Washington Post (10.25.03) - Monday, October 27, 2003
The World Health Organization will soon disclose the first
details of a global AIDS strategy to bring low-cost drugs to 3
million people in poor countries by the end of 2005. The plan,
according to top officials, will eventually include
endorsement of pills that combine three HIV drugs - lamivudine
(3TC), stavudine (d4T) and nevirapine - into a single tablet.
Fixed-dose single-pill HIV medicines, health experts say,
offer huge benefits by providing medication, effective for
about 80 percent of patients, in an easy-to-use, low-cost
form. Drawbacks include limited flexibility to adjust
medications for side effects, complicated patent infringement
issues, and that generic fixed-dose drugs have not been
thoroughly tested and would make it easier to introduce
counterfeit drugs onto the market.
If the combination pills prove popular and effective, the Bush
administration could face a politically difficult choice
between costly patented drugs and low-cost combination
generics as it implements its five-year program to fight AIDS.
Unlike current generic AIDS drugs that copy a single drug's
formula, each of the new combination pills could infringe on
several patents at once, taking the conflict of life-saving
medicine vs. intellectual property rights to new levels.
The WHO strategy will also call for treating patients at the
first sign of HIV symptoms, rather than waiting for test
results, and for radically expanding access to the medicines.
"We will say, you don't need to get care only from doctors;
let's train nurses, community organizations, and families.
We're changing the paradigm of AIDS treatment," said Paulo
Teixeira, director of WHO's HIV/AIDS Department.
The WHO strategy targets 2 million patients in Africa, with
the rest scattered throughout Asia and Latin America. Despite
its potential complications, Ellen 't Hoen, spokesperson for
the Campaign for Access to Essential Medicines of Doctors
Without Borders, said combination pills are essential to fight
AIDS in poor countries. "WHO would have to say that this is
the way to go," she remarked. "That implicitly says that
patents shouldn't stand in the way."