking with Foreign Minister Maite Nkoana-Mashabane “in the second cabinet-level strategic dialogue between the two nations,” Clinton said “that global efforts to stop the virus ‘have saved hundreds of thousands of lives,'” the news service writes. “In South Africa, 5.7 million people — 17.8 percent of the population — have tested positive for HIV,” and PEPFAR “has spent $3.2 billion on antiretroviral drugs and HIV prevention programs in [the country] since 2004,” according to the AP.
“Malawi on Monday launched a week-long campaign to test 250,000 people for HIV in what health authorities called a crucial intervention in a country ravaged by AIDS,” Agence France-Presse reports. “The week would give Malawians ‘a chance to access antiretroviral therapy if found HIV positive,’ said Deputy Health Minister Halima Daudi at the launch,” the news service writes, noting, “People will take tests in 810 sites in the southern African nation’s 28 districts.” Approximately 10 percent of Malawi’s 14 million residents are living with HIV, according to AFP (8/6).
Dominican Republic Establishes Commission To Examine Implications Of Including ART In Country Health Plan
“The Dominican Republic is one step closer to ensuring that all people living with HIV access treatment,” UNAIDS reports in an article on its webpage, adding, “The country’s National Social Security Council has established a commission to look into the technical, financial and operational implications of including antiretroviral therapy (ART) in the Basic Health Plan.” According to the article, “[t]he establishment of the commission comes after a financial feasibility study about covering people living with HIV under the country’s family health insurance,” and “[t]he newly-established commission — whose membership includes several national health system offices in addition to regional and global partners such as PAHO and UNAIDS — is set to complete its work during the last quarter of 2012” (8/23).
“Over the 30 years of the AIDS epidemic, the disease has had a profound impact on every country in the world,” and “in each country, that impact is experienced a different way,” Vivek Anand, CEO of the Humsafar Trust, and Kenneth Mayer, medical research director of Fenway Health and co-director of the Fenway Institute, write in this post in Huffington Post’s “Gay Voices” blog. “But one reality remains: In nearly every country, HIV rates are disproportionately high in gay and bisexual men, as well as men who have sex with men (MSM) who do not identify as either,” they continue, adding, “The full scope of the epidemic simply cannot be addressed until we recognize that there is no country in the world where we can overlook the MSM population.”