WHO's "massive effort" is not aggressive enough, says MSF

Press release: Geneva, 4 October 2000 - WHO's new "Massive Effort" to address HIV/Aids, tuberculosis and malaria is based on a faulty premise, according to comments made today by Médecins Sans Frontières at the United Nations Geneva headquarters. MSF disagreed with WHO's claim that "each death (from these three diseases) can be avoided with low cost technologies that are available today." The "Massive Effort" advocacy campaign is being discussed this week with more than 80 NGOs in Winterthur, Switzerland. It is a response to the G8's new global battle against infectious diseases, announced at Okinawa last July. "Although we appreciate that WHO is raising awareness about the dramatic impact of communicable diseases in developing countries and the need for prevention, we believe that the current emphasis on 'existing interventions' misleads the public into thinking that we already have the answers," said James Orbinski, President of MSF's International Council. "In fact, many effective medicines are either too expensive or don't exist. We think WHO's emerging plan fails to challenge the status quo." MSF strongly supports many of WHO's proposed solutions, such as bed nets for malaria prevention and additional funding for the current TB strategy (DOTS), but called on WHO to be more ambitious in the short and middle-term. WHO's approach to Aids was cited as an illustration of the problem. In its analysis to battle Aids, WHO outlines a series of prevention strategies and mentions the need to treat opportunistic infections. However, the drug cocktails (antiretrovirals) that have caused Aids deaths to plummet in wealthy countries are described as too expensive to consider for developing countries. In light of the fact that triple drug therapy can now be purchased for USD 800, MSF spoke of a moral obligation to begin treating patients where possible. Right now, some countries, such as Uganda, Ivory Coast and El Salvador are committed to expanding their Aids programs. MSF insists that these countries should receive assistance from WHO to secure affordable quality drugs. "We also need WHO to emphasize the fact that research and development is at a standstill for the diseases that most affect people in poor countries. We think that this message should be a critical part of the Massive Effort advocacy campaign being launched this week in Winterthur," said Orbinski. "Some of the public/private partnerships to find new drugs for TB and malaria may eventually yield results but the current level of activity needs to be dramatically increased. It is WHO that should be challenging national governments to ramp up public sector research for diseases that have been abandoned by the multinational drug industry." Of the 1,223 new drugs brought to market between 1975 and 1997, only 13 are indicated to treat tropical diseases. In a time when the private sector has shifted resources to more lucrative lifestyle diseases such as baldness and obesity, governments must fill this void. Communicable diseases are responsible for 60 percent of the total disease burden in developing countries and kill 5.5 million people each year. World-wide 34 million people are infected with HIV, one person dies every 30 seconds from malaria and nearly one billion people will be newly infected with TB over the next 20 years.