HIV-positive people in developing countries risk having no antiretroviral treatment

Hundreds of thousands of HIV-positive people in developing countries in a few years will have no antiretroviral drug treatment unless more focus is placed on drug costs and access, HIV/AIDS advocates said Wednesday at the XVI International AIDS Conference in Toronto, Toronto's Globe and Mail reports.

Although the price of first-line antiretroviral treatment in developing countries has been reduced to $132 annually per person, HIV-positive people taking the drugs likely will become resistant to them in three to four years, and second-line treatment is at least six times more expensive, according to the Globe and Mail. The issue is particularly pertinent in developing regions, where standard second-line antiretrovirals cost $1,500 annually per person, the Globe and Mail reports. "That's 10 times the price of the first line, so if 10% of your patients go on it, your overall costs double," Anil Soni, director of pharmaceutical services at the Clinton HIV/AIDS Initiative, said, adding, "But the macro issue is that this is driving an exponential increase in cost, just as we're talking about universal access" to drugs. In addition, new recommendations, released this week by the World Health Organization, list the most effective HIV/AIDS drugs, but many included on the list are too expensive for developing countries. "It means countries can't implement the guidelines," Alexandra Calmy, an advocate for drug access, said.

Kaletra Pricing
Abbott Laboratories' drug Kaletra was as at the center of much of the discussion on drug access at the conference, the Globe and Mail reports (Nolen, Globe and Mail, 8/17). Abbott on Sunday announced that it is expanding a program that provides its antiretroviral drug Kaletra at a reduced cost to include an additional 45 low- and middle-income countries. An Abbott spokesperson said the company would add countries considered "low-income" -- such as India, Pakistan and Vietnam -- as well as "lower-middle-income" countries -- including China, Jordan, Syria, and several countries in South America and Asia. The countries will pay $2,200 per HIV-positive person annually, down from the previous annual cost of $3,300 or $5,000. The company provides Kaletra at a cost of $500 per patient annually in 69 of the poorest developing countries, including all of Africa (Kaiser Daily HIV/AIDS Report, 8/15). According to the Globe and Mail, Abbot is not granting generic companies licenses to make the drugs, saying that it will increase production to make quantities to supply the drug to the developing world. Abbott spokesperson Jennifer Smoter said the drug could not be made by generic companies because it involved proprietary technology (Globe and Mail, 8/17).

Kaisernetwork.org is serving as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at http://www.kaisernetwork.org/aids2006.