Cameroon/ART: Making triple therapy availble to low incomes
Of the 920,000 people living with HIV/AIDS in Cameroon, 100,000 are very ill. Officially, the national prevalence of the disease is 11,8% (UNAIDS, 2002). Prevalence is a lot higher in high risk groups: 15% among the military (1996) and 17% among female prostitutes (1995). Until 2001, access to ARVs was restricted to a handful of very fortunate people.
MSF has been caring for patients with HIV/AIDS in Yaoundé for several years, and introduced triple therapy in January 2001. 133 patients are currently receiving triple therapy in the MSF project, which is based on a partnership agreement between the Institute for Research and Development and the military hospital in Yaoundé.
One important aim of the project is to contribute to making triple therapy accessible to Cameroonians with a low income. MSF has investigated the possibility of purchasing medicines at reduced prices, and conducted a study of the patent situation in the region. MSF has also published pharmaceutical companies and generic manufacturers' price offers and made them available to the Cameroon procurement centre.
In March 2001, thanks to Cameroon's negotiations with pharmaceutical companies, combined with the effects of generic competition, prices for first-line ARVs dropped from US$10,000 to US$277 per patient per year.
At the end of 2002, around 2,500 patients will have started ART in central and provincial hospitals in Cameroon. Many obstacles persist to wider implementation: annual monitoring costs of a patient are still very expensive - about US$445 - and the indirect costs of treatment (housing, transport) add to the burden. And although US$277 for a triple therapy is much cheaper than before, it is still far too expensive for the majority of Cameroonians.