Ecuador: Pushing for more access to AIDS medicines

MSF is working proactively at the national level on policy issues related to access to medicines and treatment.

In January 2004, MSF launched a project to improve care for people with HIV/AIDS in western Guayas province. Each month, the MSF team seeks to treat 10 new adult patients with life-extending antiretroviral (ARV) medicines, as well as to provide treatment to all HIV-positive pregnant women in the area to prevent mother-to-child transmission of the virus. At present, MSF staff care for approximately 330 patients, of whom more than 90 are receiving ARVs.

From April 2002 to June 2005, MSF ran a sexual and reproductive health program in the Flor de Bastion slum of Guayaquil, Ecuador's largest city. The goal of the program was to make quality sexual and reproductive health care services available to this excluded area's inhabitants, especially teenagers. The MSF staff provided counseling and care to help with family planning, prevention of sexually transmitted infections and HIV/AIDS, and offered reproductive health information.

MSF is working proactively at the national level on policy issues related to access to medicines and treatment. For example, MSF is urging the government to begin using and facilitating the registration and marketing of less expensive generic medicines instead of costly brand-name ARVs. Due to enormous pressure at different levels, the national protocol does not include "fixed-dose combinations."

These combinations reduce the number of pills to be taken and in that way help improve adherence to treatment and access to it. MSF has been working with other groups in the country to raise concerns about the potential effects of negotiations toward a regional free trade agreement among Ecuador, Colombia, Bolivia, Peru and the United States.

The agreement's chapter on intellectual property rights threatens access to medicines, and MSF believes that US negotiators will push to reduce the possibility of providing generic medicines to patients in these developing countries through reduced registrations of generic versions of new medicines (produced in the country or imported) for certain periods of time.

As a result, the pharmaceutical market will be monopolized during that time by brand-name products available only at higher prices. MSF is thus worried that this agreement will have a devastating effect on access to medicines for millions of patients in the Andean region.

MSF has worked in Ecuador since 1996.