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E-drug: Access to AIDS treatment in Honduras and other low resourse
countries (contd)
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The comment by James Love about Access to AIDS treament in Honduras
appllies to most developing countries characterzed by low resource (lack of
essentials).
Appropriate management of AIDS with drugs requires accurate laboratory
support such as monitoring viral load, CD4,CD8 count and consideration of
potential resistance that characterises the antiviral agents. An effective
national policy governing the use of the anti-AIDS agents should be in
place. It would be more authentic to encourage the drug regulatory
authority of the low resource countries to build up sufficient laboratory
support for both drug quality control which are tenet in drug registration
mechanisms, and evaluation of drug response via estimation of viral load
CD4 and CD8 count.
Creation of awareness to health providers about the need for an ideal
combination as well as awareness about the well known interaction of these
drugs with other drugs used for supportive therapy in the disease is an
important requirement in achieving rational drug use. It was for these
reasons that I thought the low resource countries could be saved from
spurious drug response and poor health investment that could arise from
availability of too many existing anti-aids drugs via compulsory licencing.
However, such regulatory authorities should be encouraged to give priority
to drugs such as acyclovir known to treat herpes simplex and Zidovudine
known to be efficacious in prevention of maternal HIV transfer should donor
funding be available to support such a programme sustainably. The support
of WHO in the use of drugs as suggested is valid and would go along to
resolve this problem.
Professor Francis D. Juma,
Kenyatta National Hospital,
Nairobi,
Kenya
Email: fdjuma@ken.healthnet.org
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