A round-up of news on access to treatments

Graham McKerrow, HIV i-Base

Bill Clinton brokers deal on lower prices

The Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, UNICEF and the Clinton Foundation have announced agreements that will make it possible for developing countries to purchase high-quality AIDS medicines and diagnostics at the lowest available prices.

The agreements pave the way for countries supported by the Global Fund, the World Bank and UNICEF to gain access to drug and diagnostic prices negotiated by the Clinton Foundation.

The prices have been negotiated by the Clinton Foundation with five manufacturers of ARVs and five manufacturers of HIV/AIDS diagnostic tests. These prices were announced originally in October 2003 and January 2004, and to date they have been available to the 16 countries in the Caribbean and Africa where the Clinton Foundation’s HIV/AIDS Initiative is active.

Former US president Bill Clinton said: “I am grateful for this collective effort, which will soon help many hundreds of thousands of people, and eventually millions of people, live longer, healthier lives. With these agreements, we are one step closer to making sure future generations can live without the scourge of AIDS. We are hopeful that developing countries and those who support them in the fight against AIDS will take full advantage of this agreement and act quickly to do all they can to help in this fight.”

For the full version of this article go to:


UN welcomes ‘Clinton deal’

Steven Lewis, the UN secretary-general’s special envoy for HIV/AIDS in Africa issued a statement saying:

“I wish to join today with the legions of activists and advocates in Africa and worldwide who salute the quite remarkable collaboration on the provision of anti-retroviral drugs, jointly announced by The Clinton Foundation, The World Bank, UNICEF and the Global Fund. This initiative, along with WHO’s “3 by 5” (putting three million people into treatment by the end of 2005) could well spell the turnaround of the HIV/AIDS pandemic in Africa. We’ve been desperately looking for a breakthrough. This could well be it.”

“Simply put, the Clinton Foundation will negotiate the drug prices, UNICEF will employ its procurement capacity, and the Global Fund and World Bank will provide the funding. There will be protocols and administrative requirements of course, but nothing should now stand in the way of rolling out treatment to hundreds of thousands – soon to be millions – in the immediate future.”

Agence France-Presse’s report on the Clinton deal is at:

Pharmacos ‘aim to discredit WHO procedures and control $10b US spending’

Bill Haddad, Chairman/CEO of Biogenerics, representing Cipla Ltd, the Indian generics manufacturer, reports that a meeting in Gabarone, Botswana at the end of March between multinational pharmaceuticals, organised by the US government, was intended to sew up control of the spending of $10 billion by the Bush administration on HIV treatment and prevention in poor countries.

The multinational pharmaceuticals are campaigning against the use of fixed dose combinations (FDCs) produced by manufacturers of generic drugs which offer several drugs in one pill – where the equivalent brand-name drugs are made by different multinationals and are only available as separate pills.

Haddad says that for each life saved using Bush AIDS Initiative financing, three others will die. He reports:

“The Botswana meeting was politics posing as science organised on behalf of the multinational pharmaceutical companies by the United States government. The goals were/are to discredit the WHO pre-approval process for triple anti-retrovirals and to add US Food and Drug Administration approval as a pre-requisite for receiving the $10 billion allocated over five years for AIDS assistance under the Bush AIDS initiative announced by the President in his State of the Union message in 2003.

“The emergency Botswana Conference was conceived in Washington after a similar WHO meeting in December, 2003 failed to achieve the Pharma objectives. This time the US government was taking no chances: they cherry-picked the audience, found a remote location, controlled the agenda allowing no changes and took total control of the decision-making process.”

Haddad’s full statement can be read at:

Another view of this meeting can be found on the site of the US Department of Health and Human Services at:

A report on the same meeting by the European AIDS Treatment Group is at:

381 NGOs call on US to accept the standards of the WHO’s prequalification programme

In a letter delivered to Ambassador Randall Tobias, the global AIDS coordinator at the US State Department, 381 NGOs from 70 countries called on him to accept the standards of the WHO’s prequalification programme and to support the procurement of generic medicines by recipients of funding from the President’s Emergency Plan for AIDS Relief.

The full text of their letter is at:

Pressure mounts on Bush to allow US dollars to buy generic drugs

The Bush administration is coming under pressure to use the $10 billion it has allocated for spending on HIV treatment to be used to buy generic versions of drugs rather than the more expensive brand name drugs made by the big pharmaceutical companies. Such a decision would allow millions more people to be treated but would upset the administration’s allies in the drug industry.

The Wall Street Journal’s report on this can be seen at:

MSF attacks Bush for rejecting generics

The medical charity Médecins Sans Frontières has accused George Bush of trying to “shut out the use of quality, effective generic AIDS medicines” but the administration says it is only trying to maintain quality, safety and effectiveness.

A Voice of America report on this is available at:

An audio version is available at:

MSF says US should accept FDCs

Ellen ‘t Hoen, of Médecins Sans Frontières (MSF), issued a statement at the Conference on Fixed Dose Combination (FDC) Drug Products: Scientific and Technical Issues Related to Safety, Quality, and Effectiveness.

She called upon the US to allow recipients of its funding to procure quality FDCs in addition to any other medicines that are needed, wherever they come from. She said the US should also support the WHO prequalification project.

She said failing to do so would lead to the setting up of parallel systems. “We cannot stress enough how disruptive it would be to set up parallel systems. Different treatment regimens in the same country – in some cases even in the same health care facility – would be disastrous. It would also be disastrous with regard to the development of urgently needed new FDCs, in particular paediatric formulations, which is unlikely to happen if FDCs are not endorsed by one of the key donors.”

The full statement is at:

Many conference documents for the Gabarone meeting, letters to officials and statements about the meeting can be found at:

US plan to fight AIDS is foundering

President Bush’s proposal – made 15 months ago – to spend $15 billion fighting HIV around the world is foundering because of the prolonged battles over whether to use more expensive patented drugs or cheaper generic versions. Progress in distributing the drugs has been “excruciatingly slow” according to the New York Times. As a result, only 300,000 of the six million people who need treatment are receiving it.

The full NYT report is available for a fee at:

3×5 is failing, says Joepe Lange

Dr Joepe Lange of the University of Amsterdam, one of the world’s leading figures in fighting HIV, has declared on a visit to the United States that the 3×5 initiative – the aim to treat 3 million people in poor countries by the end of 2005 – will fail to reach its target and he says the approaching International AIDS Conference in Bangkok in July will be a time of accountability.

Dr Lange told Positives4Positives newsletter, based in Wyoming: “All of the promises that the big multilaterals have been making about how many people would be on therapy by now, honest, that the 3x 5 Framework is not going to be met. And I think we have to be quite critical about that. It is an opportunity to not let them off the hook, and come up with an explanation of why we have this blah-blah, and why we’re not going to reach that target”

He also said that one of the main characteristics of the IAC would be the focus on political leadership and to that end a number of world leaders have said they will attend including former President Clinton, Kofi Annan, Mr Wolfensohn, president of the World Bank, former President Nelson Mandela, and President Machel, whose wife is one of the patrons of the conference.

The newsletter can be read online at:

BMS overturns AIDS patent in Thailand

Bristol-Myers Squibb has given up its patent to manufacture generic ddI in Thailand in an historic decision that could cause drug prices to plummet.

The US company has agreed to return the patent that allows other manufacturers to produce ddI (didanosine, Videx) in a tablet. The Department of Intellectual Properties in Thailand had granted this patent in 1988.

The decision is a great victory for AIDS activists in Thailand who fought a two-year battle to overturn the patent.

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