HEALTH: Developing World, UN Coincide in HIV/AIDS Approach

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Feb 21 2001 (IPS) - The United Nations agency entrusted with HIV/AIDS issues seeks improved access to treatment for those testing positive for the disease through a multi-faceted approach, one that coincides with initiatives put forth by developing countries in the international trade arena.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) proposes tiered pricing for medications, competition among drug suppliers to reduce prices and regional procurement in order to achieve further pharmaceutical discounts.

Other tools UNAIDS promotes include licensing agreements for medicine manufacturing and the reinforcement of health safeguards in trade accords.

The specialised agency of the UN affirms that these multiple approaches are necessary for “making advances in HIV treatment available as rapidly to people living with HIV/AIDS in developing countries as those in the industrialised world.”

The most recent UNAIDS data, from December 2000, indicate that 94 percent of the 34.3 million people infected with the human immunodeficiency virus (HIV) around the world are in developing countries.

Though there is still no cure for acquired immunodeficiency syndrome (AIDS), medical attention available in industrialised nations significantly prolongs the lives of people with HIV, as well as improving their quality of life.

UNAIDS proposes improving access to such attention, including treatment for opportunistic infections and anti-retrovirus therapy, in the world’s regions hardest hit by the disease.

With the same objective, some countries have established liberal policies for exploiting pharmaceutical patents, as is the case of Brazil, which ensures access to medications for infected individuals, free of charge.

These mechanisms have meant legal action against the Brazil, demanded by transnational pharmaceutical companies and initiated by the United States before the Dispute Settlement Body of the World Trade Organisation (WTO).

Washington charges that the Brazilian patent law violates the Agreement on Trade-Related Aspects of Intellectual Property (TRIPS) under the Uruguay Round of multilateral trade talks.

A special panel set up at the WTO is to rule on the legal validity of the US complaint in a process that is expected to last approximately nine months.

The Bulletin on Accelerating Access to HIV Care, Support and Treatment, which the Geneva-based UNAIDS released this week, refers to intervening in the patent debate between the nations of the developing South and non-governmental organisations (NGOs) on one side, and the pharmaceutical transnationals on the other.

The UNAIDS proposals cover several of the demands developing nations have put forth in a range of international trade forums.

To improve access to medicines, as well as to diagnostics and treatment, UNAIDS begins by proposing a regimen of differentiated, or tiered, pricing.

Under this system, “pharmaceutical companies make long-term commitments to making HIV-related medicines, particularly those under patent, available in developing countries at highly reduced prices, while established markets are protected.”

Another focus is on competition between pharmaceutical suppliers in further efforts to keep prices down.

This alternative applies in cases “where national legislation allows for both patented medicines from the research and development-based industry and ‘copies’ made by the generics industry.”

In addition, agreements for regional and sub-regional procurement would allow the purchase of larger volumes of drugs, meaning poorer countries would benefit from deeper discounts, says UNAIDS.

The specialised agency also advocates the signing of agreements involving companies with patented medicines “in order to offer licences to other manufacturers based in developing countries if they are able to produce the same quality medicines at lower cost.”

UNAIDS stresses that the health safeguards existing in trade agreements must be reinforced and implemented to the greatest possible extent.

This mechanism would apply when “international agreements and national intellectual property legislation allow for countries to issue compulsory licences to manufacture patented medications, where HIV/AIDS constitutes a national emergency.”

The same initiative calls for new and increased sources of public and private funding to assist in paying for treatment, “which even at the lowest prices, will still be out of reach of many of the poorest people living with HIV/AIDS.”

Even with these multiple approaches, UNAIDS cautions that efforts to improve access to medical attention and treatment constitute a complex challenge that requires the involvement of all sectors, including governments, NGOs and the pharmaceutical industry.

In that sense, the UN agency applauded the commitments some NGOs, such as Oxfam and Doctors without Borders, have made in the fight to eradicate HIV/AIDS.