Access to HIV treatment in Eastern Europe

On 24 and 25 October 2003, the European Community Advisory Board (ECAB), a working group of the European AIDS Treatment Group mainly including members from the Eastern European states, met with four major pharmaceutical companies producing antiretroviral drugs.

This was the first time that the majority of the community members representing Eastern European NGOs had formally met with industry in a community initiated forum. It was also the first time that representatives of these pharmaceutical companies had sat in the same room as HIV-positive individuals and their advocates to address access to antiretroviral treatment in Eastern Europe.

Each company – Roche Laboratories, Boehringer Ingelheim, GlaxoSmithKline and Bristol-Myers Squibb – heard first hand about official and estimated figures for incidence of HIV/AIDS in countries from Eastern Europe and the Newly Independent States, together with current availability of either brand or generic antiretroviral therapy in these countries.

It was clear that a few countries – generally those with low incidence and who have the political will to address HIV as an important health issue, such as Estonia and Latvia – have a access to treatment as patients in Western Europe. However, for people living in Ukraine or Russia – two of the Eastern States with highest rates of HIV infection – there is little access to either treatment or monitoring tests.

In Russia unofficial estimates suggest up to two million people could be living with the virus, with less than 5,000 people on treatment. In Ukraine 300,000 people are thought to be HIV-positive, with the government providing treatment to less than 100 patients a year.

In addition to discussing cost, access to drugs and laboratory tests manufactured by each of the companies, the meeting included other subjects important for patient care, such as access to trials of new agents and importantly continued access to treatment once a trial ends.

There have been reports of trial participants not receiving access to treatment that they were promised when they first enrolled.

The HIV epidemic in Eastern Europe, which has dramatically increased over the last two years, largely affects heterosexual intravenous drug users and their partners and is complicated further by very high rates – perhaps in up to 90% HIV-infected patients – of co-infection with Hepatitis C.

Additional figures from Central and Eastern European Harm Reduction Network website are included below.

  • HIV epidemic in the countries of Central and Eastern Europe and NIS (CEE/NIS) is rising faster than anywhere in the world.
  • There are over 300,000 officially registered HIV cases in the region. According to evaluations of international organizations, the estimated number of people living with HIV/AIDS is around 1.2 million.
  • Less than 0.3% of registered HIV/AIDS cases are receiving required antiretroviral treatment.
  • Injecting drug users (IDUs) are one of the most vulnerable groups at risk of HIV/AIDS. Eight of 10 HIV cases in the region are connected with injecting drug use.
  • There are 1.2 million people registered as injecting drug users in the region.
  • As a response to the epidemic, in 1994 the first harm reduction projects appeared. They provided needle exchange and substitution treatment. Now harm reduction projects work in 26 countries of the region.
  • Over 200 organizations in CEE/NIS provide needle exchange and counselling on HIV, blood-borne hepatitis, overdoses and vein care for IDUs. They have reached more than 40,000 individual drug users and exchanged more than 490,000 needles and syringes in 2002.
  • The most effective way of drug treatment – substitution treatment – is widespread in the Southern and Central European and Baltic countries. In the other parts of the region this way of HIV prevention is not accessible because of the governmental drug policies.
  • 77% of all substitution treatment services is offered in nine countries of CEE/NIS, where IDUs are less than 15% of total HIV cases.
  • In the entire region, only 12 special programs work in prisons where drug use is widely spread.
  • Sex work is closely connected with drug use. In Togliatti (Russia) 86% of female IDUs are involved in the sex industry.

Source: EATG Press Release and CEEHRN website

For more information contact Svilen Kolev Konov:

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