HIV/AIDS - What works

More than 42 million people worldwide are infected with HIV/AIDS. 95% of them live in the developing world. 3.1 million people, including 610,000 children, died from AIDS last year. Of the 42 million people infected, 6 million are in urgent need of antiretroviral (ARV) treatment to save their lives. However, only 300,000 people can access such treatment, and half of them live in Brazil. The Brazilian Case Brazil has developed an effective programme to fight against AIDS. This was especially achieved through the use of generic drugs produced locally, enabling all those in need to access ARV. Brazil's national programme has cut AIDS mortality by half and reduced common opportunistic infections by 60-80%. The resulting reduction in hospitalisation and medical care costs generated savings of US$422 million, a figure that almost entirely offset the cost of providing the ARVs. Outside Brazil, in cases where access has increased, this has been largely due to price drops of common ARV triple therapies from US$10,400 per patient per year in early 2001 to current prices of around US$250-300 for the equivalent therapy. The prices mainly dropped because of generic competition, pressure from AIDS patients groups and general public pressure. What needs to be done to increase access Treatment programmes can only be enlarged if G8 leaders provide the promised resources and support an equity pricing system. There is also an urgent need to simplify the treatment and follow-up procedures for patients in developing countries to adapt to the realities in the field. Faster laboratory testing procedures, once-a-day drugs, and in-the-field research to develop a follow-up procedure that is more clinical than biological are needed. What MSF is doing in the fight against AIDS MSF runs programmes of prevention (especially for mother-to-child transmission), free voluntary testing, psychological support, opportunistic diseases treatment, and ARV treatment. Today, MSF treats 2,600 patients, including more than 100 children, with ARVs in 10 countries: South Africa, Burkina Faso, Cambodia, Cameroon, Guatemala, Honduras, Kenya, Malawi, Uganda and Ukraine. MSF is going to double the number of patients treated in already existing programmes this year, and to start similar programmes in Burma, Ethiopia, Indonesia, Laos, Mozambique, Peru, Rwanda, Zambia and Zimbabwe. Experiences from these different programmes show that ARV treatment in countries with limited resources is possible, effective and furthermore it reinforces prevention activities by encouraging people to get tested.