[e-drug] MSF report "No Time To Quit: HIV & AIDS treatment gap widening in Africa"

E-DRUG: MSF report "No Time To Quit: HIV & AIDS treatment gap widening in Africa"
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Please find MSF's report on
http://www.msf.org/msfinternational/invoke.cfm?objectid=D9101088-15C5-F00A-258244A3E07C4A75&component=toolkit.pressrelease&method=full_html

Backtracking by international donors in funding HIV/AIDS risks undermining
years of positive achievements and will cause many more unnecessary
deaths, warns humanitarian aid group Médecins Sans Frontières (MSF) in a
new report.

Titled 'No time to quit: HIV & AIDS treatment gap widening in Africa', the
report (download here) builds on analyses made in eight sub-Saharan
countries to illustrate how major international funding institutions such
as PEPFAR, the World Bank, UNITAID, and donors to the Global Fund have
decided to cap, reduce or withdraw their spending on HIV treatment and
antiretroviral drugs (ARVs) over the past year and a half.

'How can we give up the fight halfway and pretend that the crisis is
over?'  said Dr. Mit Philips, Health Policy Analyst for MSF and one of the
authors of the report. 'Nine million people worldwide in need of urgent
treatment still lack access to this lifesaving care - two thirds of them
in sub-Saharan Africa alone. There is a real risk that many of them will
die within the next few years if necessary steps are not taken now. Also,
the current donor retreat will prevent more people from accessing
treatment and will threaten to undermine all the progress made since the
introduction of ARVs.'  The US President's Emergency Plan for AIDS relief,
PEPFAR, reduced its budget for the purchase of ARVs in 2009 and 2010, and
also introduced a freeze on its overall HIV/AIDS budget. Other donors,
such as UNITAID and the World Bank, have announced reductions over the
coming years in the funding for antiretroviral drugs in Malawi, Zimbabwe,
Mozambique, Uganda and the Democratic Republic of Congo (DRC).

The Global Fund, the largest funding institution in the fight against
HIV & AIDS, faces a major funding shortfall. The US, the Netherlands and
Ireland have already announced that they will be providing lower
contributions to the Global Fund. In 2009-2010, contributions to already
approved country grants were reduced by 8 to 12 percent.

Overall funding cuts have translated into a reduction in the number of
people able to start their ARV treatment, as seen in South Africa and
Uganda, and in DRC - where the number of new patients able to start ARV
treatment has been cut six-fold. Already fragile health systems will
become increasingly strained by an increasing patient load requiring more
intensive care.

Drug stock-outs and disruptions in drug supply are already a reality, and
will become more frequent if sufficient funding is not made available. MSF
has recently been requested by the government and other actors to assist
with emergency drug supplies in Malawi, Zimbabwe, DRC, Kenya and Uganda.

'If there is reduced funding, then it will mean more people will die, and
we will have more orphans,' said Catherine Mango, an HIV patient from
Kenya. 'The ones that are positive often need to assist others, like their
children. People will lose hope and die. It will be the end. If there are
no drugs there is no future.'

ARV treatment is lifesaving but also lifelong. This means that the number
of patients under treatment increases cumulatively each year, thus
requiring incrementally growing and sustainable funding.

'The HIV & AIDS crisis remains a massive emergency that still requires an
exceptional response. MSF calls for a sustained and renewed commitment by
donors and national governments in the fight against HIV & AIDS, so that
this disastrous public health crisis can be addressed appropriately,'
concluded Dr. Philips.

Seco Gerard
Analysis and Advocacy Unit, Gen. Dir.
Medecins Sans Frontieres
Operational Centre Brussels (OCB)
+32 2 475 36 34
Seco GERARD <seco.gerard@brussels.msf.org>

E-DRUG: UNITAID clarification on MSF report "No Time To Quit: HIV & AIDS treatment gapwidening in Africa"
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UNITAID CLARIFICATION IN RESPONSE TO MSF REPORT ON AIDS TREATMENT GAP

Geneva, 28 May 2010 - UNITAID welcomes the report released by Médecins Sans Frontières on 27 May, No time to quit: HIV/AIDS treatment gap widening in Africa. It is an important step in the lead-up to the Vienna International AIDS Conference in July, and a vital call to action to all stakeholders to keep funding AIDS and build on the many successes of the past 10 years.

However, page 18 of the report could give the impression that UNITAID aims to phase out its support in the Democratic Republic of Congo, Malawi, Mozambique and Zimbabwe without ensuring continuous treatment of patients. To clarify, these countries are part of UNITAID funded projects designed to stabilise markets for AIDS products to facilitate scale-up of treatment and/or prevention for children, pregnant mothers and their infants and people who have developed resistance to first line therapy. As with all UNITAID projects, the idea is to achieve sustainable supply of quality products and reduced prices in developing countries so that national programmes or other partners can take over to ensure continuous treatment.

For most of these projects, the initial plan was indeed for UNITAID to hand over to other funding sources earlier. However, as UNITAID's main concern is to avoid interruption of treatment, and ensure that price reductions achieved increase access and availability, UNITAID has extended funding of these projects with plans for smooth transition to the Global Fund, PEPFAR or others between 2010-2011, and potentially beyond, depending on the status of the transition.

UNITAID has spent half a billion dollars on AIDS treatment globally to cover paediatric treatment in 44 countries, prevention of mother-to child transmission of HIV/AIDS in 17 high burden countries and second-line treatment for patients failing conventional therapy in 25 countries. In less than four years significant market impact and cost savings have been achieved:
§ Creation of a market for paediatric anti-retroviral medicines (ARVs) in partnership with the Clinton Health Access Initiative, including the development of the first fixed-dose-combination tablet for children;

§ Development of the generic market for key 2nd line ARVs and reduced prices so that other donors and national governments can continue to treat patients who need to switch to 2nd line treatment with expected cost savings of between US$ 300-500 million over the next 3 years;

§ Initiation of integrated prevention of mother to child transmission of HIV (PMTCT) care packages (including the Mother and Baby Pack) to high burden HIV countries to test and treat mothers and their children in partnership with UNICEF.
  
In addition to support of current projects, UNITAID plans to continue to invest in market-oriented AIDS interventions for greater impact on public health. These include:
§ The UNITAID Patent Pool Initiative, which will establish a voluntary licensing mechanism to reduce ARV prices, enhance access and spur the development of new formulations (i.e. fixed-dose combinations, paediatric and heat-stable formulations) by improving access to intellectual property, with expected economic benefits estimated to be at a minimum of $260 million over a five-year period;
§ Efforts to develop high quality ARVs by continued investment in the WHO Prequalification Programme.
§ Scale up of viral load tests in 2011, in response to public health needs and World Health Organization recommendations. Viral load tests are vital in developing countries to extend the therapeutic value of first line regimens.

UNITAID has been able to achieve important progress thanks to over US$ 1 billion pledged since 2006, with about $ 350 million annual revenue. UNITAID fully intends to continue to support the global response to HIV/AIDS with predictable, sustainable and additional funds provided by industrialised and developing countries, mostly through a levy on airline tickets.

In order for UNITAID to continue to support the scale-up of AIDS treatment and respond to increasing treatment costs as numbers of people needing treatment grow, it is vital that donors remain committed to investing in UNITAID's work and that new donors join through the solidarity air ticket levy, which has proved to be a steady source of additional funding.

Contact: Daniela Bagozzi, UNITAID Communication, tel. +41 22 791 45 44/+41 79 475 54 90; bagozzid@who.int