E-drug: AZT price break (cont'd)
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Prof Richard Laing's question on cost of AZT in pregnant women remains
unanswered. What is the total cost of drugs, counselling and test per case?
For a developing African country, this will be a major issue.
Kenya is totally dependent on donors for its vaccine procurement. If AZT is
to be introduced (and the National AIDS Control is thinking about it) who
will bear the cost? The National AIDS Control is financed by the World
Bank. When the World Bank pulls out, the Ministry of Health will not be in
a position to finance it.
There are other interventions in pregnancy which may reduce maternal and
infant mortality. This includes good antenatal care for all pregnant women
and reducing incidence of anaemia and malaria in pregnancy.
Before a national AIDS program considers AZT, it should look at other
interventions that are cost-effective. But from bitter experiences, I know
that a vertical program approach will ignore all other interventions and
only focus on introduction of AZT. Transmission of HIV by x% will be the
main indicator of progress to be mentioned. Costs will not be in the
programme report. And those who die from anaemia in pregnancy will be
excluded as deaths due to other causes.
Dr S K Sharif
Provincial Medical Officer
Mombasa, Kenya
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